Lack of Motivation in Depression Is Not a Personal Flaw

Because of bipolar and depression, I have a lack of motivation. Lack of motivation is not technically a symptom of depression according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), but in my experience, it's highly correlated. I must admit, I harshly judge this as being a personal flaw. Here's a look at how depression and a lack of motivation are linked and how a lack of motivation isn't really a personal flaw at all.

Depression and Lack of Motivation

According to a 2015 study by Fervaha et al.,¹ even with treatment, 70 percent of people with major depressive disorder continued to experience a lack of motivation. Moreover, a lack of motivation (also known as a motivational deficit) predicted a worse outcome of illness for those with depression. According to the results of the study:

"These [motivational] deficits were significantly associated with greater functional impairments both globally and in each domain of functioning evaluated. These symptoms were also linked to worse subjective outcomes such as overall life satisfaction and quality of life. Change in the severity of motivational deficits over time was significantly linked with changes in outcome."

One Reason Lack of Motivation and Depression May Be Linked

While the above study talks about the link between depression and a lack of motivation, it notes that it's unclear why this link exists. A 2021 study by Müller et al.² suggests that this link may, at least partially, be due to fatigue, which is a DSM-5-recognized symptom of depression.

This study notes that fatigue stands in the way of motivation. Specifically, the more fatigued a person is, the less motivation the person has to exert effort. But perhaps more interesting, the study found that there are two kinds of fatigue: recoverable and unrecoverable fatigue states.

A recoverable fatigue state occurs after a shorter period of exertion, and this fatigue state can be reversed after a period of rest. This means that when fatigued, the person doesn't have the motivation to exert effort, but after a rest, that motivation is renewed.

An unrecoverable fatigue state occurs after a longer period of more demanding exertion. This fatigue state can't be reversed by a mere period of rest. So unlike a person who is fatigued after a shorter period of exertion, this person remains unmotivated even after rest.

Interestingly, these two types of fatigue were found to occur in two different parts of the brain, further indicating the distinctness of each type of fatigue. As you could guess, people with depression fall into the latter category of fatigue and it's something they may feel every day.

A Lack of Motivation in Depression Isn't Your Fault

As I said earlier, I've always harshly judged myself for my lack of motivation, even during a depression. But the fact of the matter is if you have depression and a lack of motivation, it's not because you're weak, and it's not because you just aren't trying hard enough. See this video for more.

A lack of motivation in depression is just another opportunity to show ourselves some grace. This is another instance of depression changing your brain and those changes impacting your life. 

Sources

1. Fervaha, G. et al., "Motivational Deficits in Major Depressive Disorder: Cross-Sectional and Longitudinal Relationships with Functional Impairment and Subjective Well-being." Comprehensive Psychiatry, December 2015.
2. Müller, T. et al., "Neural and Computational Mechanisms of Momentary Fatigue and Persistence in Effort-based Choice." Nature Communications, July 2021.