Listlessness – Causes, Treatment & Prevention

Listlessness describes a psychophysical state of lethargy. Those affected hardly show any goal-oriented behavior and, in extreme cases, lose all initiative. Driveless people can’t get excited or motivated about anything. You feel listless, jaded, tired or lacking in energy.

Even banal demands of everyday life (personal hygiene, food preparation, etc.) overwhelm them. Synonyms or preliminary stages of lack of drive are lack of drive, lack of drive or lack of drive. The opposite of listlessness is an excess of drive – a symptom that often occurs in manic patients. Listlessness is not an independent disease, but an expression of other underlying diseases.

Causes

Lack of drive can have very different causes. It often occurs in the context of depressive illnesses . It is also a classic negative symptom of schizophrenia . Many people develop a certain listlessness in old age, especially people suffering from dementia .At any age, listlessness can be a sign of malnutrition, e.g. B. if the intake of iron , folic acid or vitamin B12 is too low . Malnutrition triggers anemia , so that insufficient oxygen is transported through the body and performance falls.

In addition to a lack of nutrients, malabsorption syndromes can be the cause of listlessness, such as a tapeworm infestation . Metabolic disorders such as hypothyroidism can also be the cause of listlessness. Finally, listlessness can also indicate a tumor .

When to the doctor?

Lack of drive then becomes a problem and a case for the doctor if not only the person concerned suffers from it, but also his everyday life and his environment. Help is needed when one’s own children or partner have to put up with the lack of drive, when home care is no longer working or when a loss of earnings is to be expected due to a lack of work. Warning signs are arguments, tight money, an empty fridge, hungry stomachs, etc.

If lack of drive also affects your own diet, the doctor can identify nutrient deficiencies and counteract them in a targeted manner. You should definitely seek advice if the listlessness threatens to turn into depression. Because listlessness is one of the symptoms that often herald the onset of depression. This is dangerous, because if you can’t get out of bed in the morning and shut yourself off during the day, sooner or later you will become lonely and slip.

So as soon as social contacts are limited or absent altogether, a doctor must be consulted. This is also the case when other symptoms, such as crying for no reason or loss of appetite , get out of hand. The aim here is to limit the damage. It makes sense to get professional help before the lack of drive turns into depression, which causes the marriage to end or a termination from the employer.

Diagnosis and course

Lack of drive can set in suddenly, as in burnout , but can also develop gradually over weeks or months. Ultimately, there is always a significant drop in performance compared to the previous level of performance of the person concerned. Some patients suffer from their listlessness themselves and seek medical advice on their own because they can no longer cope with their everyday life as usual.

However, it can also be the case that only relatives or caregivers are worried about a person’s lack of drive, while the person concerned does not feel any psychological strain. The course of the listlessness is just as variable as how it develops: Somatic listlessness does not disappear on its own, but lasts until the hormone or nutrient balance is back on track.

Psychogenic listlessness is more unpredictable: it can improve on its own without therapy or persist for years despite therapy. Lack of drive becomes dangerous when it is so pronounced that the person concerned neglects their basic needs. Without outside help, the lack of drive can even become life-threatening because the patient z. B. not eating and drinking enough.

The diagnosis of lethargy is mainly based on a detailed medical history. This should include questions about the vegetative state, the economic and social situation, and drug or medication use. Observing the patient also provides valuable information: facial expressions, gestures and verbal expression are often reduced. Relatives or carers typically describe that the person concerned sits around passively and without occupation for hours.

In addition to the medical history, a detailed physical examination is important for the differential diagnosis. A palpation of the lymph nodes provides indications of infections or tumor diseases. The nutritional status can be examined more closely via stature, skin turgor and a blood count .

You should take a closer look, especially if you are listless in old age: This is easily dismissed as psychogenic, although it is often caused by an unbalanced diet with insufficient vitamin B12 intake. If no somatic causes can be found, a detailed neurological-psychiatric diagnosis with discussions and standardized tests should take place.

Complications

Feelings of guilt and inferiority are common complications of lack of drive, even when a physical cause is responsible for the lack of drive. In some cases, these feelings increase to the point of depression, so that additional treatment with antidepressants or psychotherapeutic methods may be necessary. A serious complication of listlessness is suicidality. Thoughts of death without a clear intention to commit suicide can already be warning signs. In this case, those affected should seek medical or psychological advice in good time.

In addition, listlessness often leads to a variety of social complications that can have a feedback effect on the psychological and medical condition. These include difficulties in the family, in the private sphere or at work, which can go as far as losing your job. In addition, the lack of drive can mean that those affected do not actively participate in the treatment. The lack of drive can make it difficult to take medication regularly, which is actually supposed to treat the cause of the lack of drive. In some patients, meeting appointments, physical hygiene or their own diet also sufferunder the lack of drive. Deficiency symptoms and the avoidance of activities (especially outdoors or together with other people) may also reduce the drive. As a result, the condition may prolong or worsen.

Treatment and therapy

There is no standard treatment for listlessness, since the therapy is not directed against the listlessness itself, but against the underlying disease. The easiest way to cure listlessness is malnutrition: First, the acute deficiency is treated with high doses, e.g. B. from iron or vitamin B12. In addition, the patient should reorganize his diet in the long term.Metabolic disorders can often be treated with hormone preparations. Antipsychotics are the mainstay in the treatment of schizophrenia. Depending on the extent, depression can be treated with antidepressants , psychotherapy , sleep deprivation, electrotherapy or light therapy.

Sport or relaxation techniques may help with mild forms of listlessness. Even with the best therapy, however, not all listlessness disappears. If patients do not feel any psychological strain and their life situation is compatible with lack of drive (e.g. in a nursing home), attempts at therapy can then possibly be given up.

Outlook and prognosis

Depending on the cause of the listlessness, it can occur spontaneously or develop gradually over weeks and months. The level of performance is reduced and everyday demands can no longer be met by the patient. The lack of drive can cause a severe drop in performance, so that even simple tasks can no longer be mastered.

However, small reductions in performance can also occur, which are to be classified as minimal compared to other people. It is therefore necessary that the individual situation of the patient is always considered in the event of listlessness. Comparisons to previous levels of performance need to be made to determine the exact extent. The listlessness is usually accompanied by therapy. The focus is on finding the cause.

Psychogenic listlessness is particularly difficult. They are considered to be difficult to predict and are therefore a greater burden for the patient and his family. The lack of drive is often subject to fluctuations and can therefore take place over a long period of time with better phases. In severe cases, patients are no longer able to provide basic care. As a result, the absorption of essential nutrients or food no longer takes place. In most cases, the listlessness at such a stage can no longer be overcome without professional or medical help.

Prevention

One way to prevent listlessness is with a balanced diet: Vegetarians, vegans and pregnant women in particular should ensure they have an adequate supply of iron, vitamin B12 and folic acid.

Iodine is also important for the formation of thyroid hormones . On the other hand, it has been proven that sport and sunlight help against mild depressive moods. Especially during the winter months, regular exercise in daylight prevents listlessness in the context of winter depression .