From the Guidelines
Lack of motivation in patients, particularly those with depressive symptoms, should be addressed by providing supportive care services, including education and information on stress reduction, fatigue, and sleep problems, as well as assessing symptoms biweekly or monthly until they have remitted. This approach is supported by the American Society of Clinical Oncology's guideline update on the management of anxiety and depression in adult survivors of cancer 1.
To manage lack of motivation, several strategies can be employed:
- Provide education and information on the normalcy of stress in the context of cancer, as well as sources of informational support and resources 1.
- Offer specific information and strategies on stress reduction, such as progressive muscle relaxation, fatigue, and sleep problems, including cognitive behavioral therapy for insomnia (CBTi) 1.
- Assess symptoms regularly, ideally biweekly or monthly, until they have remitted, and evaluate follow-through and compliance with treatment recommendations 1.
- If compliance is poor, construct a plan to circumvent obstacles to compliance or discuss alternative interventions that present fewer obstacles 1.
It is essential to note that lack of motivation can be a symptom of underlying conditions such as depression, and if persistent, it may be necessary to consult with a healthcare provider for further evaluation and treatment 1. By prioritizing supportive care services and regular symptom assessment, patients can receive the necessary support to manage their lack of motivation and improve their overall quality of life.
From the Research
Lack of Motivation
- Lack of motivation is a common issue in individuals with severe mental illness (SMI), making it difficult for them to engage in psychiatric treatment 2.
- Studies have shown that patients with higher psychosocial problem levels tend to have lower motivation for treatment, which can lead to a lower quality of life 2.
- In contrast, some studies have focused on the treatment of depression and anxiety in youth, and have found that a combination of selective serotonin reuptake inhibitors (SSRIs) and cognitive behavioral therapy (CBT) can be effective in improving symptoms 3, 4, 5.
- However, these studies do not directly address the issue of lack of motivation, and it is unclear whether their findings can be applied to this specific problem.
- One study provides an overview of the conceptualization, measurement, and neurobiology of intrinsic motivation, which may be relevant to understanding lack of motivation 6.
- According to this study, intrinsically motivated behaviors are driven by a desire to maximize reward value and minimize punishment, rather than by external stimuli.
- The study suggests that dysfunction in intrinsic motivation may be an important trans-diagnostic facet of psychiatric symptomology, but more research is needed to fully understand its contribution to psychopathology and its treatment 6.
Possible Factors Influencing Motivation
- Psychosocial problem levels: higher levels of psychosocial problems may be associated with lower motivation for treatment 2.
- Severity of symptoms: patients with more severe symptoms may be less motivated for treatment 3.
- Age and demographics: younger patients and those from minority groups may respond differently to treatment and have varying levels of motivation 3.
- Type of treatment: combination treatment with SSRIs and CBT may be more effective than monotherapy in improving symptoms and motivation 3, 4, 5.
Measurement and Treatment of Motivation
- There is a need for clear consensus on the measurement and treatment of intrinsic motivation, as well as its contribution to psychopathology 6.
- Further research is needed to develop effective treatments for lack of motivation, and to understand the underlying neurocognitive mechanisms that drive motivated behavior 6.