Marina Alves S সাo Paulo, BBC News Brazil
Indifference is not a disease, but a collection of behavioral symptoms that arise in a particular condition, such as trauma or physical illness.
In general, apathy can be characterized by lack of motivation, social apathy, isolation, apathy.
“Anyone can have a moment of depression, so it can be normal, such as anxiety or depression,” said Luiza Bisol, a psychiatrist at the outpatient clinic at the Federal University of Sierra Hospital Complex (UFC) and a lecturer at the same university. , Which is connected to the Ebserh network.
It can appear at any age, but here we will create an intersection between children, whose symptoms may appear throughout the first month of life or throughout childhood.
In young children – up to the age of five – the symptoms can be annoying, crying for no apparent reason, sadness, affection and difficulty showing emotion.
“We evaluate evolution over time, but it’s possible to have kids who show indifference,” Bissell said.
Among older children – up to the age of twelve – the most common symptoms of apathy range from isolation, discouragement and sadness to lack of interest in communicating with family or making friends. But there are no rules.
“The pediatrician is the first doctor to evaluate the child and do a separate screening. And if he tells the family that it is nothing or that it is just a stage, we will not intervene, and intervention is more important in case of mental illness,” said Deborah Pasos, Neonatal Hospital. The Intensive Care Unit underlines the pediatric neonatologist and maternity pro mater.
Indifference can be confused with certain personality traits, such as restraint or restraint.
“In shame, the person has reactions and initiative towards the world, but he is more restrained. In this case, he only needs more stimulation, which is different from apathy, when you stimulate, try to communicate and the child does not respond,” describes Mauro Victor. De Medieros Philho, a child and adolescent psychiatrist, and an adolescent psychiatrist at the Das Clinicas de la FMUSP (School of Medicine, University of S সাo Paulo) Institute of Psychiatry (IPQ) at the hospital.
This difference can be noticed when taking the child to a new environment like a party. At first he may be a little scared, but then he relaxes and starts playing. This attitude is characterized only by restraint or restraint, not by indifference.
Psychiatrists at the Institute of Psychiatry at the University of Sওo Paulo also claim that apathy can be confused with denial.
“So ‘against’ children who don’t want to do something or don’t want to face each other can’t react or react because they’re against it. To be against, which is the opposite of indifference,” Philho reports.
And there are a number of factors that can justify a persistent apathy, among them, psychological problems such as:
- Childhood depression;
- ADHD (Attention Deficit Hyperactivity Disorder)
- Anxiety disorder;
- Disorders related to trauma or severe stress that children have suffered from: sexual and moral abuse, abuse, grief, separation from parents, bullying, financial difficulties at home;
- Schizophrenia (not very common in children).
Among the major physical conditions, we have already found:
- Hypovitaminosis (when the body is deficient in one or more vitamins);
- Oncological and / or metabolic diseases.
Another factor that can lead to the development of apathy is Autism Spectrum Disorder (ASD).
Bisol, a psychiatrist at the Federal University of Sierra Leone, assessed, “There are a variety of symptoms in this group of disorders, and among them we can, yes, have apathy, because these children can have a lot of difficulty socializing.”
According to experts, changes in behavior due to epidemics and social isolation are numerous.
“These are a reflection of what we are going through and there is no related disease. It is absolutely behavioral,” explains pediatrician Deborah Passos, emphasizing that this case also requires clinical evaluation and psychological follow-up.
Jose Martins Filho, a pediatrician, professor of pediatrics at the State University of Campinas (Unicamp) and a member of the Brazilian Society of Pediatrics (SBP), draws attention to another important issue: lack of encouragement from family.
“I have a book called The Outsourced Child where I talk about moms and dads who go to work and can’t play with their kids. Then they go to school and either withdraw or stay on their devices. Electronics.
All of this can lead to this symptom of apathy, ”warns the expert, who runs a YouTube channel called Family Love and Care targeting parents and carers.
The first step is to observe the child’s behavior, because apathy is usually very noticeable.
“The continuity and frequency of these behavioral symptoms need to be analyzed, as the cause of this apathy needs to be found out first,” Cynthia Marden, a child psychologist at the outpatient clinic at the University Universit ল loro Wonderley, indicated. , From the Universidade Federal da Paraíba (HULW-UFPB), which is part of the Ebserh Network.
In this sense, it should be emphasized that each child has a different developmental time, while some walk, talk and show interest in learning earlier, others take a little longer. And that’s okay, until the child achieves what is expected for his age in terms of physical and cognitive development.
This is why it is so important that, even after the first year of life, the child continues to follow in stages.
“A pediatrician is not just a pediatrician, he is a family doctor. It is much more than a child’s weight and measurement. It often attracts the attention of a pediatrician which parents do not notice, and it often happens in practice,” said Pro Matter Hospital and Maternity Hospital. Said Mr. Pasos, a pediatrician.
In addition to doctors, teachers also have an important role to play in diagnosing potential diseases, as they spend at least half a day with children.
“It is essential to make time to communicate with the child during the week or even on the weekends, otherwise parents will not notice unusual behavior in their children,” Passos warns.
And after eliminating physical illnesses during clinical initial treatment, the pediatrician refers the child for an assessment by a psychologist or psychiatrist.
“As long as the frequency and extent of damage in the functional domain continues, such as the child does not want to bathe, does not want to do his homework, does not want to go out, has no interest in musical instruments or has social harm such as lack of contact with friends or family, we can say That apathy is starting to become a problem “, Philhoe, a psychiatrist at the hospital’s psychiatric institute from the clinic, explained.
Can apathy be treated?
Since apathy is not a disease, treatment is indicated to cause symptoms. In other words, if it is anemia, it must be treated to improve the adverse effects of the condition.
The same goes for psychiatric disorders, which are usually treated with therapy and in some cases with medication.
“Keep in mind that this is a symptom that can present in multiple diagnoses,” Philho says.
Parental posture in the face of these symptoms is based on pathology.
“So we will have a different approach to depression if the case is a concern. Parental guidance should be linked to diagnoses related to depression,” concludes Philho, a child and adolescent psychiatrist at the Hospital’s Das Clinicas Institute of Psychiatry.