The person I care for has lost interest in everything. Is it depression?

My mother spends the day sitting, with no desire to do anything, not even the things she always enjoyed, like watching soap operas or talking on the phone with friends. She doesn't seem sad, just... absent. Could it be depression?

It could be depression, but it could also be apathy — and these are different things, although often confused. Apathy is, in fact, one of the most common symptoms of dementia, affecting a large proportion of people at some stage of the illness. Distinguishing between the two helps to choose the right response.

Apathy or depression: what's the difference

In depression, the person usually feels sad, may cry, talk about hopelessness or guilt, and suffers from their lack of interest. In apathy, the person loses initiative and motivation, but does not seem to suffer from it — they are "switched off" rather than sad. Apathy results from changes in brain areas linked to motivation; it is not laziness or a choice, and does not respond in the same way to "cheering the person up".

Why it happens

Dementia directly affects the brain circuits responsible for initiating actions and anticipating pleasure. This means that the person may still enjoy something when they are doing it, but no longer has the internal energy to start on their own. That's why insisting "why don't you do anything" doesn't work — they lack the starter motor, not the underlying will.

What can help

• Initiate the activity for them. Instead of asking "do you want to listen to music?", turn on the music and observe their reaction.
• Maintain simple and predictable routines. Small tasks with clear beginnings and ends (folding laundry, watering a plant) give a sense of purpose.
• Encourage brief social contact. Short, calm visits are more effective than long gatherings.
• Use meaningful old activities. Music, photos or objects linked to the past tend to evoke more response than new things.

"I stopped asking my mother if she wanted to do something. I simply sat next to her and started — flipping through an album, singing an old song. Gradually, she would join in."

When to seek professional help

It is important to talk to the attending doctor to distinguish apathy from depression, especially if you notice expressed sadness, frequent crying, changes in appetite or sleep, or comments of hopelessness — signs more associated with depression, which can and should be treated. Depression in dementia is underdiagnosed and undertreated, but effective approaches exist; do not assume that "it's normal for their age or illness" without confirming with a healthcare professional.