Abulia in the context of "Melancholic"

Melancholia or melancholy (Ancient Greek: μελαγχολία, romanized: melancholía; from μέλαινα χολή, mélaina cholḗ, 'black bile') is a concept found throughout ancient, medieval, and premodern medicine in Europe that describes a condition characterized by markedly depressed mood, bodily complaints, and sometimes hallucinations and delusions. Besides a pathological condition, melancholy could also refer to a mood or temperament and at times it was even used as a description of the human condition in general.

Melancholy (or more precisely the 'black bile', from which melancholy derives its name) was regarded as one of the four temperaments matching the four humours. Until the 18th century, doctors and other scholars classified melancholic conditions as such by their perceived common cause – an excess of a notional fluid known as "black bile", which was commonly linked to the spleen. Hippocrates and other ancient physicians described melancholia as a distinct disease with mental and physical symptoms, including persistent fears and despondencies, poor appetite, abulia, sleeplessness, irritability, and agitation. Later, fixed delusions were added by Galen and other physicians to the list of symptoms. In the Middle Ages, the understanding of melancholia shifted to a religious perspective, with sadness seen as a vice and demonic possession, rather than somatic causes, as a potential cause of the disease.

Apathy, also referred to as indifference, is a lack of feeling, emotion, interest, or concern about something. It is a state of indifference, or the suppression of emotions such as concern, excitement, motivation, or passion. An apathetic individual has an absence of interest in or concern about emotional, social, spiritual, philosophical, virtual, or physical life and the world. Apathy can also be defined as a person's lack of goal orientation. Apathy falls in the less extreme spectrum of diminished motivation, with abulia in the middle and akinetic mutism being more extreme than both apathy and abulia.

The apathetic may lack a sense of purpose, worth, or meaning in their life. People with severe apathy tend to have a lower quality of life and are at a higher risk for mortality and early institutionalization. They may also exhibit insensibility or sluggishness. In positive psychology, apathy is described as a result of the individuals' feeling they do not possess the level of skill required to confront a challenge (i.e. "flow"). It may also be a result of perceiving no challenge at all (e.g., the challenge is irrelevant to them, or conversely, they have learned helplessness). Apathy is usually felt only in the short term, but sometimes it becomes a long-term or even lifelong state, often leading to deeper social and psychological issues.

Laziness (also known as indolence or sloth) is emotional disinclination to activity or exertion despite having the ability to act or toexert oneself. It is often used as a pejorative; terms for a person seen to be lazy include "couch potato" and "slacker". Related concepts include sloth, a Christian sin, abulia, a medical term for reduced motivation, and lethargy, a state of lacking energy.

Despite the famed neurologist Sigmund Freud's discussion of the "pleasure principle", Leonard Carmichael noted in 1954 that "laziness" is not a word that appears in the table of contents of most technical books on psychology". A 1931 survey found high-school students more likely to attribute their failing performance to laziness, while teachers ranked "lack of ability" as the major cause, with laziness coming in second. Laziness should not be confused with avolition, a negative symptom of certain mental and neurodevelopmental disorders such as depression, ADHD, ASD, sleep disorders, substance use disorders and schizophrenia.

Disorders of diminished motivation (DDM) are a group of disorders involving diminished motivation and associated emotions. Many different terms have been used to refer to diminished motivation. Often however, a spectrum is defined encompassing apathy, abulia, and akinetic mutism, with apathy the least severe and akinetic mutism the most extreme.

DDM can be caused by psychiatric disorders like depression and schizophrenia, brain injuries, strokes, and neurodegenerative diseases. Damage to the anterior cingulate cortex and to the striatum, which includes the nucleus accumbens and caudate nucleus and is part of the mesolimbic dopamine reward pathway, have been especially associated with DDM. Diminished motivation can also be induced by certain drugs, including antidopaminergic agents like antipsychotics, selective serotonin reuptake inhibitors (SSRIs), and cannabis, among others.