Friday, August 21, 2009

Brain Injuries and Apathy

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 sometime 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 and 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.


  1. As a person with a mild TBI of 5 years, for 3 of which I continued to work and exhaust myself. Who really advocates for the victim of TBI? It certainly is not the greedy merchant that caused the accident or the greedy alcoholic christian ambulance chasing attorney that made promises of finding help.
    Yes what has been referred to as depression is actually apathy. I can only hope that life is short. These websites provide information but have no clinicians that treat. Our only psychiatrist in town thinks that if you have cognitive function, the new state after tbi must be related to your parents. That is all we have. This site is about making money too, donations, selling books, etc. Quit re-raping the victims. The govt puts out money for research-does the injured benefit at all? Of course not, but it does keep someone working. Why dont you researchers develop and injection for all us to chose whether we want life or death and not attempt to look for insantiy for those who would make a reasonable choice.


  2. I write as a sign of gratitude to God, i am really happy to be alive today and see the break of another day, I lived and suffered with TBI for a very long time, I was shy and couldnt say it out because of ego issues. I suffered in silence till I was able to get herbal products by DR Jose Alessio, and with his drugs, prayers and instructions I was treated and now i am a happy survivor! pray to God and follow the instructions of Dr Jose, he has the perfect solutions for ailments,Schizophrenia,Traumatic Brain Injuries, Delusions, Brain cancer, Aphasia, Autism, Psychosis and any brain related ailment. Do not wrestle with death on your own, contact him joseherbals28@gmail. com