A symptom that may be behind some mental disorders, for example depression.
Abulia is an alteration of affectivity characterized by an absence of will , energy and motivation to perform any type of task.
It typically appears in some mental disorders , although it can also appear as an isolated symptom in healthy people, during a specific period of life.
In this article we will know what this alteration consists of, what its characteristics are, associated alterations, what symptoms it entails and the possible disorders or diseases where it appears.
Abulia: what is it?
The term abulia literally means “lack of will” ( a-bulia ) . This concept belongs to the field of the psychopathology of affectivity, and refers to a “powerlessness to make the will work”.
Thus, abulia consists of the absence of energy, will or motivation, which makes people stop doing things or simply moving. That is, it also includes voluntary motor activity. It is a typical symptom of mental disorders such as depression (and other depressive disorders) and schizophrenia (as part of its negative symptoms), among others.
In this way, a person suffering from apathy feels down, without energy, without wanting to do anything . Also, she shows no initiative at all; this covers the behavioral level (carrying out activities) and the cognitive and behavioral level (making decisions). The symptom of abulia is linked to others, which we will see later, such as anhedonia (difficulty or inability to experience pleasure) and asthenia (general fatigue).
Thus, it is understood that if the three symptoms occur together (which is usual), a person feels depressed, and may become depressed. If one can not feel pleasure with anything, or enjoy anything, it is logical that he does not have energy and / or will to do things, since in his head he can think: “why do something?”.
How does it manifest?
How does abulia manifest itself? In addition to the above, the person with this symptom or alteration is likely to feel helpless because they do not feel like doing anything , and because they do not have the strength or motivation to carry out any type of activity. In addition, these activities are practically all, and include work, social and self-care.
On the other hand, the person with abulia is not only prevented from carrying out activities, but also has difficulties making their own decisions. This entails the inability to direct their actions towards specific goals or objectives (lack of motivation).
Motivation is the engine that drives us to do things, and it must exist minimally for us to develop activities or set ourselves some goal; if this fails, abulia appears.
Associated alterations
Generally, abulia is accompanied by other symptoms such as anhedonia and asthenia . For its part, anhedonia implies being unable to enjoy things, to experience pleasure; In addition, it appears before stimuli, things or activities that before did generate pleasure (the person stops reacting to previously pleasurable stimuli).
That is to say, it is a loss of interest or satisfaction, which appears in practically all the activities of the individual. Asthenia, on the other hand, consists of generalized fatigue (weakness), which implies difficulties for the person to carry out their usual tasks.
Symptoms
The symptoms associated with abulia are the following.
1. Altered affectivity
The affective and emotional plane is altered in abulia. Thus, an apathy appears, that is, an indifference or lack of enthusiasm in the face of things that happen to oneself or to others.
That is, the person becomes “cold”, as if nothing mattered to him, and it is difficult for him to connect with the emotional states of others: for example, he can see a sad friend, suffering, and feel indifferent. This can generate a certain feeling of guilt or helplessness in the person, since he feels incapable of feeling empathy for anyone.
2. Lack of communication
Another symptom of abulia is lack of communication ; In this way, the person can lose contact with others, stop initiating interactions, and therefore, eliminate communication with those around them or with people important to them.
3. Cognitive alterations
At a cognitive level, the person with apathy can progressively “lose” the “ability to think” ; This implies that it is increasingly difficult for him to think or reflect carefully on something, since he has neither the desire nor the motivation to do it (it is as if he was losing practice).
On the other hand, it has always been said that depressive symptoms can cause cognitive alterations such as lack of attention, decreased memory, etc.
4. Lack of motivation
Another characteristic symptom of abulia, and one of the most prominent, is the decrease or lack of motivation . This also covers the interest of the person to do any kind of activity or task.
Thus, as we mentioned, the person is indifferent and disinterested in practically everything, and does not set any short- or medium-term goals (for example, start studying, work on something they like, compose a song, etc.)
5. Waste of time
All the above symptoms cause a fifth symptom (or rather, consequence) typical of abulia: loss of time. This appears because the person does not show initiative to do what he really “has to do” , and thus ends up spending time on absurd, banal things or things that lead nowhere, and neglects his work, domestic or family obligations.
That is to say, these things that the person does, in reality do not make any sense to him.
Diseases that cause it
The main mental disorders where abulia appears most frequently are: depressive disorders, schizophrenia and some dementias, although there are more.
1. Depressive disorders
Abulia generally appears in major depressive disorder (MDD) (depression) . This manifests itself as we have been seeing throughout the article, through a decrease in motivation, energy and interest, which makes the person limit himself to “doing nothing”.
On the other hand, abulia can also appear in another type of depressive disorder such as dysthymic disorder. This is similar to depression, but less severe (less intense) and longer lasting (minimum 1 year in children and 2 years in adults).
2. Schizophrenia
Schizophrenia is a psychotic disorder characterized by numerous symptoms and of different types. One of these symptoms are depressive symptoms, which include the abulia that we discussed.
This symptom manifests itself especially in residual schizophrenia; this subtype of schizophrenia appears after a psychotic episode or outbreak, and is characterized only by negative symptoms such as abulia, flattened affect, etc.
On the other hand, it is also common in simple schizophrenia; this consists of a subtype of schizophrenia proposed by the Swiss psychiatrist Eugen Bleuler, and characterized by presenting only negative symptoms (positive symptoms have never appeared, unlike residual schizophrenia).
3. Dementias
Some dementias also present the symptom of abulia, such as Parkinson’s disease (where motivation is significantly reduced), like other subcortical dementias. On the other hand, cortical dementias can also involve symptoms of apathy and abulia, such as Alzheimer’s disease dementia .
- Recommended article: “The 7 most common types of dementia (causes and symptoms)”
Bibliographic references
- Belloch, A., Sandin, B., and Ramos, F. (2010). Manual of Psychopathology. Volume I and II. Madrid: McGraw-Hill.
- Clarke D, Van Reekum R, Simard M, Streiner D, Conn D, Cohen T, Freedman M (2008). Apathy in Dementia: Clinical and Sociodemographic Correlates. J Neuropsychiatry Clin Neurosci 20:337-347.
- Sampietro, H. (2015). Understanding Depression: Asthenia, Anhedonia and Abulia. Activa Ment, Catalonia Association.
- Triglia, Adrian; Regader, Bertrand; Garcia-Allen, Jonathan (2016). psychologically speaking. Paid.
To the classic question “what do you do?” I always answer “basically I am a psychologist”. In fact, my academic training has revolved around the psychology of development, education and community, a field of study influenced my volunteer activities, as well as my first work experiences in personal services.