Why Is It Difficult to Make Decisions?

Having difficulty making decisions can be a sign of depression.

Posted Aug 02, 2014

Many people agonize over decisions. Having difficulty making decisions can be a sign of depression. When one is in the throes of despair, there may be a pessimistic view of reasonable options and an inability to act.

My client, Cindy, talked herself out of a good friendship opportunity because she did not trust that the sentiments of the person reaching out were real. Her holdback/rebuff stemmed from low self-esteem, which is a symptom of depression.

Another client, Tom, was burned a few times during his career. He feared disappointment and rejection, so he delayed a new search. After being let go from a previous job, he was plagued with self-doubt and ruminative thoughts. The "can-do” attitude that had characterized his past subsided into a lack of motivation.

Indecision can also stem from anxiety. Fear of making the wrong decision and suffering consequences or remorse inhibits some people. Worry about making a mistake and feeling guilty, remiss, exposed, or ignorant is common. Sometimes, people are paralyzed by a fear of hurting or alienating another.

Hoarders, or those that cling to clutter, have trouble deciding to discard and then following through. A fear of being ill-prepared for the future plagues them. Discarding an object can be a challenge because the “What if I need it later?” thought takes hold. Obsessional traits may be operating.

The first thing to do if you are having trouble with decisions is to see if you have an underlying depression. Helplessness, hopelessness, anhedonia (no pleasure), fatigue, or listlessness can skew your perception and prevent you from taking action or seeing clearly.

Leykin et al., in “Decision Making and Depressive Symptomatology,” found that cognitive behavioral therapy techniques helped with reclaiming decision-making capacity. “In assisting their clients with decisions, CBT practitioners encourage the use of tools such as Pros/Cons lists, examining several sides of the issue, and creatively generating options for action—all in the attempt to engage more thoughtful and productive decision-making (Beck 1995.)” CBT is also an effective treatment for many anxiety disorders.

Whether depression, anxiety, obsessional tendencies, or temporary untoward experience cause indecision and retreat, as always, insight is useful. Identifying the root of the problem leads to the proper help. Optimism, motivation, and the energy for action resurface when issues are understood or cleared away.