The Flat Affect in Schizophrenia (±x)
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Flat affect, or impaired emotional functioning, is a SIGNATURE symptom of schizophrenia. It’s a term used to describe the lack of emotional expression displayed by people with schizophrenia.
It is characterized by an apathetic and unchanging facial expression and little or no modulation of the voice. This extremely limited range of emotions occurs even in situations that would normally seem very exciting or very sad.
For instance, upon hearing great news, someone with schizophrenia may not smile, laugh or have any excitement in their tone.
What Causes Flat Affect?
Flat affect, also known as blunted affect, affects millions of people. However, scientists are not entirely sure what exactly causes it but it is hypothesized to be due to differences in brain functioning.
When shown emotional stimuli, those with schizophrenia show decreased activity in the limbic system, the part of the brain responsible for your mood, instincts, and drives. Because of this, some researchers suggest that there are chemical imbalances in the brain that blunt the limbic system’s reaction to stimuli, resulting in an apathetic or emotionless response.
How Will Flat Affect Impact My Daily Life?
If you have schizophrenia and have been affected by flat affect, you may find that it negatively impacts your social functioning. People can respond negatively to a lack of emotion, assuming that you are cold or unfeeling when you really can’t help it.
It’s important to note that while you may have trouble displaying emotion, many people with schizophrenia have no difficulties 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.
Can Flat Affect Be Minimized?
Flat affect can be treated to some degree. This symptom 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. Part of therapy usually starts with techniques to help you recognize your emotionless response and how it doesn’t match what is required in the specific situation. Your therapist may then have you practice appropriate reactions to different stimuli like grief or celebration so that you can force yourself to react as other people do. Speech therapists also can help people with schizophrenia by working on tone and modulation of voice to convey more emotion.
Gur, R., Kohler, C., Ragland, D., et al. Flat Affect in Schizophrenia: Relation to Emotional Processing and Neurocognitive Measures. Schizophrenia Bulletin, 2006, 279-287.
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Joseph S R de Saram (JSRDS)