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 find out what this alteration consists of, what its characteristics are, associated alterations, what symptoms it entails and the possible disorders or illnesses 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 alludes to an “impotence to do the will”.
Thus, the abulia consists of the absence of energy, will or motivation, which makes people stop doing things or simply moving. In other words, it also includes voluntary motor activity. This is a typical symptom of mental disorders such as depression (and other depressive disorders) and schizophrenia (as part of its negative symptomatology), among others.
This way, a person suffering from abulia feels down, without energy, without wanting to do anything. In addition, it shows no initiative at all; this encompasses the behavioural (performing activities) and cognitive and behavioural (making decisions) plane. 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 all three symptoms are present together (which is usual), a person feels depressed, and may become depressed. If one cannot feel pleasure with anything, nor enjoy anything, it is logical that one does not have the energy and/or will to do things, since in one’s head one can think: “why do something?”.
How does it manifest itself?
How does abulia manifest itself? In addition to the above, the person with this symptom or disorder is likely to feel helpless from not feeling like doing anythingand for not having 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 in making his own decisions. This leads to the inability to direct their actions towards specific goals or objectives (lack of motivation).
Motivation is the motor that drives us to do things, and it must exist minimally for us to develop activities or propose some objective; if this fails, the abulia appears.
Associated Alterations
Usually, abulia is accompanied by other symptoms such as anhedonia and asthenia. On the other hand, anhedonia implies being unable to enjoy things, to experience pleasure; in addition, it appears before stimuli, things or activities that previously generated pleasure for us (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 a generalized fatigue (weakness), which implies difficulties for the person to develop his habitual tasks.
Symptoms
The symptoms associated with abulia are as follows.
Altered affectivity
The affective and emotional plane is altered in the abulia. Just like that, apathy appears, i.e. indifference or lack of enthusiasm for things that happen to oneself or to others.
That is, the person becomes “cold”, as if nothing mattered to him, and finds it difficult to connect with the emotional states of others: for example, he may see a sad friend, suffering, and feel indifferent. This may cause the person to feel a certain sense of guilt or helplessness, as he or she feels unable to empathize with anyone.
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 their environment or with people important to them.
3. Cognitive alterations
On a cognitive level, the person with abulia can progressively “lose” the “ability to think”.This implies that it is becoming more and more difficult for him to think or reflect carefully on something, since he has neither the desire nor the motivation to do so (it is as if he were losing the practice).
On the other hand, it has always been mentioned that depressive symptoms can cause cognitive alterations such as inattention, memory loss, etc.
4. Failure to state reasons
Another characteristic symptom of abulia, and one of the most prominent is decreased or lack of motivation.. This also includes the interest of the person to do any type of activity or task.
Thus, as we commented, the person is indifferent and disinterested in practically everything, and does not propose any short or medium-term objective (for example, to study, work on something he likes, 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 one appears because the person shows no initiative to do what they really “have to do”.He ends up investing his time in absurd, banal things that lead nowhere, and neglects his work, domestic or family obligations.
That is to say, these things that the person does don’t really 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 usually appears in major depressive disorder (TDM) (depression). This is manifested 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 may 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 characterised by numerous symptoms of different types. One of these symptoms are depressive symptoms, which include the abulia we are discussing.
This symptom is especially manifested in residual schizophrenia; this subtype of schizophrenia appears after an episode or psychotic break, and is characterized only by negative symptoms such as abulia, flattened affection, 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. Dementia
Some dementias also have the symptom of abulia, such as Parkinson’s disease (where motivation is significantly reduced), as are other subcortical dementias. On the other hand, cortical dementias may also involve symptoms of apathy and abulia, such as dementia due to Alzheimer’s disease.
Bibliographic references
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Belloch, A., Sandín, B. and Ramos, F. (2010). Manual of Psychopathology. Volume I and II. Madrid: McGraw-Hill.
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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.
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Sampietro, H. (2015). Understanding Depression: Asthenia, Anhedonia and Abulia. Activa Ment, Catalunya Associació.
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Triglia, Adrian; Regader, Bertrand; García-Allen, Jonathan (2016). Psychologically speaking. Paidós.