Abulomania (extreme indecision)
En español: lee sobre esta manía en Fobias.org.
Choosing what to eat, how to reply to a message or what to wear can take some people minutes or even hours of going back and forth. From the outside it can look small, but living with it is exhausting, and many people hide it because they feel embarrassed. If that sounds familiar, you are not being difficult or lazy.
What it is
Abulomania, also spelled aboulomania, is indecision so strong and lasting that it blocks even small everyday choices. The term is old: it was coined in 1883 by the neurologist William Alexander Hammond, who saw it as a loss of willpower. Today it is not a recognised diagnosis in the DSM-5-TR, and very little research has been done on it. Most of what is written comes from case reports and from its overlap with other problems.
Rather than a fear of choosing, it is usually described as doubt that will not switch off. You compare options again and again, ask several people what they think and, once you finally choose, keep going over it. It overlaps with OCD and with finding uncertainty hard to bear, and with anxiety. Trouble making decisions is also a common symptom of depression. If the main feeling is dread at the very idea of having to choose, the page on fear of making decisions (decidophobia) may fit better.
How it differs from a phobia
A phobia is a fear that makes you avoid something. Abulomania is less about fear and more about being stuck: a pull to keep weighing options, checking and seeking reassurance, so the decision stays open long after it could have been made. The two can overlap, and fear of getting it wrong often sits underneath, but the core problem here is endless doubt rather than avoidance.
Read more about manias and phobias
Common signs
- Small choices taking far longer than they need to
- Going over a decision long after making it
- Asking lots of people for their opinion
- Researching endlessly before choosing
- Changing your mind again and again
- Leaving decisions until someone else makes them
- Feeling drained after simple choices
When it tends to show up
- Choosing between very similar options
- Decisions that cannot be undone
- Being asked for a quick answer
- When other people depend on your choice
- Menus, shops and websites with lots of choice
- After getting a similar decision wrong before
- When you are tired, stressed or low
- At night, replaying the day’s choices
Symptoms
In your body
- Tight neck, shoulders or jaw
- A knot in your stomach when you have to choose
- Feeling tired after small decisions
- Trouble sleeping because of doubts
- Restlessness or fidgeting
In your mind
- Doubts that return even after you have decided
- Fear of getting it wrong or regretting it
- Needing to feel completely sure first
- Comparing options without reaching an answer
- Little trust in your own judgement
What you might do
- Put off decisions until someone decides for you
- Ask many people for reassurance
- Keep searching for more information
- Avoid situations where you have to choose
- Go back on decisions you have already made
What causes it
There is no single known cause, and because so little research has been done, the ideas put forward are a mix of factors. A very protective or very strict upbringing may mean someone gets little practice at deciding for themselves, or learns to fear mistakes. Bullying, humiliation, stress, trauma and personality may also play a part. Indecision is closely linked with OCD, where doubt and difficulty living with uncertainty are central, and with anxiety. Low self-esteem can make it harder to trust your own choices. In depression, finding it hard to make decisions is common, so new and marked indecision alongside low mood is worth checking. Putting off a choice brings quick relief, and that relief keeps the pattern going. It is not a lack of willpower.
How it can affect your life
Small choices can swallow hours of your day, and big ones, like changing jobs, moving house or starting treatment, can sit on hold for months. At work it may show up as tasks that slip or leaning heavily on other people’s opinions. At home, a partner or family may end up making most decisions, which can lead to tiredness and friction on both sides. Many people feel frustrated or ashamed, and over time trust in their own judgement wears thin.
Treatment
In the UK, your GP is the usual first step. They can check whether something like anxiety, OCD or depression is behind the indecision and talk through options. Talking therapy is the main approach, for example cognitive behavioural therapy (CBT), which works on the doubting loops and builds up decisions in small, practical steps.
If OCD is part of the picture, CBT with exposure and response prevention helps you make a choice and resist checking or seeking reassurance. If anxiety or depression is involved, treating that helps too, and a doctor may discuss medication. In England you can also refer yourself to NHS Talking Therapies.
Things that can help day to day
- Break a big decision into small, concrete steps
- Give yourself a reasonable time limit to decide
- Cut the options down to two or three
- Aim for good enough rather than perfect
- Practise on low-stakes choices, like which fruit to buy
- Write down what you chose and why, then leave it
When to get help
See your GP if indecision takes up a lot of your time, stops you moving forward at work or in your studies, or means others have to decide almost everything for you. Go sooner if it has come on recently along with sadness, loss of interest, tiredness or changes in sleep, as it can be part of a mood problem that can be treated.
If you are also feeling very low, talk to your GP or call Samaritans free on 116 123. For urgent mental health advice, call NHS 111 and choose the mental health option, and if you have thoughts of harming yourself or someone else, call 999 or go to A and E. Mind has information on anxiety and low mood, and OCD-UK and OCD Action can help if doubting and checking feel like OCD.
See also: Fear of making decisions (decidophobia)
How I can help
When I work with someone who gets stuck in endless indecision, over Zoom, I use hypnotherapy and NLP alongside, not instead of, talking therapy such as CBT or any care from their GP. We look at the moments just before the doubting loop starts, so you can catch it earlier, and work on calming the tension that comes with having to choose. In hypnosis we rehearse making small decisions calmly and then leaving them alone, which builds tolerance of uncertainty a step at a time. We also work on trust in your own judgement, and many clients find everyday choices start to feel lighter.
Common questions
Is abulomania a real condition?
It is a real experience, but it is not a recognised diagnosis in the current medical manuals. The term dates from 1883 and very little research has been done on it. It is mostly discussed alongside anxiety, OCD and low mood.
Is abulomania the same as decidophobia?
They are similar and the words are sometimes used almost interchangeably. Decidophobia is described as an intense fear of making decisions, while abulomania puts the focus on doubt that does not end, even after choosing. In practice the two can happen together.
Why do I find it so hard to make decisions?
There can be many reasons, such as fear of getting it wrong, perfectionism, tiredness, stress, anxiety or low mood. Doubting now and then is normal. If it takes up a lot of your time or holds you back, your GP or a therapist can help you understand what is behind it.
Can indecision be a sign of depression?
Yes, finding it difficult to make decisions is a common symptom of depression, although being indecisive does not mean you are depressed. If it comes with low mood, loss of interest or sleep changes that last more than two weeks, see your GP.
Further reading: Cureus: Aboulomania, a mental disorder characterized by pathological indecisiveness · NHS: Depression in adults, symptoms · NHS: Obsessive compulsive disorder (OCD) · Mind: What is self-esteem? · NHS: Talking therapies
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