Weak will: what to do if you can’t force yourself to act

Abulia is a pathological lack of will in a person. The word "Abulia" is of ancient Greek origin and consists of two particles a - the universal negative particle, and boulia - will.
The patient becomes extremely passive and uninitiative. All this happens due to lack of will. But what is will and what is its role in our lives?

Will is a very important mental function. Without it, we turn into passive, as they say, plants that cannot satisfy even their basic needs. It is an independent component of mental activity, and the most important component in the structure of the psyche for the implementation of many mental processes (memory, attention, thinking, motor activity). With the help of will, a person can control his behavior, take purposeful actions, satisfy his needs and move towards goals.

The first function of the will is incentive. With its help, we can take action, move towards a goal, provide for our needs and overcome obstacles that arise along the way. The incentive function manifests itself both in large-scale situations and in the most ordinary ones. The moment you get up from the couch to grab a bite to eat and the moment you spend years moving to the top of the career ladder - all this is an incentive function of the will.

But it is important to understand that not all human activity is dictated by will. For example, when a stone flies at you and you dodge it, this is not will, but a defensive reaction. This action of yours is determined by the situation that has arisen, and not by your will. The difference between volitional action is its arbitrariness and goal orientation.

The second function of the will is inhibitory. Its main task is to stop those desires and impulses that are undesirable for a person’s behavior in a particular situation. That is, with the help of volitional inhibition, a person can stop or prevent those of his actions that contradict his beliefs, worldview and upbringing. I.P. Pavlov believed that volitional inhibition requires more significant effort from a person than active action.

Signs of abulia

The main signs of abulia are lack of will. What happens to a person whose willpower is significantly reduced?

Abulia is a medical term for a painful state of lack of will in a person. He cannot perform even basic actions and does not find the strength to make a decision. Even if this decision is extremely necessary, and he realizes it.

A less pronounced condition, characterized by a decrease in desires, motives and volitional activity, is called hypobulia. Compared to abulia, in this case the will is not completely absent, but is only in a weakened state. Patients have difficulty choosing a goal and concentrating on it. They are lethargic, passive, indifferent and can also remain in one position for a long time, as with severe abulia.

It is important to note that abulia is not an independent disease. Experts always consider a painful lack of will as part of certain mental or neurological diseases.

These are neurological diseases such as organic brain lesions: tumor, traumatic brain injury and brain atrophy. In rare cases, this syndrome may occur in people who have had a stroke. Abulia can be caused by a lack of blood circulation to the brain, damage in the frontal lobe, anterior cingulate cortex or basal ganglia.

Abulia is observed in mental illnesses such as depression, schizophrenia, and atrophic processes in the brain.

There are also cases of congenital abulia with severe mental retardation, the so-called. apathetic oligophrenia.

Errors leading to complications of the disease

The most important mistake of loved ones is encouraging a disease such as abulia. The types of agitation in illness vary. Often, loved ones themselves push the disease to develop. They feel sorry for the patient and let him wallow in his indifference to life. To the point that the patient begins to enjoy his position as a victim.

Such actions are unacceptable. You should not feel sorry for the patient, but shake him thoroughly. There is no need to give the opportunity to hide and withdraw into yourself. Keep the patient occupied with whatever you want. It is best to do something together so that the person feels close and at the same time under observation. For example, cooking together, coloring pictures, various crafts when it comes to children.

Be attentive to yourself and your loved ones!

Abulia with depression

Typically, as already mentioned, abulia is observed in depression, schizophrenia, dementia, and sometimes after a stroke.

Abulia, that is, a decrease and loss of impulses, is not only an element of a mental defect in schizophrenia, but no less expressively occurs during a period of depression. Here, abulia is reversible synchronously with the elimination of the depressive syndrome. With depression, abulia is much better understood by patients than with schizophrenia, and, moreover, it differs in that it is painfully experienced by patients, accompanied by complaints and a desire to get rid of it. Often, depressed patients, when describing their condition, put abulia first and say that they cannot bring themselves to do even the most basic things - get up, get dressed, cook something, wash, and everything else. Thus, the independent nature of this symptom, which is not at all an integral part of the apathetic defect, becomes clear. And the reversibility of abulia demonstrates that this disorder can, in principle, be corrected in patients with apato-abulia defect. In the self-esteem of depressed patients, the reversibility of abulia is usually perceived by them as an encouraging sign of upcoming recovery, which indeed reflects the parallelism of the severity of abulia and hypothymia (depressive affect or low mood).

Abulia. Symptoms

What are the symptoms of abulia? Patients may be aware of their lack of initiative, passivity, lack of desires and motivation. In the early stages, abulia can be perceived as ordinary laziness. Therefore, this decrease in volition, as a symptom of the disease, must be diagnosed by a doctor.

Patients suffering from abulia do not experience any urges. They are partially or even completely weak-willed, have no motivation for action, are passive, and do not show initiative in activity. Their actions and thinking are essentially slowed down. If you ask a patient with abulia a question, he will answer it not immediately, but after some time. It gets to the point that a person in this condition cannot even eat, drink, take a shower or wash himself. Lack of will can develop to the point of inability and unwillingness to provide all one’s basic vital needs.

Abulia is classified according to its dynamics. It is this approach to classification that helps to better select the optimal treatment and give a prognosis for the development of the disease. Pathological lack of will is divided into short-term, periodic and permanent.

With short-term abulia, the patient retains the will and awareness of actions, but it is difficult for him to do something. It is diagnosed with asthenic syndrome, neurotic disorders and adynamic depression.

Periodic abulia is observed in depression and depressive-delusional symptoms in schizophrenia.

With constant abulia , as the name implies, lack of will accompanies the patient constantly, and it is difficult to treat. Persistent abulia occurs with increasing schizophrenic apatho-abulic defect, traumatic brain injury and atrophic processes in the brain.

Diagnosis of abulia is carried out by a psychiatrist. For diagnosis, observation of the patient and his behavior is necessary. Collecting information can take a long time, from several days or more. To clarify the diagnosis, computed tomography (CT) and magnetic resonance imaging (MRI) are also performed. Using these methods, organic brain lesions can be detected.

Treatment

Once abulia is diagnosed, treatment will depend on the underlying disease that caused the symptoms:

• for schizoid disorders, antipsychotics are prescribed;
• For depressive conditions, antidepressants are prescribed.

The drugs are prescribed by a psychiatrist, and the following procedures may also be prescribed:

• swimming;
• medicinal baths;
• oxygen therapy.

If the apathetic state is diagnosed in a severe form, then therapeutic measures, unfortunately, do not give the desired result. The prognosis in this case will be unfavorable.

Mild forms of pathology can be treated with the help of complex therapy and help a person return to normal life.

Apato-abulic syndrome

Patients with apatico-abulic or apatico-abulic syndrome (defect) are characterized not only by abulia, but also by emotional emasculation. In the affective sphere, this is emotional impoverishment, indifference, including coldness towards loved ones, their problems or achievements. These changes that occur in a patient with schizophrenia increase gradually. The final stage of the apato-abulic defect in patients with schizophrenia, as already mentioned, is a constant stay in bed, when they are unable to provide for their vital needs and do not monitor hygiene. They may not wash, not get a haircut, and sleep in bed in outerwear. In extreme cases, they even defecate on themselves. There is no way to attract such patients to activity, because they lose not only their will, but also their desires. They speak little, or their speech is monotonous and unemotional. Interacting with other people is not at all interesting for them; they refuse to communicate under the pretext of fatigue.

There are various characteristic combinations of abulia with other disorders. For example, if a person experiences immobility with abulia, this condition is called abulic-akinetic syndrome, which may be a possible sign of a pathological process of frontal callous localization. In the case of apathy (indifference, decreased emotional reactions) with abulia, this is apathetic-abulia syndrome, which is the main variant of the schizophrenic defect.

Types of violation of will

Abulia is an extreme state of impaired will. When a person no longer wants to decide anything. Even those things that were previously important to him become indifferent.

But this condition can be prevented if you notice it at the initial stage, which is called hypobulia. At this stage, a person begins to change, and close people can notice this if they pay enough attention. First of all, appetite is lost, and the patient begins to fade away, painful facial features appear. Sexual desire decreases, a person stops usual activities. For example, those who like to read give up their habit and just sit, looking out the window.

Apato-abulic syndrome in schizophrenia

Apato-abulic syndrome most often occurs in schizophrenia. Patients who begin to develop these symptoms gradually, from mild passivity and indifference, reach complete emotional coldness and indifference.

Abulia is one of the main symptoms of schizophrenia. In such patients who suffer from this mental disorder for a long time, emotional decline occurs, the schizophrenic apatho-abulic defect increases, in which a weakening of the will and an increase in abulia are observed. The longer the schizophrenic process proceeds, the more passive the patient becomes, eventually ceasing to care for himself, monitor his diet and hygiene, spending most of his time in bed. Zharikov N.M. recalls this in the “Textbook of Psychiatry” for 2002. Sometimes in these patients with a pronounced apatho-abulic defect in schizophrenia, parabulia is observed - a perversion of the will, when basic physiological drives can be disinhibited, for example, excessive sexuality and gluttony are observed.

Abulia. How to treat the disease

How to treat abulia? Treatment for abulia is aimed at the underlying disease of which it is a symptom. Medications used in the treatment of abulia include antidepressants, antipsychotics, nootropics, and cholinesterase inhibitors.

To treat apato-abulic syndrome (defect) in schizophrenia, antipsychotic drugs with an activating spectrum of action are used. Some authors recommend psychostimulants. However, in this case you need to be extremely careful, because the use of these drugs can lead to exacerbation (resumption) of productive symptoms, increase delusions and hallucinations. A psychiatrist must select the correct drug treatment that will have a beneficial effect on apatho-abulic manifestations in patients with a mental disorder.

Modern medicine has learned to cope with many diseases, and a good specialist can help most patients. The main thing is to seek help in time and not delay. Then the chances of returning to your usual lifestyle and enjoying every new day increase.

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Treatment

To get rid of abulia, it is necessary to treat the underlying disease. Treatment is comprehensive, including the use of medications and psychological support.

Depending on the underlying pathology, appropriate therapy is prescribed:

Additionally recommended:

• physiotherapy - helps improve the performance of the nervous system;
• phototherapy;
• medicinal baths;
• swimming.

Psychological help:

1. Finding a hobby or interesting activity. It is aimed at overcoming the barrier of loss of interest.
2. Involvement in social activities helps relieve the patient from the feeling of uselessness.
3. Overcoming pity. Often patients harbor this feeling within themselves; sympathy and compassion only worsens their condition.