It's normal to drag your feet when you have an annoying chore to do. But if you have "avolition," your habit of putting off a task is on a whole different level.
Avolition is a total lack of motivation that makes it hard to get anything done. You can't start or finish even simple, everyday tasks. Getting off the couch to wash the dishes or drive to the supermarket can feel like climbing Mount Everest.
If you don't get treatment, avolition can affect every part of your life, from your relationships to your job. It's hard to take care of yourself or your home when you don't have the drive to do anything.
Medicine and therapy can help treat avolition when it's caused by schizophrenia. You may need to try a few different types before you find one that helps.
What Causes Avolition?
Besides being a symptom of schizophrenia, avolition is also a side effect of some medicines. Some of the antipsychotic drugs that you take to treat schizophrenia can also cause it.
One theory is that a drop in dopamine causes avolition. When you have less dopamine, you have less motivation. You may not want to do anything if you don't think you'll get rewarded for it.
Avolition is also a symptom of severe depression and other conditions, such as:
- Bipolar disorder
- Persistent depressive disorder (dysthymia)
- Premenstrual dysphoric disorder (PDD)
- Posttraumatic stress disorder (PTSD)
- Traumatic brain injury
- Alzheimer's disease
People who don't get enough mental stimulation can also have avolition. For example, you could get it if you sit alone in bed all day, perhaps because of an illness. It could also happen to prisoners in solitary confinement.
Signs of Avolition
If you have avolition, you might find that you don't wash or groom yourself like you should. You might not show up for meetings or events that you had planned to attend.
You also might not respond when friends call, text, or email. You won't put in any effort at work or school. You might not pay bills or take care of other everyday tasks.
It's possible you may not notice these symptoms are happening. A friend or family member might have to point them out to you.
A mental health professional such as a psychologist or psychiatrist can diagnose avolition. You'll see one of these doctors if you have symptoms of schizophrenia, severe depression, or other disorders that cause avolition.
If your doctor thinks schizophrenia is behind your avolition, he will try to rule out medical conditions, drugs, or injuries that cause the same symptoms as schizophrenia.
To get a schizophrenia diagnosis, you need to have two or more of these symptoms:
- Disorganized speech, like jumping from one topic to another or using combinations of words that don't make sense
- Disorganized behavior, such as acting in an unusual way or not moving (catatonic)
- What doctors call "negative" symptoms, such as a flat tone to your voice, less enjoyment in life, or avolition
Your doctor may use a questionnaire to figure out your symptoms and see if you have avolition or similar problems, such as:
- Alogia (lack of talking)
- Asociality (not motivated to be social)
- Anhedonia (inability to feel pleasure, which can lead to a lack of motivation)
Antipsychotic drugs are the main treatment for schizophrenia, whether or not you have avolition with it. These drugs affect dopamine levels in the brain. They work very well for symptoms like hallucinations and delusions, but they don't help as much for avolition. Sometimes antipsychotic drugs can make avolition worse.
Newer, second-generation antipsychotic drugs may work better for avolition or similar symptoms than older ones:
- Aripiprazole (Abilify)
- Clozapine (Clozaril)
- Iloperidone (Fanapt)
- Olanzapine (Zyprexa)
- Quetiapine (Seroquel)
- Risperidone (Risperdal)
- Ziprasidone (Geodon)
Antidepressant drugs may also help some people. Sometimes medications to treat memory or thinking can also help.
Besides medicine, you might try cognitive behavioral therapy (CBT), art therapy, or social skills training.
It can take a few tries to find a treatment or combination of treatments that helps you. If you still have avolition after treatment, see your doctor again to try something new.