Abulie – causes, treatment


Abulie is a symptom of various diseases, which mainly manifests itself in the form of lack of will and weakness of will. Accordingly, the abulia cannot be treated independently. Rather, after the diagnosis, the focus is on treating the underlying disease.

What is abulia?

Abulia is a pathological lack of will associated with weakness of will, indecisiveness and the inability to make decisions yourself. It is not a disease in its own right, but a symptom of another disease. It is most common in frontal brain diseases, such as tumors , neuroses or depression , as well as in schizophrenic psychoses .

Affected people would like to carry out an action, but are unable to make a decision or carry it out. This applies to work as well as leisure activities and self-sufficiency. Patients can no longer put good intentions into practice, actions are repeatedly postponed and it is not possible to concentrate on the actual project .

Consequently, the person loses their willpower and becomes less and less socially active, which can lead to complete isolation. In addition, the inability to speak as a result of a loss of functional supply to the vocal tract is also referred to as abulia.


The abulia occurs as a result of various diseases. As different as these diseases can be, so are their triggers. However, the pathological lack of will often occurs in the context of depression. This, in turn, can have many causes that have not yet been fully clarified.

What is certain, however, is that several internal and external factors usually interact. These include but are not limited to heredity, alcohol, drugs, certain medications, physical illnesses, mental disorders, stress, and biochemical triggers. The pathological lack of will in connection with a cannabis addiction occurs more and more frequently.

But brain tumors , neuroses or a schizophrenic disorder can also trigger abulia. It is often the result of sadness, listlessness or the impoverishment of emotional life.

Diseases with this symptom

Diagnosis & History

If abulia is suspected, a doctor should be consulted immediately. After all, the diagnosis requires a previous illness, such as a brain tumor, schizophrenia, depression or a neurosis. If such a disease has not yet been identified, the doctor will initiate appropriate examinations. The first point of contact is usually the general practitioner.

He will check your physical health and, in a detailed discussion, investigate the suspicion of various mental disorders. The doctor will then call in the appropriate specialists. They carry out further examinations, including behavioral observations of the patient, neuropsychological tests and interviews with relatives.

Targeted therapeutic measures can only be started as a result. However, it is often problematic that in many cases the weakness of will itself prevents the decision to consult a doctor. As a result, an early diagnosis is only extremely rarely possible. As the disease progresses, abulia is often accompanied by melancholy.

In addition, there may be muteness ( mutism ) or taciturn language with long interruptions and the inability to speak at length. In addition, abulia often leads to social isolation and, in many cases, to alcohol or drug addiction. It is not uncommon for the abulia to end in the patients themselves losing their will to live.


Untreated abulia often leads to permanent melancholy or even depression . Patients often justify their lack of will as a temporary phenomenon based on increased stress . They avoid going to the doctor and take refuge in medication to calm them down or drink more alcohol . This in turn has the consequence that in many cases a dependency occurs.

The abulia can also affect communication with other people. This means that those affected only speak less or not at all. In some cases their speech is slowed down and it is difficult for the other person to follow their train of thought. The large number of drugs requires that the correct diagnosis is made. Common complications in the treatment of abulia are the side effects of the drugs and dependence on the therapist.

For example, patients feel safe under the care of their doctor and can structure their everyday life. Once they are back on their own, their suffering worsens. The danger with medication is not just addiction. They can also cause disturbances in the gastrointestinal tract , libido and heart rhythm. Another complication of drug treatment for abulia is weight gain . Although the patients feel well and manage their everyday life as usual, they suffer from their increased weight.

When should you go to the doctor?

Abulia is initially a general weakness of will. It is a symptom of several different diseases and can only be treated as part of the therapy for the underlying disease. Those affected by an abulia are unable to implement a plan or make decisions – be it professionally or privately. As abulia progresses, people withdraw more and more to the extreme of social isolation. Parallel to this definition, the organically caused inability to speak is also referred to as abulia.

Abulie is mainly associated with frontal lobe diseases, neuroses, depressions and schizophrenic psychoses. The first thing you should do to start therapy is to see your family doctor . After initial examinations, he often refers his patient to a neurologist , psychiatrist , psychologist or psychotherapist . The abulia should be treated as soon as possible.

Otherwise, there is a risk of depression manifesting itself, as well as the abuse of alcohol or pills in order to be able to bear the situation better, which, however, would create new health problems and start a vicious cycle. In the treatment of abulia, it has proven helpful to involve the patient’s relatives, who act as co-therapists, so to speak.

Treatment & Therapy

Abulia is not an independent disease, but a symptom of another disease. Because of this, she herself cannot be treated. Rather, it is important to treat the underlying disease first. If the pathological lack of will occurs, for example, in the context of depression, the treatment of this disease is in the foreground.

In this case, both medication and psychotherapeutic measures can be prescribed. It is important that all underlying diseases are identified first, as there are often several mental disorders present at the same time. In this case, only a holistic therapeutic approach can lead to success. Relatives are also regularly involved in this process.

Depending on the disorder pattern and behavioral problems, there are different forms of therapy. Some approaches focus on problem-solving skills and behavior management. Other approaches, on the other hand, are dedicated to manipulating or modifying the patient’s environment. In any case, it is helpful if Abuli affected persons clearly structure their daily routine and concentrate on a few tasks.

This can prevent failures that would otherwise lead to self-doubt and increase weakness of will. A written daily schedule and checklists can be very useful. They can provide relief and counteract the constant postponement of certain actions. In addition, patients usually require external assistance in carrying out their daily tasks, as well as encouragement and appropriate praise. Relatives are often brought in as co-therapists.

Outlook & Forecast

The prognosis for an abulia always depends on the underlying condition. If the symptoms are due to depression or schizophrenia, the weakness of will can become even worse. However, if the cause is recognized early and treated adequately, the abulia also decreases over time. However, automatisms that have already formed can still cause difficulties in everyday life for those affected for a long time after recovery.

Depending on the severity of the abulia, therapy can have a positive effect on the course. Abulia as a result of a psychosis can also be treated effectively with rapid measures. The prognosis for an abulia is accordingly positive. Therapy can also increase the chances of success in the case of a weak will as a result of a neurosis or other mental disorders.

Since the abulia can lead to the development of a wide variety of problems, and procrastination can often lead to exclusion from social life, the treatment is a lengthy process that is often associated with setbacks. However, the outlook is positive if the right measures to treat the abulia and the underlying cause are taken early on.


In order to prevent abulia, a timely diagnosis of the underlying disease is necessary. For example, it helps if depression is recognized at an early stage. In this case, professional therapeutic measures can be initiated even before a pathological lack of will sets in and the patient is completely isolated.

If abulia-promoting diseases occur, the environment of the affected person must be very attentive. You should regularly monitor the patient’s behavior and inform the doctor of any abnormalities.

You can do that yourself

Depending on the underlying disease, those affected can support the treatment of pathological lack of will with self-help measures. The transition from outside help to self-help is fluid. Coping strategies learned in therapy must be independently integrated into everyday life. This also reduces the risk of relapse.

In order to counteract an apathetic, listless mood, a structuring daily plan in writing is helpful, which makes it difficult to repeatedly postpone activities. Excessive demands and unrealistic goals should be avoided. It makes sense to prioritize daily goals and to balance unpleasant and pleasant activities.

A daily and weekly schedule developed in this way offers important planning assistance on the one hand and serves as motivation through documented healing successes on the other. Checklists are recommended as relief for recurring, complex tasks. Those affected ensure contact with relatives and friends through regular meetings with binding appointments. Self-help groups and patient clubs also offer the opportunity to counteract social withdrawal and isolation.

Depending on the underlying main diseases, those affected can practice mindfulness exercises in everyday life to distinguish between healthy withdrawal and self-protection behavior on the one hand and pathological lack of will on the other. Some patients benefit (depending on their individual life situation) from living with pets. They offer occasion and motivation to get out of the paralyzing lack of will. It is important that there is no additional pressure and that being together with the animals can be experienced positively.

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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.