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Aboulomanía: symptoms, causes and treatment

Aboulomanía: symptoms, causes and treatment

March 24, 2024

Everyone at some point in our lives has been tormented by having to make a complicated decision, which generates high levels of anguish and uncertainty. Now imagine that this sensation accompanies us constantly, in each and every one of the activities that we carry out.

This malaise is what is experienced with the aboulomanía , a very rare mental disorder in which the person feels incapable of taking any type of decision, however simple, and which is also accompanied by obsessive thoughts about these decisions.

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What is the aboulomanía?

The aboulomanía consists of a strange mental disorder that affects the will of the person, weakening it and generating a sensation of constant and pathological indecision. As a result, the person feels absolutely incapable of making any kind of decision, not even only in the activities he performs throughout the day.


In addition, this disorder is highly related to pathologies such as anxiety, stress, depression and the feelings of anguish; therefore, it greatly interferes with the ability of the person to initiate and maintain social interactions. Reaching, in the most severe cases, to provoke the suicide of the person.

Although feelings of doubt, indecision or uncertainty are not usually abnormal when experienced punctually and with a normal degree of intensity, in cases of aboulomanía these feelings become obsessions that generate high levels of anguish in the person he suffers them since, in addition, these doubts flood absolutely all the contexts and activities of the patient.


Therefore, when making a decision, regardless of the transcendence of this, the person with aboulomania feels the need to constantly reevaluate their decisions , which tends to qualify negatively. As a consequence, this uncertainty and negative over-analysis of situations ends up becoming a typical picture of obsessive disorders.

Aboulomania and abulia: differences

The apathy is another disorder related to the will and motivation, similar to the aboulomanía, in which the person also experiences a decrease in motivation, energy and will with the main difference that in this case these sensations are not they become an obsession for the patient; which acts almost automatically, as if by inertia.

Unlike abulia, in the aboulomania this inability to make decisions becomes obsessive , and generates recurrent and intrusive thoughts in the person, who is unable to avoid the constant rumination of these.


  • Related article: "Abulia: what is it and what symptoms warn of its arrival?"

What symptoms does it present?

The main symptom that a person with an aboulomania experiences is, as mentioned above, a total inability to make any kind of decision. This incapacity is constant and continuous, and extends to all areas of the person's life.

Further, this uncertainty generates very high levels of anxiety and anxiety , since in many occasions the person remains in a situation that is harmful or unpleasant for her only due to the fact that she is not able to decide if she stays in this situation or not.

The ruminations, recurrent thoughts and obsessive ideas with the decisions that must take are other symptoms that belong to a clinical picture of aboulomanía. In the same way, just as this disorder presents emotional and cognitive symptoms, a series of behavioral symptoms may also appear, such as:

  • Avoidance of responsibilities personal
  • The person avoids being alone by all means.
  • Passive attitude in intimate relationships or as a couple.
  • Avoidance of public exposure for fear of being criticized or disapproved.
  • Avoid ending a relationship to not feel helpless.
  • Problems to express disagreements or disagreements with other people.

What is the cause of this disorder?

For the moment, it has not been possible to determine exactly the cause of the aboulomania. However, it is hypothesized that factors related to the psychological development of the person, together with biological factors They can trigger this type of disorder of the will.

As for the organic root of the aboulomanía, a possible involvement of the prefrontal cortex is speculated. The reason is that this brain area is directly associated with making conscious decisions.

Some studies point to the idea that this organic basis, together with certain authoritarian or overprotective parenting styles, can play a very important role in the development of this disorder.

Researchers theorize that parenting styles in which overprotection and intrusive behaviors predominate on the part of parents can encourage dependence on the child , so if the child has an organic susceptibility it will be quite likely that he will develop a disorder of the will such as an aboulomania.

However, these researchers treat this issue with great caution, specifying that the person must go through many other negative experiences for this disorder to appear. These experiences can range from abandonments or very traumatic ruptures to situations in which the person has felt humiliated or publicly ashamed. Further, they can also generate many doubts and great uncertainty in the person, who is not able to perform any type of activity correctly, nor is she able to assume responsibilities or lead an independent life.

How can it be diagnosed?

The first step in the diagnosis of the aboulomanía is to completely rule out that there is an organic base that produces it. For this, the medical professional must perform all kinds of tests and physical examinations, as well as a complete medical history.

Once eliminated the possibility that there is an organic damage at brain or neurological level, the patient should be referred to a mental health specialist . Then, the psychologist or psychiatrist who is in charge of the case must make a complete clinical history of the patient. For this purpose, the health professional can use the following diagnostic tests:

  • Clinical Multiaxial Inventory of Millon (MCMI-II)
  • Minnesota Multiphasic Personality Inventory (MMPI-2)
  • Thematic apperception test (TAT)

Is there a treatment?

As a general rule, the number of people suffering from an aboulomania who decide to seek help or treatment is very limited. However, due to the symptoms related to anxiety and depression that accompany this disorder, certain patients end up requesting some kind of psychological assistance .

If the mental health expert manages to expose the problem of aboulomania, a symptomatic treatment can be carried out for the anxiety or depression problems together with a training in skills that facilitate the development of the autonomy of the person.

The training in assertiveness techniques and social skills It can be very effective in reducing the symptoms of the aboulomanía, as well as to help the person to establish healthy personal relationships with other people.

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