Has everything stopped mattering?

What it can look like

Lesia used to be the one who organised weekends with friends: she picked the place, messaged everyone and settled on a time. Now she goes along with any plan. She isn't annoyed and doesn't argue; she simply hardly cares where they go, or whether she goes at all.

Maksym has loved one band for years. When his friends bought concert tickets and took him along, he enjoyed the evening. But this time he never even opened the message about the ticket sale. The pleasure he gets from the music is still there; what has gone is the drive to start anything himself.

In both stories the person hasn't stopped caring about others and hasn't "become lazy". What has changed is initiative: the wish to act on your own, without a push from outside.

What apathy is

Apathy is a noticeable drop in motivation, initiative and emotional engagement compared with how a person used to be.

It is a symptom, not a diagnosis. It can appear in many different conditions, so on its own it does not point to a specific cause.

Questions that help describe the change

Think back over the last few weeks and compare them with a period that felt normal for you. The answers won't give you a diagnosis, but they help you describe your state more precisely to yourself, to people close to you or to a doctor.

• When did you first notice the indifference? Did it build up gradually or appear suddenly?
• What changed shortly before that: a heavy workload, stress, an illness, a new sleep pattern or new medication?
• When something pleasant does happen, do you enjoy it?
• Do you not want to act, or do you want to but lack the energy?
• Have your sleep, appetite or usual level of activity changed?
• Has it become harder to concentrate and make decisions?
• Alongside the indifference, is there low mood, anxiety or a sense of emptiness?

If none of these describe you, and the indifference only shows up on the odd day after a demanding period, it may be a natural reaction to overload. Give yourself time to rest and notice whether your interest comes back. If several answers do describe you and it has been going on for weeks, there is no need to wait for it to "pass on its own".

Apathy and similar states

Apathy is easy to confuse with other experiences. The difference between them hints at where to look for the cause.

• Fatigue. You want to do things but lack the energy, and rest usually helps. More: Persistent fatigue.
• Anhedonia. You can still act, but familiar activities bring no pleasure. In our example with Maksym, it is the other way round: the pleasure is still there, and it is initiative that is missing. More: Anhedonia: nothing feels enjoyable.
• Emotional numbness. Almost all feelings seem dulled, not just interest in activities. More: Emotional numbness.
• Hard to get started. You are interested in the task, but the first step feels very hard. More: I don't want to do anything.

These experiences often overlap, so a single sign does not tell you what exactly is going on.

What may lie behind the indifference

Apathy can be linked to exhaustion after a long period of strain, sleep problems, changes in mood or physical health. Sometimes it appears after a change in medication.

If the indifference comes together with persistently low mood and loss of interest in life, a doctor may check for depression. For a general overview, see NIMH: Depression. At the same time, apathy also occurs without depression, so on its own it does not mean that diagnosis.

One manageable step

You don't need to get back your old level of activity all at once. Choose one small thing you used to do without effort and arrange it with someone close to you. Make the request specific: not "support me", but "let's go grocery shopping together on Saturday" or "remind me this evening to call my mum".

If the step doesn't work out, that isn't a failure. It is one more observation worth remembering for your conversation with a specialist.

When to see a specialist

See a doctor or a mental health professional if the apathy doesn't go away, gradually gets worse or noticeably limits your daily life. Don't put off a consultation especially if it becomes hard to keep up hygiene, eat regularly, work or study, leave home or stay in touch with people.

Discuss your state with a doctor without delay if the apathy started suddenly, comes with marked physical or neurological symptoms, or appeared after a change in medication.

Who to start with. If the biggest change is in your mood, thoughts or behaviour, you can start with a psychiatrist. They will ask when and how the apathy began, what came before it and how it affects your day, and then discuss with you whether further tests are needed and what help would be appropriate. If you have physical complaints, it is also worth seeing a family doctor to check your general health.

In the doctors' directory you can see which concerns each specialist works with. It helps to write down your answers to the questions above in advance; the conversation will then be more focused.

If you have thoughts of death or of harming yourself, don't stay alone with them. Tell someone close to you and seek help the same day. If you are in immediate danger, call 103 or 112 in Ukraine. More: Suicidal thoughts.

For family and friends of someone with depression there is a separate guide: How to help someone with depression.