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. They may also have no verbal reaction.
Flat affect is a symptom of other conditions. It’s not a condition or disorder on its own.
People who show symptoms of flat affect should be examined by a psychologist or psychiatrist. These doctors diagnose and treat mental health conditions. Many of the underlying causes for flat affect are the result of a mental health disorder or disease.
People who experience flat affect show symptoms including:
- no or low emotional expression on the face
- no or low emotional reaction in both verbal and nonverbal ways
- appearance of apathy
- a monotone speaking voice
- avoidance of eye contact with others
- little to no change in facial expressions
Most of the conditions that cause flat affect are related to the brain. These conditions include:
- Schizophrenia: This disorder affects everything from how a person performs tasks and behaves, to how they feel and react. Some people with schizophrenia report they still experience a wide range of emotions, but they may not show those emotions in the form of facial expressions.
- Autism: Flat affect is common in people with an autism spectrum disorder. Some people with autism appear to have little emotional reaction to activities.
- Depression: The chemical imbalances of depression may interfere with proper brain function. This can lead to symptoms including flat affect.
- Brain damage: Injuries, such as a traumatic brain injury, can cause a variety of symptoms. These include depressed mood, loss of interest in things that typically produce pleasure, and flat affect.
- Posttraumatic stress disorder: This disorder is common in individuals who have experienced a significant event which was perceived as traumatic. The resulting condition causes a variety of symptoms, including depression, anxiety, emotional withdrawal, and flat affect.
Two other common causes of flat affect are not the result of altered brain activity. These include:
- Side effects of medications: Some medications like antidepressants and seizure drugs may impact affect.
- Facial paralysis or muscle disorders: Muscle disorders or facial paralysis may prevent some people from displaying the emotions they feel.
Flat affect may be the result of unusual brain activity. Specifically, the area of the brain that’s responsible for arousal doesn’t appear as active as it does in people who don’t experience the lack of emotions.
Exhibiting signs of flat affect doesn’t mean a person doesn’t experience emotions. Some people with flat affect report that they feel emotions, but they just don’t show it on their face or in their actions. This isn’t because they don’t have the feelings. Their brain and body have a hard time translating an emotion into a physical reaction.
Treatment for flat affect falls into two main categories.
The first treatment type aims to address the underlying cause of symptoms. For many of the most common causes of flat affect, medications, therapy, or some combination of the two may greatly reduce symptoms. Treating these primary causes may increase the display of emotions.
The second treatment type helps individuals with flat affect learn to create emotional reactions when they don’t naturally occur. A psychologist, behavioral therapist, or occupational therapist can help individuals recognize emotions in other people and create appropriate responses. Speech-language pathologists can help individuals train their voice to express more emotion using different tones of voice. These responses may include both facial reactions and verbal communication techniques. Learning to respond to others can help create and support social relationships.
Flat affect is a symptom of several conditions. Preventing or treating those conditions avoids the possible side effect.
If you’ve been diagnosed with any of the conditions, work with a doctor, therapist, or neurology specialist to treat the underlying cause. Getting ahead of symptoms and treating them before they worsen can help prevent flat affect.
Flat affect is a symptom of several mental health conditions. These conditions can be treated. Treating the underlying cause can help prevent or improve symptoms like flat affect.
The good news for some people with flat affect is that treatment can help restore normal emotional display. For some people, however, the condition may be permanent.