Flat Affect and Depression

Flat affect is defined as a severe reduction in emotional expressiveness. It is commonly seen in depressed and schizophrenic individuals. Patients are seen as extremely apathetic and lacking in facial expressions.

I lost a music therapy internship in part because of an extremely flat affect. For years, I was painfully aware of being apathetic and slow to react in social situations. This caused a great deal of frustration because I felt so hopeless about it. Year after year and day after day I tried in vain to conquer this situation but ended up failing millions of times. I thought it would be my cross to bear.

Patients who manisfest this symptom are affected in almost every area of life. In order to survive, it can become necessary to withdraw more and more, thus exacerbating the situation.

Flat affect can:

• Deepen depression because few want to associate with someone who has a limited range of emotional expression. This plus the slowed thinking often accompanying depression can make social interactions expremely difficult if not impossible.


• Increase isolation because flat affect often accompanies extreme apathy which causes lImited ability to communicate.


• Be a source of deep frustration. Patients know it is a problem but may feel powerless to do anything about it.


• There is hope. Following are a few suggestions that have worked well for me.


• I used a counter bought at a sporting goods store. Everytime I said hello to someone, I checked the counter which I kept hidden in a pocket and gave myslelf an award for every twenty clicks.


• I stood in front of a mirror every morning before going to work and practiced various facial expressions.


• I watched people who are at ease socially and I emulated their body language and facial expressions.


• I learned to morve around instead of remaining so still and impassive most of the time.


• I exercise to reduce depression and anxiety.


• I learned to laugh - a lot.


• I stopped hiding socially.


• I practice forgiveness to bring peace of mind.

Dear readers: If you know anyone who fits this description, be patient with them. Chances are that depression may be a reality for them. Be gentle about trying to help. Often just being there is the greatest assitance they can receive. Gently point out the need to develop better social skills.

Readers: If you have any ideas about overcoming flat affect, please comment about it. I'm open to any and all suggestions.