Showing No Emotion? It Could Be Flat Affect (2023)

We each express our emotions differently. But if you feel you don’t have much of an emotional response to life events, here’s what it could mean.

Some people smile or laugh out loud when feeling happy. Others may feel that same sense of joy yet maintain a neutral facial expression.

If you can relate to the latter, this may just be your personality. But it’s also possible that you’re living with something called “flat affect.”

Whether this symptom came on suddenly or you’ve been experiencing it for as long as you can remember, there are many possible causes.

The term “affect” refers to your ability to express emotions. For example, how your face shows happiness, sadness, fear, or anger. It’s also an umbrella term for everything related to your emotions, from your mood to the physical sensations related to them.

Beyond your facial expression, your affect also includes your hand gestures, body language, and even your tone of voice.

A flat affect, then, refers to low or lack of an emotional expression when the situation may merit a more evident reaction. For example, smiling or laughing at a good joke.

A flat affect isn’t a condition on its own. It can be a symptom of a mental health condition, although this isn’t always the case.

While researchers don’t know the exact cause of a flat affect, it may be related to brain chemistry.

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More specifically, certain parts of your brain, like the sensorimotor system or the amygdala, may be underactive compared with people who don’t have a flat affect.

While a flat affect is most commonly associated with symptoms of schizophrenia, this isn’t the only explanation for it. Here are some other potential causes.

Antidepressant medications

Certain medications, like antidepressants, can cause a flat affect.

In a 2017 study that examined 3,243 user reviews of antidepressants from three health websites, 41% of reviews reported negative emotional and behavioral effects, including a flat affect.

In this case, the reviewers were taking either:

  • escitalopram (Lexapro)
  • duloxetine (Cymbalta)
  • vilazodone (Viibryd)
  • vortioxetine (Trintellix)

Autism spectrum disorder

Research shows an overlap in symptoms between schizophrenia and autism. This may sometimes include a flat affect, which has confused experts for decades because the two conditions are very different.

Some autistic people may have a hard time expressing emotions or responding to social interactions, which can present as a flat affect.

For example, in a small 2019 study, researchers found that autistic people had more muted muscle movements in their faces when watching films designed to stimulate emotions than a control group.

Dementia

Some forms of dementia can cause changes to the frontal and temporal lobes of the brain, which can sometimes manifest behaviorally as a flat affect.

Although not always the rule, symptoms of dementia may include progressive aphasia (the inability to communicate) and a loss of facial expression, according to the National Institute on Aging.

Depression

As you may know, depression exists on a spectrum.

In some cases, a flat affect may be present along with related symptoms, like anhedonia, or the inability to feel pleasure. This isn’t always the case, though.

Flat affect can result from a decreased emotional response to events around you.

Muscle disorders

Facial paralysis, such as after a stroke or from other muscle disorders, can give someone the appearance of a flat affect.

Parkinson’s disease

According to a small 2021 study, people with Parkinson’s disease may experience hypomimia, more commonly known as a “masked face.” This refers to a progressive decline in facial expression, which can manifest as a flat affect.

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Schizophrenia

A flat affect is considered a “negative” symptom of schizophrenia, which means there’s an absence of a certain emotion or behavior.

Research suggests that people living with schizophrenia have a decreased ability to express their emotions, as well as a decreased ability to pick up on the emotional reactions of others.

Schizoid personality disorder

People who live with schizoid personality disorder may sometimes have some symptoms that overlap with schizophrenia.

According to the diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), this includes avoiding social interactions and displaying emotional coldness, detachment, or a flat affect toward others.

Traumatic brain injury

Research shows that 62% of people with traumatic brain injuries experience behavior changes. For some people, this could mean rapidly shifting emotional expressions. For others, it could mean a flat affect.

Having a flat affect doesn’t mean that you don’t feel emotions. Rather, it means that your reactions on the outside don’t necessarily match what you’re feeling on the inside.

For example, let’s say your friends throw you a surprise party. As you walk in the door and everyone shouts “Surprise!” you may feel shocked and excited. But your facial expression may register as apathetic or even bored.

Some telltale signs of a flat affect include:

  • appearing to lack interest
  • avoiding eye contact
  • apathetic body language or nonverbal cues
  • neutral facial expressions
  • monotone or flat voice
  • lack of hand gestures

While a flat affect and emotional blunting may sound like the same thing, they are indeed different (but still related).

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Like a flat affect, emotional blunting is a symptom of a condition. It’s a diminished emotional response, like suddenly not laughing at a movie you once found funny.

If you’re not feeling much of an emotional response to a stimulus, you may not show an emotional response either, which is how it’s linked with a flat affect. But in flat affect, you do have an emotional response, although you don’t show it in your face or body.

Emotional blunting is present in many of the same conditions as a flat affect, including:

  • depression
  • schizophrenia
  • traumatic brain injury

What about blunted affect?

As far as emotional responses go, blunted affect and flat affect are on the same spectrum, but here’s the difference:

  • Blunted affect is a muted emotional response, like a smirk instead of full-on laughter.
  • Flat affect is a lack of an emotional response, like a neutral face instead of laughter.

If you have a flat affect, you may consider treating it. With the appropriate treatment plan in place, this symptom may be treatable and recovery is possible.

It’s highly advisable to reach out to a doctor, neurologist, or mental healthcare professional. A trained professional will be able to determine the underlying cause of your flat affect and provide treatment options.

Treatment will vary according to what caused the flat affect. Options may include:

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Medications

If a medication is causing your flat affect, your doctor may change the type of medication you’re taking or the dosage.

If your flat affect stems from a mental health condition, medication may help alleviate several of your symptoms, including a diminished emotional expression.

Psychotherapy

Therapy is considered a first-line treatment in many of the conditions associated with a flat affect.

If you’re not sure where to start, you may find it useful to locate a therapist with our search tools.

Social skills training

For people living with schizophrenia, social skills training can teach you how to express your emotions and body language appropriately for social situations.

Speech therapy

Since a monotone voice is often a sign of a flat affect, this type of training can help you express more emotion using different tones of voice.

Couples counseling or family therapy

At times, a flat affect may interfere with your relationships.

If your loved ones can’t read how you’re feeling all the time, they may find it difficult to know how to connect with you.

Having an intermediary, like a couples counselor or family therapist, may help you sort out any communication problems.

A flat affect could make you feel different from other people, or pose a communication challenge between you and those you love. But flat affect can be managed.

Your treatment plan will depend on what caused your lack of emotional expression. Since there are many possible causes of a flat affect, it’s best to work with a professional.

Most importantly, don’t give up on healing. There is hope for your recovery.

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FAQs

Can people with flat affect show emotion? ›

What Is Flat Affect? Flat affect is a condition that causes people to not express emotions in the same way other people might. For example, when a person without flat affect is happy, they may smile brightly or in some other way show that they're pleased. A person with flat affect shows no facial expressions.

What is it called when a person shows no emotion? ›

apathetic. / (ˌæpəˈθɛtɪk) / adjective. having or showing little or no emotion; indifferent.

What happens when you show no emotion? ›

When you lose the ability to feel or express any emotions, this is called flat affect. If you feel numb only to positive emotions but are still able to feel negative emotions, this is called anhedonia. Anhedonia is a common symptom of depression and shows up in a lot of mental health conditions.

What causes someone to have a flat affect? ›

Flat affect is a severely restricted or nonexistent expression of emotion. A person with flat affect does not express emotion the way other people do. It is not a condition by itself; it's a symptom of various other conditions, including schizophrenia, autism, or post-traumatic stress disorder.

What does emotional flatness mean? ›

You may be elated or depressed, but others can't tell. This is called a flat affect. People who have it don't show the usual signs of emotion like smiling, frowning, or raising their voice. They seem uncaring and unresponsive. Flat affect can be brought on by different conditions.

What does emotional blunting mean? ›

Emotional blunting is a condition present in many psychiatric disorders, including depression, schizophrenia (26) and post-traumatic stress disorder (27). As its name suggests, emotional blunting refers to a sense of numbing of both positive and negative emotions.

What causes a person to show no emotion? ›

There are a number of different things that can cause emotional numbness to occur. While depression and anxiety are the most common causes, others include the following: Stress and stress hormones: Elevated cortisol levels can lead to emotional numbness in some people.

How do you deal with someone who is emotionally detached? ›

Focus on your own feelings

Both Neblett and Gatling agree that if you address someone's emotional unavailability, express how it's affecting you and lead with "I" statements. It's also important to have clear examples of why you think they're emotionally unavailable so that they don't feel ambushed, Neblett emphasizes.

What is flattened affect PTSD? ›

Flattened affect causes the loss of ability to express emotions or react to events and circumstances that typically trigger an emotional response. Most people with flattened affect still feel emotions, but they do not instinctively express those feelings the way a person without the condition would.

Is feeling numb a coping mechanism? ›

Some research suggests that emotional numbness may develop as a sort of coping mechanism when a person is facing extreme stress. It can help a person avoid processing information that is shocking or upsetting.

Is flat affect a negative symptom? ›

A flat affect is considered a “negative” symptom of schizophrenia, which means there's an absence of a certain emotion or behavior. Research suggests that people living with schizophrenia have a decreased ability to express their emotions, as well as a decreased ability to pick up on the emotional reactions of others.

What are the five types of affect? ›

There are several types of affect in psychological research: broad, restricted, blunted, flat, and liable.

What is a blunted vs flat affect? ›

People who have a flat affect show virtually no outward evidence of any emotion. Blunted affect. People who have a blunted affect show very little outward emotion. Constricted affect. People who have a constricted affect show some emotion but less than most other people show.

What does emotional blunting feel like? ›

Emotional blunting—inability to feel positive or negative emotions, detachment, or reduced emotional responsiveness—is common in people with depression.

What is a blunted affect? ›

Blunted affect, also referred to as emotional blunting, is a prominent symptom of schizophrenia. Patients with blunted affect have difficulty in expressing their emotions [1], characterized by diminished facial expression, expressive gestures and vocal expressions in reaction to emotion provoking stimuli [1–3].

What does emotional deprivation feel like? ›

How emotional deprivation affects a person. People with ED schema report feeling lonely, bitter, and depressed, but aren't aware of the reason. As adults, they no longer expect other people to help, protect, or even understand them. They sometimes feel that they do not get enough attention or affection and warmth.

Is emotional detachment a disorder? ›

Emotional detachment is not an official diagnosis in The Diagnostic and Statistical Manual of Mental Disorders (DSM 5), like major depressive disorder. However, it can be a symptom of other disorders, such as attachment disorders, or it can be the result of past trauma.

What disorder causes emotional detachment? ›

These conditions might include depression, PTSD, or borderline personality disorder. Medication and therapy are often helpful for these conditions. If the emotional detachment symptoms result from trauma, your doctor may recommend psychotherapy, also known as talk therapy.

Can emotionally detached people love? ›

Many people ask questions like can emotionally unavailable men fall in love? The answer is yes! They can fall in love when they see the right person. Emotionally unavailable men would be ready to drop all their unhealthy behaviors so that they would not scare their love interest away.

Can you love someone and be emotionally detached? ›

Detached love doesn't mean you don't want to be deeply connected and connected for a long time; it means that while you're connected you choose to allow the beloved to fully be themselves without expectations about the outcome of your relationship.

What are three 5 PTSD symptoms? ›

Common symptoms of PTSD
  • vivid flashbacks (feeling like the trauma is happening right now)
  • intrusive thoughts or images.
  • nightmares.
  • intense distress at real or symbolic reminders of the trauma.
  • physical sensations such as pain, sweating, nausea or trembling.

How does a person with complex PTSD Act? ›

Symptoms of complex PTSD

feelings of worthlessness, shame and guilt. problems controlling your emotions. finding it hard to feel connected with other people. relationship problems, like having trouble keeping friends and partners.

Is being emotionless part of depression? ›

Feeling emotionless can often be a symptom of mental health problems, such as depression, anxiety and post-traumatic disorder so it's not something to dismiss or downplay. In these cases, seeking the help of a professional is crucial. So remember you don't have to work through this alone.

What does emotional avoidance look like? ›

Emotional avoidance is when a person avoids thoughts or feelings about a traumatic event. This type of avoidance is internal to the person; others around you may not know what you are avoiding and why.

How do emotionally numb people act? ›

Being emotionally numb means your emotional experience is lower than expected, dampened, or completely missing. In situations where you might be expected to experience joy or sadness, you may feel empty or detached instead. This feeling isn't positive or negative; instead, it's absent of emotion.

What is an incongruent affect? ›

Incongruent means "conflicting." As such, mood incongruence implies that the symptoms conflict with the person's current mood. Examples include: Believing you have superpowers despite going through a major depressive episode. Laughing when your dog dies.

What is dysphoric affect? ›

A dysphoric mood is a consistent state of profound unhappiness and dissatisfaction. Symptoms can include discontent, irritability, stress, aggression, and feelings of anger, guilt, or failure.

What is a shallow affect? ›

Shallow affect has a similar meaning to blunted affect, but it is often used to describe the emotional experience of persons with psychopathy. A person with shallow affect will feel little emotion about situations that would expect to elicit specific feelings.

What is a dysphoric mood? ›

Dysphoria or dysphoric mood is a mental state in which a person has a profound sense of unease or dissatisfaction. While not a mental health diagnosis on its own, dysphoria is a symptom associated with a variety of mental illnesses, some of which include stress, anxiety, depression, and substance use disorders.

Can you cry with flat affect? ›

While people with flat affect still experience emotion, they are unable to express emotions in typical and expected physical ways. They exhibit a lack of response to emotional stimuli such as reduced or absent facial expressions, monotone voice, and difficulty understanding the emotions of other people.

What does a constricted affect look like? ›

constricted affect: diminished variability and intensity with which emotions are expressed. delusion: a false belief strongly held in spite of invalidating evidence. disheveled: being in loose disarray; unkempt, as hair or clothing; untidy.

Can people with flat affect laugh? ›

Beyond your facial expression, your affect also includes your hand gestures, body language, and even your tone of voice. A flat affect, then, refers to low or lack of an emotional expression when the situation may merit a more evident reaction. For example, smiling or laughing at a good joke.

What mood is congruent with flat affect? ›

If a person is euthymic, they are feeling relatively neutral, and are not extremely happy or sad. Congruent affect means that their emotions match the situation. Choice B is euthymic with incongruent affect, C is euthymic with blunted affect, and D is euthymic with restricted affect.

Can you have euthymic mood and flat affect? ›

Euthymia with congruent affect: This means your emotions are appropriate for the situation, whereas incongruent means they may not be appropriate. Euthymia with blunted or flat affect: This means a situation may not affect your emotions at all, or you may not show a response.

What causes emotional blunting? ›

For most people, antidepressants are the main cause of emotional blunting. In most cases, feelings of numbness go away when you stop taking the antidepressant that is causing you to feel this way.

What is the difference between flat and blunted affect? ›

People who have a flat affect show virtually no outward evidence of any emotion. Blunted affect. People who have a blunted affect show very little outward emotion.

What is the opposite of flat affect? ›

The opposite of blunted affect is expressing emotions in the ways we usually expect to see it. People using the full range of ways to express emotion have regular changes in their facial expressions and tone of voice as they transition between different emotions.

Is blunted or flat affect worse? ›

Flat affect describes when a person displays absolutely no emotion. Blunted affect is a step above flat, with some mild expression present on occasion. Any emotional display is severely restrained.

What is a euthymic mood? ›

In simple terms, euthymia is the state of living without mood disturbances. It's commonly associated with bipolar disorder. While in a euthymic state, one typically experiences feelings of cheerfulness and tranquility. A person in this state may also display an increased level of resiliency to stress.

What is incongruent behavior? ›

Incongruent behavior in people is when there is a misalignment between the real self and the ideal self. When there is incongruence, the individual is lacking in self-worth, self-image, and self-esteem. The real self can also be thought of as the present self.

Is flat emotions a symptom of schizophrenia? ›

Flat Affect, Negative Symptom

The result is a pronounced lack of emotional display. In this sense, flat affect is known as a negative symptom of schizophrenia, because it's a set of behaviors (the display of appropriate emotions) that are expected but absent.

What is affective blunting? ›

Blunted affect, also referred to as emotional blunting, is a prominent symptom of schizophrenia. Patients with blunted affect have difficulty in expressing their emotions [1], characterized by diminished facial expression, expressive gestures and vocal expressions in reaction to emotion provoking stimuli [1–3].

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