Flat Affect in Schizophrenia Symptoms and Treatment

Flat Affect in Schizophrenia Symptoms and Treatment Schizophrenia Print Schizophrenia and the Flat Affect How to Recognize Impaired Emotional Functioning and Minimize Symptoms By Catherine Harrison, PhD Medically reviewed by Medically reviewed by Steven Gans, MD on August 05, 2016 Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Steven Gans, MD Updated on January 05, 2020 Schizophrenia Overview Symptoms & Diagnosis Causes & Risk Factors Treatment Living With In Children David Ryle / Getty Images In This Article Table of Contents Expand Causes Symptoms and Impact Treatment Coping and Support View All Flat affect (diminished emotional expression) is a hallmark symptom of schizophrenia, although it may also affect those with other conditions. It is a lack of showing emotion characterized by an apathetic and unchanging facial expression and little or no change in the strength, tone, or pitch of the voice. This extremely limited range of expressions occurs even in situations that would normally seem very exciting or very sad. For instance, upon hearing the great news, someone with schizophrenia may not smile, laugh, or have any joy in their response. Flat affect is more common among men than women and is often present during the onset of schizophrenia.?? Causes Although millions of people are affected by flat affect, scientists are not entirely sure of the exact cause. It is hypothesized that it is due to differences in brain functioningâ€"and some of the neurocognitive deficiencies that accompany schizophrenia.?? Does Schizophrenia Alter the Thinking Process? More often than not, flat affect is an underlying symptom of several conditionsâ€"not just schizophrenia. It may even be a side-effect of certain medications, including antidepressants. Conditions linked to the flat affect include:?? AutismBrain damageDepressionParkinsons diseasePost-traumatic stress disorder (PTSD)Muscle disorders or facial paralysis Symptoms and Impact If you have been affected by flat affect, you may find that it negatively impacts your social functioning.?? People can respond negatively to the way you react in a situation or conversation, leading to the assumption that you are cold or unfeeling when thats not true. Signs of Flat Affect Monotone or flat voice with no modulation or expressionLack of eye contactLack of discernible interest in the topic at handNo changes in facial expression regardless of the circumstance (neutral expression)Lack of verbal response to emotional stimuliBody language or non-verbal responses that are not typical to the experience, conversation, or situation at hand Its important to note that while you may have trouble displaying emotion, many people with schizophrenia have no difficulty recognizing emotional responses in others. This is an important factor in working with your doctor to define a treatment plan, as it gives you a foundation to build on to create appropriate social exchanges. How to Recognize Negative Symptoms in Schizophrenia Treatment Treatment for flat affect often depends on the underlying cause. A plan of action should begin by consulting with a psychologist or psychiatrist who diagnoses and treats mental health conditions. Flat affect can be treated to some degree. It often requires comprehensive therapy, including working with a healthcare provider and taking medication. While it often cannot be completely eliminated, therapy and intervention can help you interact with others more warmly and naturally and get your other symptoms of schizophrenia under control.?? Get Support With the 9 Best Online Therapy Programs Therapy and Intervention Cognitive behavioral therapy, or CBT, is one of the most researched models of therapy used in the treatment of schizophrenia. CBT can help people with flat affect begin to recognize how their emotionless response does not match what is required in a specific situation.?? Your therapist may have you practice appropriate reactions to different stimuli (like grief or celebration) so that you can learn how to react as other people do. Social skills training, a type of behavioral therapy, can also be used to teach people with schizophrenia to express feelings and needs, ask questions, and control their voice,  body, and facial expressions.Speech therapy can help with tone and modulation of voice to convey more emotion. How Behavioral Therapy Is Used in Psychology Medication In addition to evaluating your medicationâ€"since some meds can cause flat affectâ€"your mental health provider can prescribe antipsychotic medications to control  symptoms of schizophrenia, including delusions and hallucinations. Typical antipsychotics function by blocking receptors for dopamine. The newer atypical antipsychotics also influence other neurotransmitters in the brain and may help with a flat affect. Clozaril (clozapine) is one of these agents shown to help combat flat affect in people with schizophrenia and other mental illnesses for which this is a concern.?? Atypical Antipsychotics Prescribed to Treat Schizophrenia Coping and Support for Caregivers Caring for a loved one who is suffering from flat affect is challenging. Its much more than dealing with a loved one who tends to be cold. Its not a personality trait. This symptom of schizophrenia makes it impossible for your loved one to translate emotion into a verbal or physical expression. The brain and body are not connecting. While he or she may be unable to express his or her emotions, your emotions are likely in overdrive as you struggle to come to terms with this symptom of schizophrenia. Continuing to educate yourself on the condition and the experiences your loved one will face is one of the most important ways to cope. Gathering information can help you better understand what to expect and what you can do to help. Although your primary focus is on supporting your loved one, its also important to remember to help yourself. This means seeking support from local or online groups, a mental health provider, or a trusted friend or family member. Sharing your experiences and challenges can help you process your emotions and give you encouragement and hope. You may also gain helpful information about new or progressive treatment methods as well as other resources to help your loved one.