Avolition
A Symptom of Multiple Mental Health Conditions That Is More Than Just a Lack of Motivation
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It is not unusual to experience times when getting things done feels more challenging. But if you have avolition, your lack of motivation is persistent and often distressful. Doing simple everyday tasks can feel like running a marathon or climbing a mountain.
Avolition is common with different mental health disorders. It is more than a lack of motivation. It can be paralyzing and challenging to overcome without medical help. Not getting treatment for it can affect every aspect of your life, from your job to your relationships. But it is manageable once a healthcare provider can pinpoint its underlying cause.
This article will cover what avolition is, its causes, how it is treated, and more.
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Symptoms of Avolition
The term avolition describes a significant decrease in initiation, motivation, and goal-directed behavior. It is not a specific medical health condition but rather a symptom experienced by people with conditions like schizophrenia, bipolar disorder, and depression.
Avolition can make it hard to get things done even if those things have consequences, such as losing a job or disrupting relationships. The research on avolition shows that even when people with this symptom are rewarded, they can still not complete tasks.
For some, avolition is so overwhelming that it makes caring for your health or hygiene physically challenging. Most people who experience avolition are unaware of the symptom until family and friends bring it to their attention.
Signs that might indicate that a person is living with avolition include:
Not bathing and grooming
Lying in bed for hours
Watching the day go by while doing very little or nothing at all
Not showing up to events or meetings you promised you would attend
Ignoring friends' calls, texts, or emails
Having difficulty starting projects and completing tasks at work or school
Feeling uninterested in your work or social activities
Not paying your bills
Missing deadlines
Feeling detached and uninterested in your relationships
It should be noted that avolition is much different than laziness or procrastination. People who live with avolition might feel a type of paralysis, which makes it hard to act, whereas laziness is often a choice. Further, procrastination involves looking for distractions to push a task to a later time.
Causes of Avolition
Some researchers think the link between avolition and conditions like depression, bipolar disorder, and schizophrenia is severe drops in dopamine, a neurotransmitter (chemical messenger of the nervous system) involved in the brain's reward system. That drop causes diminished motivation to the point at which even a reward or consequence cannot push a person to act.
Three common conditions in which avolition may be a symptom are:
Schizophrenia
Schizophrenia is a severe mental health condition affecting how people view reality. It can affect a person's functioning. It requires lifelong treatment, but treatment can get symptoms under control and prevent serious complications.
People with schizophrenia have symptoms that fall into two categories—positive or negative. Positive symptoms are changes in behaviors and thoughts that are abnormally present in people with the condition, such as paranoia, hallucinations, or delusions. A negative symptom is a symptom that is abnormally absent from a person with schizophrenia, such as an absence of emotions, behaviors, or thoughts. Avolition is considered a negative symptom of schizophrenia.
Research shows up to 60% of people with schizophrenia will experience negative symptoms, including avolition. It might coincide with similar symptoms like the inability to make decisions (abulia) or speak (alogia).
Depression
Depression is characterized by anger, sadness, hopelessness, irritability, loss of pleasure, impaired concentration, sleep troubles, or thoughts of death and suicide. The severity of depression is determined by how much symptoms interfere with your daily life. Severe depression is considered a more debilitating depression.
Even though researchers do not know much about the connection between severe depression and avolition, a connection exists. For example, avolition can be found in people who experience sadness, pessimism, being self-critical, and worthlessness as the main symptoms of their depressive disorder.
If you are having suicidal thoughts, contact the 988 Suicide & Crisis Lifeline at 988 to connect with a trained counselor. If you or a loved one is in immediate danger, call 911.
Bipolar Disorder
Bipolar disorder is a mental health condition that causes extreme mood swings of emotional highs (mania or hypomania) and lows (depression). Avolition in people with bipolar disorder seems to have similar severity to people with schizophrenia. It might also be linked to more impairment of function.
The reasons for avolition may differ between bipolar disorder and schizophrenia, according to a 2022 Schizophrenia Research report. For example, people with bipolar disorder who reported more intense sad moods were more likely to report engaging in less productive and more passive activities. Sad moods and unproductive activities could predict poorer everyday functioning.
Other Conditions
Additional conditions that might lead to avolition are:
Stroke (a blockage of blood flow or bleeding in the brain)
What Medications Can Cause Avolition?
Avolition can be a side effect of some medications, especially antipsychotic drugs. These medications can be beneficial for managing positive symptoms of schizophrenia because they help balance the brain's neurotransmitters (chemicals that help brain cells communicate).
While most antipsychotic drugs manage schizophrenia, they can also cause negative symptoms like avolition. There is no recommended drug treatment for negative schizophrenia symptoms in the United States. But the research and awareness of negative symptoms are growing, and newer treatments might be available in the future.
How to Treat Avolition
Since avolition is a symptom, treating it involves managing the underlying cause. For example, if depression or bipolar disorder is the cause, a healthcare provider can treat you with mood stabilizers, antipsychotic drugs, antidepressants, and antianxiety medicines.
With schizophrenia, treatment mainly aims to reduce or stop positive symptoms. The reason for the focus on the positive symptoms is that those are usually worse. Antipsychotic drugs treat schizophrenia and are available as pills, liquids, and injections.
People who experience avolition might be able to respond to medicines in combination with cognitive behavioral therapy (CBT), a type of talk therapy. Electroconvulsive therapy, which uses electrodes to send currents through the brain, may also help to manage avolition.
Self-care strategies might also help to manage the effects of avolition. Such strategies include:
A lifestyle of eating healthy, exercising, practicing good sleep hygiene, and not smoking or overindulging in alcohol
A type of behavioral therapy called social skills training
Social participation
Stress management practices, such as mindfulness meditation and journaling
Asking a loved one to create reminders for essential items like taking medicines, practicing personal hygiene and bathing, appointments, and chores
Complications and Risk Factors Associated With Avolition
Avolition is commonly seen in people with mental and neurological disorders. It is unknown what leads to conditions like schizophrenia, bipolar disorder, or depression, but researchers have identified risk factors.
Such risk factors include:
Genetics
Early adverse experiences, such as trauma and abuse.
Drug and alcohol use
Environmental exposure to toxins
Brain injuries
Experiences related to ongoing medical conditions
While avolition does not lead to physical complications, it can affect every area of your life, from relationships with loved ones and coworkers to how you perform in school and at work. It can deter you from participating in your life and managing your health. Those effects can be detrimental and lead to problems managing the underlying cause.
Are There Tests to Diagnose the Cause of Avolition?
Your healthcare provider or a mental health professional will request various tests to determine the source of the avolition and rule out our causes.
Such testing might include the following:
A physical exam and neurological examination to rule out physical problems that could be causing symptoms
Lab work to check for infections, thyroid or hormone function, or screen for alcohol or drugs
A psychological evaluation of symptoms, thoughts, feelings, or behaviors
Imaging, including a brain magnetic resonance imaging (bMRI) or similar studies, if a healthcare provider suspects brain injury, stroke, or a neurological condition that might contribute to symptoms
When to See a Healthcare Provider
You should seek out mental health care if you have symptoms of a disorder in which avolition presents. This is especially important if other family members have had such conditions.
Even if avolition is absent or you have no family history of mental illness, it is vital to seek medical help for depressed feelings lasting more than a few weeks, if you have thoughts of harming yourself or others, severe mood swings, hallucinations, paranoia, or delusions.
Help is available for avolition and its underlying causes. What you are feeling is not your fault and has nothing to do with a lack of willpower. Avolition and the conditions that cause it are complex and require medical treatment.
Summary
Avolition is a symptom of many different mental health disorders, including schizophrenia, depression, and bipolar disorder. A neurological condition like Alzheimer's disease or a traumatic brain injury might also cause it.
People who live with avolition might experience a sense of motivational paralysis, which makes it hard to act even when the action is rewarding. Signs a person is experiencing avolition include not bathing or grooming, watching the day go by and accomplishing nothing, feeling uninterested in work or school, and feeling detached from personal relationships.
Researchers think avolition might be linked to severe drops in dopamine or medicines that treat schizophrenia. Treatment typically involves managing the underlying cause with medicines, CBT, electroconvulsive therapy, and self-care strategies.
You should seek medical attention if you experience avolition or have symptoms of a condition that might lead to it. A healthcare provider or mental health professional can diagnose its underlying cause and start you on a treatment plan.
