Abulia: what is it and what symptoms warn of its arrival?

Many times we can find ourselves in situations where we do not feel like doing anything. For example, a large number of patients with major depression report not wanting to get out of bed. bed, or trying to achieve their goals no matter how rational or even simple they may seem to them. This lack of motivation and energy is what we know as abulia., an extreme form of apathy.

But... What is this curious psychological phenomenon due to? Next we will see what causes apathy and how it affects us.

• Related article: "Major depression: symptoms, causes and treatment"

Abulia: concept and symptoms

It is understood as apathy to the loss or lack of will to make decisions, focus on objectives and have the motivation to achieve them. The person with abulia has a low level of vital energy and a practically non-existent interest in stimuli or activities that previously would have motivated him. It can be considered an extreme form of apathy.

The abúlic subject tends to have severe difficulties to start and finish most acts and activities, so it is common for them to postpone them. This applies not only to hobbies but also to work and other responsibilities and even basic activities of daily life, such as eating.

Social difficulties are also common, having no motivation or willingness to relate.

On the other hand, people with apathy have problems when making decisions and organizing the own thought due to the depressed state that his psychological state supposes, with a thought slowed down. The movements of the subject also tend to present alterations, spontaneous movement being reduced and taking longer to respond to stimulation. People with apathy generally feel helpless and indecisive, sometimes suffering greatly emotional pain and in others, it can reach affective dullness.

Although at first this term was conceived as a mental disorder, today the abulia is considered a symptom or set of symptoms indicative of different types of mental and physical disorders.

Causes

The causes of abulia can be very varied, depending on what disorder it is a symptom of. At the neurological level, it has been found that it can appear in cases of frontal lesions in the brain, in the basal ganglia or in the anterior cingulate, all of them areas related to motivation and the initiation of movements. These injuries can be caused by different disorders and diseases, as well as strokes or head injuries.

It can also be caused by different types of infections such as syphilis if it ends up affecting the brain. Similarly, symptoms similar to abulia can be observed. in anemic people, lacking various essential nutrients.

In addition to these biological causes, it is possible to find states of abulia in people who suffer or have suffered prolonged stress over time, with a high level of frustration and suffering that is lived with helplessness and hopelessness.

Disorders in which it appears

Apathy as a symptom can appear in a large number of disorders and diseases. Some of which are as follows.

1. Dementias

Apathy is a characteristic symptom in people with different dementias such as Alzheimer's, due to the progressive degeneration of brain structures that occurs in these types of disorders.

• Related article: "Alzheimer's: causes, symptoms, treatment and prevention"

2. Major depression

One of the mental disorders in which apathy occurs most frequently is major depression. The state of demotivation, hopelessness and a feeling of little control They can end up generating a lack of desire to act, and many times they occur together with the absence of pleasure from pleasant activities, a phenomenon called anhedonia.

3. Schizophrenia

Abulia too may appear in psychotic-type disorder, as in the case of schizophrenia. In this case, we would be facing a negative symptom that would reduce the ability of the subject to function in the normal life, and it is frequent that it appears together with the allegiance. If the existence of different types of schizophrenia is considered, the subtype schizophrenias disorganized, simple or catatonic are some in which they can appear more frequently and more visibility. It can also be seen as a residual symptom after a psychotic break.

• You may be interested: "The 6 types of schizophrenia and associated characteristics"

Possible treatments

Treating abulia as a symptom is possible in a large number of cases, although the treatment in question will largely depend on its causes. Treatment can be carried out both at a psychological and pharmacological level.

On a psychological level, the use of different strategies applied in cases of depression is recommended. These strategies are based on promote action and the realization of different activities that are enjoyable and gradually awaken the motivation and desire to act. Helping and motivating to create and carry out different actions and routines is essential, while working on the beliefs and thoughts that may have caused or maintained the problem.

It may be useful to provide guidelines, tools and information to the relatives and close environment of the patient, in order to way that they contribute to establish and maintain different goals and propositions that generate desire and will to Act. In some cases Physiotherapy can be very useful in order to cause an increase in motor activity, as well as sports that in turn can help generate endorphins.

At the pharmacological level antidepressants are especially effective, especially those that cause an increase in the level of dopamine. In this sense, other stimulating substances can also be useful.

Bibliographic references:

• American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. Fifth edition. DSM-V. Masson, Barcelona.

• Marin, R. S. & Wilkosz, P. TO. (2005). Disorders of diminished motivation. Journal of Head Trauma Rehabilitation, 20 (4).

• Santos, J.L. (2012). Psychopathology. CEDE PIR Preparation Manual, 01. CEDE. Madrid.

• Vijayaraghavan, L.; Krishnamoorthy, E. S.; Brown, R. G. & Trimble, M. R. (2002). Abulia: A Delphi survey of British neurologists and psychiatrists. [Article]. Movement Disorders, 17 (5), 1052-1057.