A study of stroke survivors found a slower rate of recovery among those experiencing apathy, caring little about themselves and the world around them. And a study of healthy middle-aged women found an association between hopelessness and unexpected thickening of the carotid artery, the main blood vessel to the brain.

It’s an admittedly imperfect method of measurement, “but we used what we had.” Reports indicated that a third of the stroke survivors had minor apathy through the first year, with 3 percent having high levels of apathy. Apathy worsened for 7 percent of the survivors, and eased for 7 percent during the year.

Measurements of physical function showed that even very minor apathy had just as strong an impact on recovery as major apathy. Answers about the quality of life of the stroke survivors, such as their engagement in social activities, found lesser improvement among those whose apathy worsened.

It’s not clear what can be done to help in such a situation in large part because very little research has been done on apathy.

Drug therapy is a vague possibility, along with behavioral therapy. We don’t have anything that has evidence-based data other than being kind and enthusiastic. There needs to be a lot of work.

The report on the physical effect of hopelessness was an offshoot of a nationwide study of cardiovascular disease in women.

A previous study led by Everson-Rose, using the same questionnaire in Finnish men, found an association between hopelessness and cardiovascular disease outcome, other study in women with documented cardiovascular disease.

This new study found a direct relationship between rising hopelessness and thickening of the lining of the carotid artery, a risk factor for stroke. Overall, women measuring higher on the hopelessness scale had .02 millimeters more thickening, equal to the amount caused by one year of aging. Women with the highest hopeless scores had an average .06 millimeters greater thickening than those with the lowest scores.

This doesn’t necessarily mean that hopelessness had a direct physical effect, since it could be operating through mechanisms we didn’t measure.

Physicians should tell patients that emotional states can have a physical effect, and that they should seek appropriate treatment for them. Psychiatric treatment for severe depression and hopelessness is warranted.