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

This psychological symptom appears in people with an extreme lack of motivation and initiative.

We can often 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, or to try 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 abuliaan extreme form of apathy.

But... What is the cause of this curious psychological phenomenon? Next we will see what produces the abulia and in what ways it affects us.

Abulia: concept and symptoms

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

The abulic subject tends to have severe difficulties in initiating and finishing most acts and activities, so it is common for him 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. It is also frequent that he presents social difficultiesThey are also often socially unmotivated and unwilling to socialize.

On the other hand, people with abulia have problems when making decisions and organizing their own thinking due to the state of despondency that their psychological state entails, with slowed thinking. The movements of the subject also tend to present alterationsThe spontaneous movement is reduced and it takes longer to respond to stimulation. People with abulia usually feel helpless and indecisive, sometimes suffering great emotional pain and at other times may become emotionally numb.

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

Causes

The causes of abulia can be very varied, depending on which 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 brainIn the basal ganglia or in the anterior cingulate, all of them areas related to motivation and initiation of movements. These lesions can be caused by different disorders and diseases, such as stroke or traumatic brain injury.

It can also be caused by different types of infections such as syphilis if it eventually affects the brain. Similarly, symptoms similar to abulia may be observed in anemic persons in anemic people, with a lack of various essential nutrients..

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

Disorders in which it appears

Abulia as a symptom can appear in a great number of disorders and diseases.. Some of which are the following.

1. Dementias

Abulia is a characteristic symptom in people with different dementias with different dementias such as Alzheimer'sAlzheimer's disease, due to the progressive degeneration of brain structures that occurs in this type of disorder.

2. Major depression

One of the mental disorders in which abulia is most frequently present is major depression. The state of unmotivation, hopelessness and feeling of little control can eventually lead to a lack of desire to act, and often occur together with a lack of pleasure from pleasurable activities, a phenomenon known as anhedonia.

3. Schizophrenia

Abulia can also can also appear in psychotic disorders, as in the case of schizophrenia.. In this case we would be in front of a negative symptom that would reduce the capacity of the subject's usual vital functioning, and it is frequent that it appears together with alogia. Considering the existence of different types of schizophrenia, schizophrenias of disorganized, simple or catatonic subtypes are some in which it may appear more frequently and with greater visibility. It can also be observed as a residual symptom after a psychotic break.

Possible treatments

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

At the psychological level, the use of different strategies applied in cases of depression is recommended. These strategies are based on encouraging action and the realization of different activities that are pleasant and gradually awaken 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 can be useful to provide guidelines, tools and information to the patient's relatives and close environment, so that they contribute to establish and maintain different goals and proposals that generate desire and willingness to act. In some cases physiotherapy can be very useful in some cases, in order to provoke in order to provoke an increase of the motor activity, as well as of sport that in turn can help to generate endorphins.

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

Bibliographical references:

• American Psychiatric Association. (2013). Manual diagnóstico y estadístico de los trastornos mentales. Quinta edición. DSM-V. Masson, Barcelona.

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

• Santos, J.L. (2012). Psicopatología. Manual CEDE de Preparación PIR, 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.