Apathy is very common following a traumatic brain injury and may often occur in conjunction with depression, but not always. It may become apparent shortly after a brain injury or may not be evident until a few years later.
There are many indications of this deficit - a decrease in goal-oriented activities and no interest in making goals of any kind; no interest in working towards rehabilitation; no effort towards becoming independent; no effort made towards any work-related activities; no interest in achievements of any kind; an emotional indifference; little effort at communication; little concern for their own health; loss of interest in daily activities; reduced interaction in personal relationships; few emotional reactions to situations and circumstances; unable to initiate, take action or make any plans; no interest in the future; little appreciation or notice of recovery made to date, and withdrawal creating social isolation. Their feelings of self-worth may plummet and they could possibly experience a sense of hopelessness. When survivors of brain injury are living with this deficit, they are often considered to be 'lazy' or possibly 'couch potatoes'.
Following a brain injury, 61.4% of adults will exhibit signs of apathy. They will feel they have lost their role in life. For most of us, our role is defined by relationships we have established with others. But often after an injury friends don't come by as often and eventually may stop coming altogether and sometimes family relationships will become strained as well. Survivors often no longer seem to be the same person they once were.
Although apathy can be associated with depression, the latter is more common - found in 83% of traumatic brain injury survivors. There can however, be other factors associated with apathy, i.e.: health issues such as hypothyroidism or other illnesses; personality changes; difficult factors existing in their life; poverty or even the beginnings of dementia. Apathy is associated with a faster cognitive decline. There are, however, medications available for the treatment of this deficit.
From a recent study it has been suggested that there is a correlation with coping strategies and adapting - an active way of adapting to problems and managing stress versus a passive (avoidance) method which results in doing nothing and which often leads to substance abuse.
If someone is currently taking an anti-depression medication but still appears to be suffering from 'depression-like' symptoms, they may instead be suffering from the deficit of apathy; particularly if they continue to show a general lack of interest in most things in their life. If this is the case, it is important for them to see a medical practitioner.