Understanding Motivation in Bipolar Disorder

Everyone has difficulties with motivation at times. There are always tasks to be completed and jobs to be done, but they are not always desirable or enjoyable. Accomplishing these tasks requires extra motivation, but sometimes motivation can be hard to come by. People who experience depression like that in major depressive disorder and bipolar disorder may have worse problems with motivation than those who do not. Understanding motivation is key in being able to find it or create it.

Motivation is what causes people to act with a specific goal in mind. It initiates and helps continue behavior. Motivation applies to everything from going to bed because you are tired to exercising for your health or applying for a new and better job. Everything requires motivation, even if that motivation is simply “because it will make me happy.”

There are generally two types of motivation:

Intrinsic motivation
This comes from within the individual and is driven by internal rewards. Actions are performed for inherent pleasure. The action itself is the goal. Examples include reading a book for the sake of knowledge, participating in a hobby for fun or exercising to be healthier.

Extrinsic motivation
This comes from an outside source. The reward is not something that can be produced by the individual, it has to be given to them. The reward may even be the absence of punishment. The actions may or may not be enjoyable, but they must be done in order to receive a reward. Examples of extrinsic motivation are working for a paycheck or to meet a deadline, entering a contest for a prize or exercising because you were told to do so for health insurance requirements.

There are a few reasons why people with bipolar disorder or major depressive disorder might have problems with motivation, even when there may be repercussions.

Brain structure
People with bipolar disorder can have both structural and functional differences in the brain. The limbic system and the prefrontal cortex, in particular, may hold some responsibility for motivation. Research has shown there may be connectivity and structural integrity problems in these areas that can negatively affect motivation in depressed states.

Decision making
Acting on motivation requires the decision to do so. In depression, decision making is made harder by problems with cognitive function that also affect planning, attention and memory. Fatigue is also an issue with depression, and when the body is fatigued, there is less energy to spare for decision making and motivation.

Anhedonia is the lack of pleasure. One of the symptoms of depression is the loss of interest or pleasure. Since intrinsic motivation is guided by pleasure, if there is no pleasure, there is no reason to have motivation. The lack of caring about a reward leaves little room for extrinsic motivation as well.

Anxiety or Shame
Those who experience intense anxiety or shame (a symptom of depression) can also experience what is called avoidance. Instead of having the motivation to do something, if there is anxiety involved a person may instead choose to avoid the activity altogether to avoid the anxiety. Then it becomes a cycle because of anxiety or shame involved in not completing the task.

It may feel like the lack of motivation is impossible to overcome. It very well may be that the best self-care is to take some time off to recover from depression. However, there are some small ways to help muster motivation.

  • Use positive self-talk like “I can do this” or “everything will be okay.”
  • Take one step at a time. Step one: Get up. Step two: Shower, etc.
  • Make plans with others to provide extrinsic motivation and accountability.
  • Reward yourself for accomplishments, even if they are intrinsically motivated.
  • Ask for help to make it easier to accomplish even small goals.
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