Does even a simple choice feel exhausting?

When a choice gets stuck

Katia finds it hard to choose even in small things, Stanislav goes round the same arguments, and Demyd looks in the news for a certainty that is not there. The section “Indecision and its neighbours” explains how this kind of indecision differs from neighbouring difficulties.

If at least one of these stories resembles yours, note what exactly gets in the way of choosing. If none of them fits, the questions in the section “What makes choosing hard?” can help you work it out.

Indecision and its neighbours

Indecision is often part of another difficulty. Compare which is closer to your experience.

• Intrusive negative thoughts. A doubt keeps coming back, and checking does not bring certainty. See the page on intrusive negative thoughts.
• Concentration problems. The options slip away because it is hard to keep your attention on thinking them through. Compare with the description of concentration problems.
• Slowed thinking. Thinking things through takes longer, although the choice itself does not frighten you. The page on slowed thinking looks at what this is like.
• Apathy. You do not want to choose because you do not care how it turns out. See the page on apathy.

These difficulties often occur together, and one of them on its own decides nothing.

Reducing the number of options

To make a decision, you need three things:

1. Energy to think it through. When it is low, even choosing from a menu, as with Katia in our example, is exhausting.
2. A clear criterion. One or two main “what matters to me” points, not ten equally weighted considerations, as with Stanislav.
3. A sense that you can handle the consequences. Not certainty of a perfect outcome but readiness to cope with any of the options – exactly what Demyd is looking for in the news.

It is easier still if the choice leaves at least a little satisfaction. When one item on this list is missing, the decision is put off again and again. So it helps to try:

• Fewer options. When overloaded, reduce the number of options and identify a few of the most important criteria.
• Time to think. For less important decisions, set a time limit in advance and choose a good-enough option instead of the perfect one.
• Stages. Break a complex decision into stages: define the problem, list the main options, weigh their pros and risks, and then choose the next manageable step.

If indecision is linked to anxiety, it helps to notice the urge to get absolute certainty: in many life situations, the risk of a mistake cannot be removed completely. In a depressive state it may be necessary to postpone major irreversible decisions until you feel better and to discuss them with someone you trust or with a professional.

What makes choosing hard?

Difficulty making decisions is a state in which it becomes hard to choose even between relatively simple options. Think of the last choice that was hard for you and answer these questions:

• When did decisions become harder, and what did you use to decide faster?
• Do the difficulties arise only with important choices or even in simple everyday situations?
• Do you have a strong fear of making a mistake or regretting the decision?
• Do you feel the need to check and compare the options again and again?
• Do you also have low mood, anxiety, apathy or a sense of hopelessness?
• Has it become harder to concentrate, plan or keep information in mind?

If it is hard to make even necessary decisions about food, treatment or safety, see the second point of the section “Choices will not come: a pointer”.

Doubt, exhaustion and fear of mistakes

Decisions can be made harder by anxiety, fear of mistakes, exhaustion or loss of interest. It matters whether this is a new change and whether it affects almost every choice. A doctor will help assess the circumstances, not decide for you how to live.

If low mood and loss of interest in life persist along with indecision, a doctor may also assess for depression. Indecision on its own does not yet mean that you have this disorder.

How a psychiatrist can help with hard choices

If your main difficulties involve mood, thoughts or behaviour, you can start with a psychiatrist. They will ask when choices became harder and what lies behind it, and will discuss help with you. With physical complaints, an assessment by a family doctor is also appropriate.

To get a sense in advance of how the conversation will go, have a look at the initial psychiatric consultation page. The specialists’ areas of work are described on the clinic’s doctors page.

Choices will not come: a pointer

1. If difficulties with thinking and decision-making appear suddenly, especially with confusion, speech problems, weakness or numbness in the limbs, disorientation or other acute neurological symptoms, you need urgent medical help: call 103 or 112 in Ukraine.
2. If a person stops making necessary decisions about food, treatment, safety or other basic needs, it is better not to put off a professional assessment.
3. If indecision comes with marked low mood, anxiety, slowed thinking, concentration problems, apathy or a sense of hopelessness, a consultation is especially important.
4. If difficulties with decisions persist, get worse or noticeably affect work, study, relationships and everyday tasks, see a doctor or mental health professional.
5. If choices stall only when you are overloaded, start with the steps in the section “Reducing the number of options”.