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

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

June 24, 2024

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, or trying to achieve their goals, however rational or even simple they may seem. This lack of motivation and energy is what we know as abulia , an extreme form of apathy.

But... What is the reason for this curious psychological phenomenon? Next we will see what produces the abulia and in what ways 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 meet them. The person with abulia presents a low level of vital energy and a practically non-existent interest in stimuli or activities that would have motivated him before. It can be considered an extreme form of apathy.

The abulic subject tends to have severe difficulties to initiate and finish most acts and activities, so it is usual to postpone them. This applies not only to hobbies but also to work aspects and other responsibilities and even basic activities of daily life, such as feeding. It is also frequent to present social difficulties , having no motivation or willingness to relate.

On the other hand, people with apathy have problems when making decisions and organizing their own thinking due to the state of depression that is their psychological state, with slowed thinking. The movements of the subject also tend to present alterations , seeing spontaneous movement reduced and taking longer to respond to the stimulation. People with abulia usually feel helpless and indecisive, sometimes suffering great emotional pain and in others can reach affective dullness.

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


The causes of the abulia can be very varied, depending on which disorder is a symptom. At a 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 initiation of movements. These injuries can be caused by different disorders and diseases, as well as cerebrovascular accidents or traumatic brain injuries.

It can also be caused by different types of infections such as syphilis if it ends up affecting the brain. In the same way, symptoms similar to abulia can be observed in anemic people, with a lack of diverse 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

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


Abulia is a characteristic symptom in people with different dementias such as Alzheimer's , due to the progressive degeneration of cerebral structures that happens in this type of disorders.

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

Major depression

One of the mental disorders in which abulia most frequently occurs is major depression. The state of demotivation, despair and feeling of little control they can end up generating a lack of desire to act, and many times they occur along with the absence of pleasure before pleasurable activities, a phenomenon called anhedonia.


The abulia also may appear in psychotic disorder, as in the case of schizophrenia . In this case we would be faced with a negative symptom that would reduce the ability of the subject to function normally, and it is common to appear next to the alogia. If the existence of different types of schizophrenia is considered, the schizophrenias of disorganized, simple or catatonic subtype are some in which they can appear with more frequency and greater visibility. It can also be observed as a residual symptom after a psychotic outbreak.

  • 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 depend to a large extent on its causes. Treatment can be done both at the psychological and pharmacological levels .

At the psychological level, the use of different strategies applied in cases of depression is recommended. These strategies are based on promote the action and the realization of different activities that are pleasant and gradually awaken motivation and desire to act. Helping and motivating to create and carry out different actions and routines is fundamental, while at the same time 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 family members and the patient's immediate environment, so that they contribute to establishing and maintaining different goals and propositions that generate desire and willingness to act. In some cases Physiotherapy can be very useful in order to cause an increase in motor activity, as well as in sports, which 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. A. (2005). Disorders of diminished motivation. Journal of Head Trauma Rehabilitation, 20 (4).
  • Santos, J.L. (2012). Psychopathology. CEDE Preparation Manual 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.

Schizophrenia - causes, symptoms, diagnosis, treatment & pathology (June 2024).

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