Mental health conditions
Avolition: Symptoms, causes, and treatment options
Avolition is a severe lack of motivation linked to depression and other conditions. Learn signs, causes, and how to get help and treatment.
By Ryan DeCook, LCSW • Clinically reviewed by Michael Heckendorn, LPC, NCC
You’re watching the hours go by. There are things that need to get done, but they keep not happening. It feels like you’re paralyzed, stuck in quicksand, and unable to move.
This experience, which is felt by so many, is called avolition. It’s often related to mental health disorders such as depression or schizophrenia, but it can also be a result of medication side effects or a traumatic brain injury.
This guide explains what avolition is, how it shows up in daily life, what causes it, how it differs from laziness, and how treatment can help. While avolition can feel like a mountain you can’t climb, it’s a well known symptom and there are ways forward.
What is avolition?
A lack of motivation, struggling to get active, and an inability to keep up on important life activities are all aspects of avolition. Put simply, it just feels very hard to do the things you know you need or want to do. Avolition is often described as a negative symptom, meaning the absence of something normally present, like motivation or drive.
Sometimes, avolition takes away the desire to do things. Other times, some desire is there, but it feels impossible to start or continue a task.
Still, avolition is different from laziness or procrastination. Avolition is like an engine that has no fuel in the tank. You lack the drive to accomplish things and it’s often related to an underlying mental health condition. It is not a character flaw.
Laziness, on the other hand, is usually considered more of a choice and related to a person’s willpower. Procrastination means avoiding tasks or using less important distractions to push important tasks to a later time.
Signs and symptoms of avolition
Avolition can impact multiple areas of a person’s life: motivation, behavior, emotions, and daily functioning.
The specific signs include:
- Lack of interest and motivation. It feels difficult to muster the drive to do much of anything. Things you normally like to do don't sound very interesting.
- Difficulty starting and finishing tasks. The lack of drive can make it feel impossible to start tasks or get things done. Even if you know they are important things, you struggle to be productive or do things you need to do.
- Poor performance. The challenge of getting things done can impact areas of life that require productivity like school or work. Grades or performance reviews might suffer as you miss deadlines or aren’t able to get things done.
- Long periods of inactivity. It feels easy to stay in bed for long periods of time. Hours can pass without doing much at all.
- Neglecting self-care and hygiene. You struggle to take care of yourself and your environment. You might not shower, brush your teeth, or shave. Things might be piling up in your home.
- Emotional numbness. You can’t feel much emotion. Normal emotions are mostly gone and you just feel flat.
- Lack of expression and connection. You can’t express or share much emotion. When you don’t have much feeling, it’s hard to share feelings with others. This can leave you feeling disconnected from others.
- Withdrawal and isolation. You don’t feel like being around other people. Since it feels hard to connect, it may seem easier to isolate and be alone. You might avoid making plans or responding to friends or family reaching out.
Causes of avolition
Avolition is not something that usually happens on its own. It typically comes from an underlying mental health or neurological condition.
The main causes include:
Depression
Avolition often shows up in depression through the intense lack of motivation and interest in normal activities. That lack of drive can lead to being less active and to isolating, which can worsen the other symptoms of depression — including low mood and low self worth.
Bipolar disorder
Mood swings from the highs of mania to the lows of depression mark bipolar disorder. (Bipolar disorder involves shifts between elevated mood states and depressive episodes. In Bipolar I, these elevated periods are called mania; in Bipolar II, they involve a milder state called hypomania.) Avolition is not typical during a manic state. However, it’s common during a state of depression and can occur even during a more stable state. It’s experienced similarly with low motivation, interest, and activity levels.
Schizophrenia
Schizophrenia is a complex mental health condition that can affect how a person perceives reality, thinks, and functions. It can involve experiences like hallucinations or delusions, as well as negative symptoms like avolition. Individuals with this disorder also often experience symptoms such as avolition. Avolition usually shows up with reduced enjoyment (anhedonia), social isolation, and emotional difficulties. Avolition can also sometimes combine with reduced speech (alogia) or difficulty making decisions.
Brain injuries or neurological conditions
Traumatic injuries to the brain can cause impairments that lead to avolition. These are usually caused by a blow to the head or other physical trauma to the brain.
Neurological conditions such as Alzheimer's can relate to avolition as well. As Alzheimer's progresses, it can contribute to depression, avolition, and reduced engagement with one's environment.
Medication side effects
Certain medications, especially antipsychotic drugs for schizophrenia, can lead to side effects of avolition. While the medications help with the psychotic symptoms of hallucinations and delusions, they can sometimes lead to other unhelpful symptoms.
How to manage and treat avolition
There are several ways to treat avolition. These typically focus on treating all symptoms and causes of the related mental health disorder. Treatments can often be used together.
These different approaches include:
Therapy
There are several types of therapy that can be applied to help the internal thoughts, feelings, and behaviors (or lack of behaviors) related to avolition.
Cognitive behavior therapy (CBT) can be applied for depression, bipolar disorder, and schizophrenia. It helps people to notice and shift negative thoughts that can relate to a lack of feelings and inactivity. CBT for psychosis (CBT-p) was developed to specifically help people with schizophrenia.
One aspect of CBT that can be really helpful for avolition is called behavioral activation (BA). BA helps to structure goal-directed activities in a manageable way by breaking them down into smaller steps. This structured way of planning activities can help people get active which can positively impact their mood and lead to doing more activities.
Motivational interviewing (MI) can be used for people who aren’t sure if they’re ready to start getting active again. This is a method where the therapist asks structured questions to try and help identify and draw out a person’s internal motivation to change. MI isn’t a fix for avolition on its own, but it can help people participate in treatment more fully. It has proven to help with engagement when combined with another therapy such as CBT.
Medication
While there is no medication specifically approved for avolition, there are medications that can impact avolition by helping the underlying mental health disorder. Antidepressant medications and mood stabilizers for bipolar disorder can be useful. There are certain antipsychotics that have shown promise in helping people experiencing avolition with their schizophrenia.
It’s a good idea to speak with a psychiatrist or psychiatric nurse practitioner about medication options or other avenues if medication side effects are causing avolition.
Lifestyle and self-management strategies
Exercise has meaningful research support for helping with avolition, especially in schizophrenia. Healthy sleep routines, diet, and social interactions all have benefits for mental health challenges.
But if you’re struggling with avolition, how can you make these happen?
Start by breaking what you want to do down into the smallest steps that feel realistic. Maybe hanging out with friends feels like too much, so start with one text. Or going for a run sounds like climbing a mountain, so start with walking to the end of your block and back. Reward yourself after doing these small steps with something you enjoy: a favorite song, a nice snack, a moment of self-compassion. Small steps and rewards can be the foundation to start building repeated routines that help build positive momentum.
If you or someone you know is in crisis, support is available. Call or text 988 (Suicide & Crisis Lifeline), text HOME to 741741 (Crisis Text Line), or call 911 for a mental health emergency.
Getting help when motivation feels impossible
Avolition is a difficult but treatable condition; there are ways to treat the underlying mental health conditions that are causing it. A therapist, psychiatrist, or psychiatric nurse practitioner trained to deal with depression, bipolar disorder, or schizophrenia can help identify what's driving your avolition and build helpful support around it.
Finding a mental health care provider is easier than ever with a directory like Headway. You can filter through options based on your preferences. Once you find someone you like, you can verify your insurance, get upfront cost estimates, book instantly, and get started.
This content is for general informational and educational purposes only and does not constitute clinical, legal, financial, or professional advice. All decisions should be made at the discretion of the individual or organization, in consultation with qualified clinical, legal, or other appropriate professionals.
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