Do I Need Health Insurance To Receive This Service
The referral service is free of charge. If you have no insurance or are underinsured, we will refer you to your state office, which is responsible for state-funded treatment programs. In addition, we can often refer you to facilities that charge on a sliding fee scale or accept Medicare or Medicaid. If you have health insurance, you are encouraged to contact your insurer for a list of participating health care providers and facilities.
Hamilton Depression Rating Scale
It is a 17 question scale used for measuring the severity of depression . Scores varying between 0 and 53 are acquired from the scale and high scores indicate an increase in depression severity. Scores of 0-7 indicate no depression, 8-15 indicate mild, 16-28 indicate moderate, 29 and above indicate severe depression. Turkish reliability and validity studies of the scale have been carried out .
Psychometric Characteristics Of The Structured Interview For Apathy
Test-retest reliability was calculated by a single examiner, who assessed 10 patients , 24 weeks apart. Diagnostic agreement between the initial and follow up evaluations was perfect . Inter-rater reliability was assessed in an additional series of 10 patients , in separate interviews carried out by two different examiners blind to each others diagnosis. There was perfect diagnostic agreement between examiners. The Structured Interview for Apathy had high internal consistency , indicating substantial homogeneity among the items. Based on information obtained with the Structured Interview for Apathy, patients meeting diagnostic criteria for apathy had a significantly higher mean score on the caregivers rated Apathy Scale than patients without apathy : 24.1 v 15.5 , respectively t=4.74, df=148, p< 0.0001.
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Treatment For Apathy In A Person With Dementia
Compared with depression and anxiety there is less evidence about what treatments can help a person with dementia who has apathy.
Drugs only play a small part in treating apathy. Some people who take medication for Alzheimers disease or mixed dementia are more motivated and have better memory and concentration. A person with apathy may also be offered an antidepressant drug.
However, there isnt much evidence that antidepressants help people with apathy who have Alzheimers disease, mixed dementia or vascular dementia. In fact, there is some evidence that these drugs make apathy worse.
Therefore non-drug approaches should generally be tried first. For example, music therapy, group art therapy, reminiscence and cognitive stimulation that are delivered by a trained professional can help. However, these therapies are not available everywhere. Contact your local dementia support worker or adult social services to find out what is available in your area.
People with dementia who have apathy may also benefit from doing general creative activities, such as music and art, rather than a specific therapy with a trained professional. Even if they find it difficult to take an active role in these activities, they can still benefit from being involved.
What Is Samhsa’s National Helpline
SAMHSAs National Helpline, , or TTY: is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations.
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Alcohol Tobacco And Other Drugs
The misuse and abuse of alcohol, tobacco, illicit drugs, and prescription medications affect the health and well-being of millions of Americans. SAMHSAs 2020 National Survey on Drug Use and Health reports that approximately 19.3 million people aged 18 or older had a substance use disorder in the past year.
When To Contact A Doctor
Anyone dealing with persistent or severe feelings of apathy should speak with a doctor, who can assess their overall health. The doctor can provide guidance on how to ease the symptoms and improve day-to-day life.
If feelings of apathy worsen and an individual is in crisis, they can call the National Suicide Prevention Lifeline at 800-273-8255 or 988 for free, confidential help around the clock.
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History And Other Views
Christians have historically condemned apathy as a deficiency of love and devotion to God and his works. This interpretation of apathy is also referred to as Sloth and is listed among the Seven Deadly Sins. Clemens Alexandrinus used the term to draw to Christianity philosophers who aspired after virtue.
The modern concept of apathy became more well known after World War I, when it was one of the various forms of “shell shock“. Soldiers who lived in the trenches amidst the bombing and machine gun fire, and who saw the battlefields strewn with dead and maimed comrades, developed a sense of disconnected numbness and indifference to normal social interaction when they returned from combat.
In 1950, US novelist John Dos Passos wrote: “Apathy is one of the characteristic responses of any living organism when it is subjected to stimuli too intense or too complicated to cope with. The cure for apathy is comprehension.”
Montreal Cognitive Assessment Test Kognitif Deerlendirme Testi
MoCA has been developed for distinguishing healthy individuals from mild cognitive impairments . It is a short and easy to apply scale. Translation and adaptation studies have been carried out to 24 different language including Turkish. The scale has items that evaluate attention and concentration, executive functions, memory, language, visual-spatial skills, abstract thinking, calculation and orientation dimensions. The lowest score that can be obtained from the scale is 0, whereas the highest score is 30. Turkish standardization study has been carried out. Cut-off score for distinguishing healthy individuals from those with mild cognitive ones has been determined as 21 .
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As Nouns The Difference Between Depression And Apathy
Hamilton Anxiety Rating Scale
Prepared for determining the anxiety level and symptom distribution as well as the severiry . Comprised of 14 items that question the psychic and physical symptoms of anxiety. Highest score that can be obtained is 56. Scores of between 0-4 indicate no anxiety, below 17 indicate mild, 18-24 indicate moderate, above 25 indicate severe and high anxiety. Turkish reliability and validity studies of the scale have been carried out .
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Strategies To Manage Apathy
Like all the symptoms of Parkinsons, apathy requires that you make active choices to achieve your best quality of life. Here are some you can try, right away.
#1 Get out of the house daily
Create a weekly plan, or at least a plan for the day ahead, of leisure activities you want to do outside the home. If you plan the activity ahead of time, you dont even have to think about it, and you can just step into it.
Ideas to consider:
Standardized Mini Mental State Examination
SMMSE is a short, useful and standardized scale used for determining the global cognitive level . It is comprised of five sub-sections: orientation to time and place, record memory, attention, recall and language. The highest score that can be obtained from SMMSE is 30. Scores of between 24 -30 in SMMSE indicate normal, between 20-23 indicate mild, between 10-19 indicate moderate, whereas betwen 0-9 indicate severe neurocognitive deficit .
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Can You Have Depression Without Apathy
Yes, you can have depression without apathy.
While a loss of interest or pleasure is one possible symptom of depression, its not required for diagnosis. For some, depression could also manifest in other ways, such as anger, addiction, or irritability. These depression symptoms can be more common in men.
Depression could also manifest in intense feelings of worthlessness, constant worrying about life events, or increased sensitivity to rejection or criticism experiences that are not consistent with apathy.
Diagnosis Of Apathy In Traumatic Brain Injury
The Apathy Evaluation Scale has been validated to measure the severity of apathy in TBI . Muller and coworkers used ambulatory actigraphy to measure daytime locomotor activity in 24 patients with TBI and 12 controls and found a significant association between high scores on the Apathy Evaluation Scale and reduced locomotor activity. On the other hand, Glenn and coworkers reported that the Apathy Evaluation Scale is a poor instrument to screen for apathy in TBI. Studies are needed to validate both a structured assessment for apathy in TBI and standardized diagnostic criteria.
Karen E. Anderson, in, 2011
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Caregiver Training Part Iii: Depression And Apathy
Daughter explains that her mother has not been wanting to do any of the things she used to like to do. She is frustrated that her mother lays in bed all day and refuses to get up.
Common response: Mother is lying in bed during the day. Daughter asks her mother to get up but mother refuses. Daughter gives up and leaves the room discouraged.
Expert explanation: Depression and apathy occur in many persons with dementia. Apathy is different from depression. With apathy, a person may experience a lack of motivation, effort or energy to do everyday tasks, no longer have interest in talking with others or participating in activities, or show a lack of reaction to people or things that occur. People with depression may be sad or tearful, irritable, restless and have feelings of low self-worth. People with depression may also have sleep problems, loss of energy and appetite changes. See medical attention if the behavior is significant or if it is a sudden change from their usual self.
Recommended response: Mother is lying in bed during the day. Mother initially refuses to get up from bed. Daughter uses an incentive for mother to get out of bed by saying her friend is coming to visit. Mother is excited that she is having a visitor and gets out of bed. Mother goes to the living room and is enjoys working on a jigsaw puzzle with her friend.
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View the Facilitator & Advanced Learning Notes.
Common Signs Of Apathy
Apathy may make you feel like you are empty or feeling nothing, but it can cause noticeable changes in your demeanor, such as:
- Low or no reaction to emotions, like not feeling or expressing emotions, either positive or negative, or feeling indifferent to situations others may have a reaction to.
- Neglecting your responsibilities, like not engaging with work or schooleven if there may be negative consequences, like a poor performance review or bad grade. From the outside, it may look like you are lazy.
- Neglecting your needs, like self-care, hygiene, diet and exercise, or regular sleep patterns.
- Difficulty starting or finishing everyday tasks, like chores or homework.
- Not engaging with others, including friends, teachers, classmates, or coworkers. From the outside, it may look like you arent interested in other peoples lives.
- Lack of motivation to complete goals or make changes to your lifestyle, even if you know they would benefit you.
- Lack of interest in hobbies that you once enjoyed.
- Feeling fatigued or low energy.
If you or someone you know is exhibiting signs of apathy, text START to 741-741 or call 1-800-273-TALK
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Factor Based Scoring For Bdi
To help disentangle the assessment of apathy and depression symptoms, we propose a modified scoring of the BDI-II and AS. In addition to summing the items to derive total scores, a complementary method would combine items across scales to create subscale scores that map onto the four factors found in this study. This will provide four separate indices: pure apathy, pure depression, overlapping symptoms of loss of interest and pleasure, and somatic symptoms. Based on this study, the apathy/loss of motivation subscale contains 10 items , depression/dysphoric mood subscale contains 11 items , loss of interest and pleasure subscale contains 5 items , and the somatic subscale contains 7 items . We briefly examined descriptive statistics in our sample .
Apathy Signs And Symptoms
You may be able to see the signs of apathy in yourself. Or a friend or family member might point out that you don’t seem as interested or engaged as you used to be.
The doctor might diagnose you with apathy if you’re no longer motivated and you:
- Lack the effort or energy to do everyday things
- Depend on other people to plan your activities
- Have no desire to learn new things, meet new people, or have new experiences
- Don’t care about your own problems
- Feel no emotions when good or bad things happen
To count as apathy, your symptoms must be severe enough or happen often enough to affect your social life, job, or other parts of your life. And they can’t be due to drugs, alcohol, or any other substance you take.
Feeling Overwhelmed Or Burned Out
If we dont feel like our hard work at school, at work, or at home is being acknowledged or rewarded, we can begin to feel resentful of others who are not acknowledging us. If we dont practice self-care while were working hard, we can start to feel exhausted and overworked. If youre feeling overworked, burned out, or unfulfilled by your current lifestyle, you may start to shut down and feel apathetic.
Determining The Causes And Symptoms Of This Depression
In most cases, apathy appears when an event leaves a person feeling disappointed and dejected, if only for a moment. Having apathy is a way for the mind to defend itself from feeling rejected or offended by this event. It suppresses difficult feelings, so you can move forward and attempt to try other things that may result in success instead.
According to The Curse of Apathy: Sources and Solutions by Dr. Leon F. Seltzer, events that may cause apathy include being turned down for a job you really wanted, breaking up with someone you genuinely cared about, or performing the same routine every day without any sign of improvement in your life. When these events spawn overwhelming negative thoughts about failure and its implications, apathy is a way of resisting these emotions.
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Phenomenology Of Apathy And Depression In Dementia
We next examined whether symptoms of apathy may be construed as a specific sub-syndrome within the spectrum of depression in dementia, and to this end we calculated a factor analysis on the 17 item Hamilton Depression Rating Scale. To reduce the number of variables, the items of loss of appetite and weight, and the items of early, middle, and late insomnia were collapsed into single variables of appetite and sleep disturbances, respectively. Two factors were obtained. The first factor loaded on the items of loss of interest, psychomotor retardation, agitation, loss of energy, and loss of appetite/weight and was construed as an apathy factor. The second factor loaded on the items of depressed mood, feelings of guilt, suicidal ideation, psychic anxiety, and insomnia and was construed as a sadness/anxiety factor.
To examine the clinical correlates of each factor, we calculated a stepwise regression analysis with each factor as the dependent variable, and age, years of education, stage of illness, and scores of cognition, anxiety, and apathy as the independent variables . Factor 1 showed a significant overall correlation , and the variables that accounted for a significant part of the variance were the apathy scores , anxiety scores , and MMSE scores . Factor 2 showed a significant overall correlation , but only anxiety scores explained a significant part of the variance .
Parkinson’s Disease And Parkinsonian Syndromes
Apathy has been reported in the various parkinsonian syndromes. The prevalence of apathy among patients with Parkinson’s disease has been reported as 16.5% to 20%.4,53,54 Apathy in Parkinson’s disease is correlated with advanced stage of disease, greater cognitive impairment, and executive dysfunction.54,109
The prevalence of apathy among patients with progressive supranuclear palsy has been reported as 84% to 90%,4,53 and apathy has been associated with lesions of the orbitofrontal and medial frontal circuits.53 Among patients who have dementia with Lewy bodies and corticobasal degeneration, the prevalence of apathy has been reported as 90% and 40%, respectively.4
Melissa Jones MD, Ricardo E. Jorge MD, in, 2019
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Apathy Is A Sign Of Many Mental Health Conditions
If there is no apparent causefor example, you have not gone through a sudden major tragedy or other significant life changeand you still have prolonged feelings of apathy and emptiness that you cant shake, this may be cause for concern, especially if feeling apathetic is interfering with other areas of your life. Apathy can be a symptom of a larger mental health issue, or related to other mental and physical health issues.
Apathy is often occurs at the same time with other aspects of mental health conditions:
- Anhedonia: Literally meaning without pleasure, people with anhedonia no longer enjoy activities that they usually do.
- Lethargy: People who are lethargic feel abnormally slow, sluggish, heavy, or fatigued. Lethargy can affect people physically and mentally.
Apathy, anhedonia, and lethargy are all symptoms of depression. If you are feeling a combination of these symptoms, seek help from a mental health professional, or text START to 741-741 or call 1-800-273-TALK for a free and confidential conversation.
On its own, apathy is recognized as one symptom of many mental health conditions, such as: