Amotivational Syndrome: Definition, Causes, & Treatment

What Is Amotivational Syndrome?

Amotivational syndrome is a term first coined in the late 1960’s to describe a collection of symptoms believed to be caused by chronic, heavy use of cannabis.¹ Common symptoms include feelings of apathy or detachment, and a general lack of motivation, focus, and follow through in daily tasks and activities.^{2, 5, 6}

Since its origins, amotivational syndrome has been the source of controversy and debate within the field of addiction and mental health, and is not officially recognized as a stand-alone clinical diagnosis.^{3, 7, 8} Studies on the condition have provided mixed results, but some have continued to substantiate it as both a real and debilitating experience.^{3, 5, 7}

Amotivational symptoms have been documented in people who use marijuana, methamphetamines, and other illicit drugs.^{1, 2, 4} Less commonly, it may also affect individuals prescribed SSRI antidepressants.⁹. It is interesting that both major depressive disorder and this treatment option can cause amotivational syndrome.^{7, 10}

Amotivational Syndrome Symptoms

Because the DSM 5 does not officially recognize amotivational syndrome as a diagnosable disorder, there isn’t a standardized set of symptoms used by clinicians to identify it. Instead, amotivational syndrome is regarded as a feature of certain substance use disorders and may also be experienced by some people with schizophrenia.^{2, 5}.

Common symptoms of amotivational syndrome include:^{1, 2, 3, 6}

• Feelings of apathy or emotional numbness
• Feeling detached, indifferent, or disinterested
• Blunted or restricted emotions
• Lack of motivation to complete tasks or engage in activities
• Withdrawing from activities and routines
• Trouble focusing and concentrating
• Problems with memory or short-term amnesia
• Becoming more withdrawn or less active, productive, and social

It’s important to note that many of these are also symptoms of depression. A person who believes they have amotivational syndrome may actually be struggling with depression.^{1, 4, 8}

Additionally, seeing as amotivational syndrome is closely linked to substance use, it’s likely that many symptoms may subside if a person stops using the substance.⁶ However, one should never stop taking their prescribed medication without the guidance of a physician.

Signs of Amotivational Syndrome

Research suggests that amotivational syndrome occurs either as an adverse effect of a prescribed or illicit substance, or as a result of another psychiatric, neurocognitive, or addictive disorder.^{1, 3} Depending on the causes and contributing factors, the signs of amotivational syndrome can vary.^{1, 4}

Common signs of amotivational syndrome include:

• Demotivational effects: Not feeling driven or motivated to do things; a loss of ambition or drive; not feeling able to begin or finish something.
• Anhedonia: Feeling less interested and excited to do things one used to enjoy, and not being able to find pleasure in those activities.
• Blunted emotions: Feeling unable to experience a full, normal spectrum of emotions; feeling like one’s emotions are less intense than normal.
• Impaired cognitive function: Having trouble thinking clearly, concentrating on things, remembering things, or having ‘brain fog.’
• Apathy: Feeling indifferent or uninterested in people, things, and activities normally enjoyed; feeling detached or ‘not caring about anything.’
• Lower productivity: Being less active and productive at work, in one’s personal life, or both; increased procrastination; feeling like small tasks are too draining.

Causes of Amotivational Syndrome

Studies confirm that the symptoms of amotivational syndrome are very real and debilitating, though their exact cause isn’t known.^{6, 7}

Possible causes of amotivational syndrome include:

SSRI Antidepressants

One study found that as many as one in three people prescribed an SSRI will experience apathy or emotional indifference, and up to 40% reported a loss in motivation.¹¹ These side effects are more likely to occur for those prescribed higher doses.^{6, 11} It’s believed that in SSRI-induced amotivational syndrome, the cause of the symptoms is an imbalance in brain chemicals like serotonin that interfere with the prefrontal lobe’s functioning.⁶

Illicit Substances

Amotivational syndrome is closely associated with chronic intoxication, especially from certain drugs.⁸ In particular, chronic, heavy cannabis is closely linked to a lack of motivation, and can also cause many of the other cognitive impairments associated with amotivational syndrome.^{5, 12}

Methamphetamine use disorder may also result in amotivational symptoms. However, using any addictive drugs will affect certain brain chemicals, such as dopamine, that influence mood and motivation. Therefore, using illicit substances (particularly stimulants and marijuana) increases the risk for amotivational syndrome.¹

Pre-Existing Mental Health Conditions

Amotivation is a symptom commonly associated with mental health conditions such as depression, bipolar disorder, other mood disorders, and schizophrenia. Having an existing diagnosis of certain disorders may increase the likelihood of experiencing amotivational syndrome. Researchers aren’t in full agreement on whether these conditions can cause amotivational syndrome or whether they play a contributing role.^{1, 3}

Neurocognitive Disorders

Neurocognitive disorders like dementia, Parkinson’s, and Alzheimer’s can also be a potential cause of amotivational syndrome. A lack of interest, emotions, and motivation are all common in these conditions, and can be a sign of decline.^{7, 10}

Structural & Chemical Brian Abnormalities

Brain scan studies have revealed that many of the symptoms of amotivational syndrome are linked to impairments and abnormalities in the prefrontal lobes of the brain.¹ These can be related to chemical imbalances caused by drug use, prescribed medications, or psychiatric and genetic predispositions.

Treatment for Amotivational Syndrome

Luckily, there are treatment options available to help people who are suffering from symptoms associated with amotivational syndrome. Many treatments for depression can also provide relief. Some people find a combination of antidepressant medication and therapy are the most effective treatment. For those with substance-induced amotivational syndrome, addiction treatment and recovery groups can support sobriety efforts.

Below are common treatment approaches for amotivational syndrome:¹³

• Cognitive behavioral therapy (CBT): CBT helps people change the way they think and behave, and CBT is a proven treatment for depression, anxiety, and also addictions. It can help clients with amotivational syndrome find new avenues of thinking that can combat some of their symptoms.
• Acceptance and commitment therapy (ACT): ACT is proven to help people respond to difficult thoughts and feelings in healthier ways. Using mindfulness, emotional acceptance strategies, and identifying core values are all aspects of treatment that may help people learn how to get better motivated.
• Motivational interviewing (MI): MI is a form of coaching that is incorporated into healthcare settings, counseling, and addiction treatment. It may be a good option for people with amotivational syndrome who have substance use issues, as well as those who need help overcoming bad habits that could be contributing to their issue.
• Psychiatric medication & antidepressants: Psychiatric medications used to treat depression can often be helpful. SSRI medications boost levels of serotonin in the brain, which can help improve a person’s mood and energy levels. When used, medication is recommended in combination with counseling or other forms of needed treatment.
• Psychiatric consultation: If SSRIs are suspected to be part of the problem, consulting with a psychiatrist to inquire about lowering your dose, changing, or stopping medications is a good idea. If you’re on any psychiatric medication and are struggling with amotivational syndrome symptoms, you should discuss this with your prescriber, as it may indicate a need to adjust your medications.
• Addiction treatment or rehab: People who use illicit drugs often find that getting clean and sober is the only way to overcome their symptoms. Depending on the type of drug you use and how much and how often you use it, it may be necessary to enter into an inpatient rehab facility to detox and safely withdraw.

How to Cope With Amotivational Syndrome

Many describe that their lack of interest, motivation, and emotional response impairs them in their personal and professional lives and relationships. Some may withdraw and isolate themselves, procrastinate on important tasks, and even feel unable to complete their normal daily routine.^{1, 3, 6} Seeking professional treatment from a mental health or medical provider is a key step to take, but there are also some ways to cope with this syndrome on your own.¹⁴

Below are some tips for coping with amotivational syndrome:

• Use self-care to lower stress: Sometimes, a loss of motivation, interest, energy, and emotion is a sign of high stress. Lower your stress levels naturally by dealing with problems in the moment, avoiding rumination later, and incorporating healthy self-care activities like exercise, meditation, and social activities into your routine.
• Use your support system: Times of distress are often when you need your support system the most. Making time to connect (or reconnect) with the people in your inner circle is a great way to boost your mood, feel more energized, and get back to a routine that fosters mental wellness.
• Set small goals and follow through: Having unrealistic goals for yourself can set you up for failure, especially if you’ve been in a pattern of letting things slide. Avoid this trap by setting goals that are small enough to be attainable, but important enough to make some positive difference in your quality of life.
• Reconnect with your values: Finding energy, passion, and motivation is easiest when you’re dedicating your time and energy to things you actually care about and enjoy. If you’ve abandoned a hobby or activity you always loved, consider resuming it. Make a list of some of the things you find interesting so you can pull it out and pick from it during times when you’re feeling most unmotivated.
• Build up positive momentum: One of the top proven ways to overcome depression-related apathy and amotivational symptoms is to push yourself to do more when you feel like doing less. Even though this seems counterintuitive, using this skill (called behavioral activation or activity scheduling) is one of the best ways to counteract that unmotivated feeling.

Final Thoughts

Amotivational syndrome includes a collection of symptoms some people experience as a result of a substance use, prescribed medications, or an underlying mental or neurocognitive condition.^{1, 2, 3} While more research is needed to fully understand this condition, many of the symptoms can be effectively managed and treated with therapy, medication, or a combination of the two.