[Cyllya]

I really hope the person who submitted the "feeling paralyzed everyday" question to Ask a Therapist will see this post....

I have the exact problem described in this question, and it really sucks. I think Dr. Dan might've written his response for a different question and it got matched with this one by accident, but either way, it didn't seem like it would help, so I wanted to share what info I've found. Unfortunately, I haven't found much because this problem doesn't seem to be discussed much at all.

This is called initiation deficit or initiation impairment, and it's related to executive functioning. It's a common problem among people with traumatic brain injury (e.g. concussion), and TBI resources are pretty much the only place you'll see anyone acknowledge the problem. It's also very common in people with ADHD and, to a lesser extent, autism. Some countries also have an obscure diagnostic label called Pathological Demand Avoidance Syndrome.

The only help I've found is the stimulant drugs used to treat ADHD--I take Adderall specifically. It's not perfect, but it makes a huge life-changing difference. Unfortunately, initiation deficit isn't part of the diagnostic criteria for ADHD, so you might have trouble getting someone to prescribe that kind of medicine if you don't also have attention control problems.

I haven't found any coping techniques and talk therapy hasn't helped, even when I finally found a therapist who could understand what I was talking about. The only coping techniques I've heard about have to do with minimizing all the other problems that keep you from being productive (e.g. if you are overwhelmed by a task, "break it up" into smaller steps and write those steps down; if you tend to forget about tasks, create some kind of reminder; if you have motivation issues due to depression, get that treated, etc).

Some resources on "procrastination" deal with this, if they're talking about ADHD-style procrastination, not typical-person procrastination.

This problem is essentially being "lazy," but when people are lazy for normal reasons, it's because they get some kind of benefit from it, and they can stop acting lazy when it suits them. I always feel like I should be able to overcome this through will power... but even if I can get some things done that way, it just not sustainable.

Hopefully this points you toward some help or at least lets you know you're not the only person who has this issue!

[jacquelinekay]

I am so glad I stumbled across this. I have been endlessly searching for a term to describe what I have been going through for the fast 4 years. I can honestly say that this inability to make myself do anything is close to ruining my life. I have tried fighting it over and over again but the cycle has held and I always end up back at square one. Until now, I haven't been able to find anything about this feeling that is accurate to my own experience, as others are usually depressed with a lot of reasons behind their inaction. Thank you and good luck.

[Justmedarkstar]

Wow. This is amazing. Lack of motivation is definitely an issue and I constantly tell people that I feel paralyzed so that I can barely even function. At first I thought maybe it was a mild depression but I'm going on almost five years of this and I'm properly medicated for depression. I've tried the lists and they work for a few days but then they are forgotten and thrust to the side. I'm going to have to research this. Thanks so much for the post.

Gee thanks Cyllya! While I don't deal with this myself it sounds just like the symptoms someone at my support group has - and doesn't understand. With your permission I'd like to cut and copy your post and hand it to them. May I?

[Cyllya]

Yeah, go ahead. I also wrote a more detailed page which is available here:

Initiation, Motivation, Procrastination