Apathy and Parkinson’s Disease

One of the biggest non-motor complaints for Parkinson’s patients is a decline in motivation to participate in daily activities.  If it is taking every effort to get off your couch or out of your bed to engage in desired activities, you may be experiencing a very common symptom of Parkinson’s disease-apathy.  Apathy affects anywhere from 17-60% of patients with Parkinson’s disease regardless of disease progression.  It is manifested as a reduced lack of interest and participation in purposeful behaviors, difficulty with initiating, sustaining and completing tasks, and lack of concern for yourself and those around you.  Family members and friends may be thinking you are just being “lazy” or “uninterested”, but realize that apathy is caused by both physiological changes resulting from changes in the brain, including depletion of dopamine, and external factors of adjusting to a life with Parkinson’s.

If you are experiencing symptoms of apathy it is important to talk to your health care provider about medical management of your symptoms. There are some useful tips to help increase your participation in needed and desired activities:

  • Create or have assistance creating a daily schedule of activities, with set times to get things done.  Make every effort to start and complete each task.  Write these down on a daily planner or calendar and cross things off as you accomplish them.  Include both activities that you enjoy and that simply just need to get done (i.e. mowing the lawn, housework).  Make the plan realistic and not overwhelming.
  • Create small weekly goals for leisure activities.
  • Establish a reward system for successful completion of activities, i.e. getting to watch a favorite TV show, an outing to your favorite restaurant, and a walk at your favorite park.
  • Elicit the help of others to engage in an activity, not only will assistance of others help you accomplish the activity, but social interaction is motivation in itself and makes the activity more “fun”.
  • EXERCISE:  Daily exercise not only can slow down the progression of Parkinson’s disease, but also releases chemicals in the brain that elevates mood and increases motivation.
  • SLEEP:  Try to get a good night sleep every night.  Sleep affects motivation for everyone, not just those with Parkinson’s disease. Medication management may be necessary to minimize symptoms affecting sleep, but also consider establishing a nighttime routine (lower the lights, engage in relaxing activities such as reading, yoga, warm bath, soothing music)and avoid stressors such as the nightly news, emails and certain foods including caffeine and alcohol before bedtime.    Ensure your environment is set up for restful sleep including a comfortable mattress, dark room, appropriate temperature and is free of distractions.
  • Try to stay relaxed, consider deep breathing strategies, attending yoga or Tai Chi classes.
  • Get out of the house:  attend Parkinson’s disease support groups, religious outings, dinner with friends…Being around others and engaging in interesting conversations and experiences can boost mood and enhance motivation.

Remember that apathy and your lack of motivation is not your fault, but rather is related to the chemical changes in brain.  There may be medications available to assist with your symptoms and the above tips can help increase your participation in needed and desired activities.

Follow up with your physician, psychiatrists, psychologists or rehab therapists for further treatment of apathy if necessary.


*Written in part by Michelle Foley, OTS

About the Author


Heather Simpson, OTR/L

Heather Simpson graduated with a B.S. in Exercise and Sport Science with a minor in Early Education from the University of Florida in 2007. Following…

Read all articles by Heather Simpson, OTR/L