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 missed a music therapy internship in part due to extremely flat affect. For years, I was painfully aware of being apathetic and slow to react in social situations. This caused a lot of frustration because I was feeling very 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 manifest this symptom are affected in almost all areas of life. In order to survive, it may be necessary to retreat further and further, which aggravates the situation.

The flat effect can:

• Deepen depression because few want to associate with someone who has a limited range of emotional expression. This, in addition to the slow thinking that often accompanies depression, can make social interactions extremely difficult, if not impossible.
• Increase isolation because flat affect often accompanies extreme apathy causing limited ability to communicate.
• Be a source of deep frustration. Patients know it’s a problem, but may feel powerless to do anything about it.
• There is hope. The following are some suggestions that have worked well for me.
• I used a counter purchased at a sporting goods store. Every time I greeted someone, I checked the counter that I had hidden in my pocket and gave me a reward for every twenty clicks.
• I would stand in front of a mirror every morning before going to work and practice various facial expressions.
• I observed people who are comfortable socially and emulated their body language and facial expressions.
• I learned to snot instead of staying 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 someone who fits this description, bear with them. Most likely, depression is a reality for them. Be kind when trying to help. Often just being there is the most help they can get. Gently point out the need to develop better social skills.

Readers: if you have any ideas on how to overcome flat affect, please comment on it. I am open to any and all suggestions.