What Is Avolition?
This article will further define avolition. It will also talk about the symptoms, causes, diagnosis, and treatment of the condition.
Avolition refers to the lack of drive or motivation to complete tasks. More specifically, these are tasks with an end goal, such as grocery shopping or paying bills. Reward anticipation, generally the feeling of satisfaction upon completion, is not enough to encourage a person with avolition into taking action. In schizophrenia, bipolar disorder, and severe depression, medical professionals consider avolition a negative symptom.
The inability to complete routine tasks can make it challenging to go about your everyday life, maintain relationships and a job, and complete health-related tasks such as washing yourself. For these reasons, healthcare professionals consider avolition a negative symptom as they indicate the loss of ability to experience or do things.
Avolition is different from avoidance. Those with avolition are not avoiding certain activities or outright choosing not to complete them. Instead, they cannot act.
If you experience avolition, you will likely feel incapable of completing tasks. You may notice that you are having difficulty completing health-related tasks. For example, you may not be washing or grooming yourself properly, eating well, or exercising.
Additionally, you will typically find it hard to start or finish everyday tasks such as paying bills, grocery shopping, or keeping appointments. Those close to you may notice avolition as you withdraw from your life. For example, you may withdraw from social events, stop responding to texts, calls, and emails, or may not show up to events you planned to attend.
Symptoms of avolition you may notice include:
- allowing trash, dishes, and household items to pile up
- having an inability to get out of bed for hours
- having a lack of self-grooming
- getting barely anything done during a day
- not showing up to appointments
- not paying bills
- being unable to start projects at home or work
- ignoring friends and family members who try to contact you
- having challenges with making eye contact
- feeling uninterested or detached from relationships
- having difficulty talking with others
In public, colleagues at work or school may notice your lack of effort. When you do engage in conversation, avolition may appear as disjointed and dull mannerisms of speaking.
Avolition often looks and feels like a person receives no enjoyment from life and has little to no enthusiasm for living. The severe lack of motivation can make it impossible to muster the energy and enthusiasm for many parts of your routine.
Symptoms of avolition that others may notice include:
- reticence to participate in events or gatherings
- avoidance of social contact, including phone calls, texts, or email
- does not make eye contact during conversation
- disjointed or limited speech
- difficulty starting or finishing projects
- no enthusiasm on special occasions
- repeatedly failing to show up for appointments or meet deadlines
Avolition is a significant lack of motivation and is not the same as laziness or irresponsibility. Those with avolition may feel paralyzed, making them incapable of acting, unlike laziness which is often a choice or willful act. Furthermore, avolition is different than procrastination, or the search for distractions to put a task off until a later time or date.
If you experience avolition, you may or may not notice these symptoms in yourself. However, if you do not recognize that you have avolition, a friend or relative may need to point them out to you.
There are a few different situations in which avolition can occur. Most commonly, avolition is a symptom of schizophrenia. However, avolition can also occur with bipolar disorder and severe depression. Finally, avolition may be a side effect of specific medications such as antipsychotic drugs.
Avolition in schizophrenia
Healthcare professionals consider avolition a negative symptom in those with schizophrenia. Medical experts believe that the brain chemical dopamine may be the link between the condition and avolition.
Dopamine is the chemical associated with the reward system of the human brain. Decreased dopamine may be linked to a lack of motivation that is connected to the believed lack of reward which may make it difficult to start or complete tasks.
However, medical experts still do not completely understand why some individuals develop avolition. Factors that can contribute to avolition and schizophrenia may include:
- brain development
- pregnancy or childbirth complications
Those experiencing avolition in schizophrenia may have other negative symptoms, including:
- Anhedonia: This means being unable to experience pleasure or anticipate reward.
- Affective flattening or blunting: This is the inability to express or show feelings with speech and body language.
- Alogia: This is a difficulty in carrying on a conversation due to problems following discussion and forming thoughts.
- Attentional impairment: This is difficulty concentrating and focusing.
- Anosognosia: This means a lack of awareness or the inability to recognize mental illness within yourself.
Sometimes, the above symptoms are combined and listed as avolition because they are similar and interrelated.
Avolition in other conditions
Schizophrenia is not the only condition in which avolition can appear. The following disorders can also present with avolition as a symptom:
- severe depression
- bipolar disorder
- premenstrual dysphoric disorder (PDD)
- persistent depressive disorder
- post-traumatic stress disorder (PTSD)
- Alzheimer’s disease
- traumatic brain injury (TBI)
Additionally, those who do not receive enough stimulation, including individuals in solitary environments, can also develop avolition.
A mental health professional will typically diagnose avolition.
In most cases, you will see a mental health professional if you have symptoms of a disorder in which avolition presents, such as schizophrenia, severe depression, or bipolar disorder. If your mental health professional believes one of these disorders may be the reason behind your avolition, they may try to rule out other causes, like traumatic brain injury or medications.
Diagnosis of disorders like schizophrenia can take time and often have a standardized process. Your doctor will make sure that you meet the criteria of having two or more specific symptoms, including:
- disorganized speech
- disorganized behavior
- negative symptoms, including avolition
They may also ask you to complete a questionnaire that helps them determine if you have other symptoms or similar issues.
Since avolition is a symptom and not a disorder, a diagnosis of avolition often comes with identifying a disorder.
Treating avolition often focuses on treating the disorder causing it. For example, if avolition is a result of schizophrenia, your mental health professional will typically work to treat you for schizophrenia.
In the case of this disorder, your doctor may prescribe antipsychotic medications. These medications affect your brain’s dopamine levels and work to correct neurotransmitter levels, which may or may not help with avolition. In some cases, avolition may worsen with medication use.
Antipsychotic medications include:
Side effects may be common with many of these medications. Side effects may include:
- slowness or sluggishness
- abnormal tongue and jaw movements
- sexual issues
Second-generation antipsychotics, like clozapine, tend to produce fewer side effects. However, having elevated cholesterol, blood sugar levels, or triglycerides is often associated with newer antipsychotic medications.
If taking your medications is part of your avolition treatment, some antipsychotic drugs are sometimes given by injection bi-weekly, monthly, or four times a year.
Treatment may also include an antidepressant. Some individuals will need to take antipsychotic medications with antidepressants to manage their symptoms.
Along with medication, therapies such as cognitive behavioral therapy (CBT), a kind of talk therapy, or electroconvulsive therapy, in which electrodes send currents through your brain while you are under anesthesia, may help. Furthermore, self-care strategies such as the following may help:
- social skills training
- art therapy
Finding a combination of treatments involving medication and therapy is often recommended.
Avolition is a symptom often associated with mental health disorders like schizophrenia, bipolar disorder, and severe depression. This lack of motivation is often mistaken for laziness. However, it is more than being lazy. Avolition makes it nearly impossible to begin or complete certain tasks.
Treatment can help reduce avolition because it focuses on managing the disorder causing it. Working with your doctor to find a combination of treatment options for the disorder, like schizophrenia, can help you live a fulfilling, independent, and productive life.
If treatment is not producing the desired result, you should talk with doctor about other treatment options. In addition, mental health agencies can provide information and resources regarding support for housing, employment, healthcare, and other basic needs.