What is Emotional Blunting: Causes, Symptoms, Risk factors, Diagnosis and Treatment

What is Emotional Blunting?

Emotional blunting is a term used to describe a condition where an individual experiences restricted emotional reactivity. In fact, many times, the person might not even be experiencing any emotions at all. Individuals who have emotional blunting may also report experiencing an unpleasant numbness rather than feeling emotions. Depending on the cause, emotional blunting can last for a few minutes, a few months, or even years. There are many reasons why a person experiences emotional blunting, including substance abuse, psychiatric prescriptions, and certain mental health conditions. Depending on the cause of emotional blunting, your doctor will determine the treatment.(1, 2, 3, 4, 5)

Symptoms of Emotional Blunting

As the name suggests, the main symptom of emotional blunting is a numbing of emotions or emotional experiences. This also includes how an individual feels internally. Emotional blunting can also be accompanied by blunted affect. It may also be said that emotional blunting is an inability to express emotions on their face, through their behaviors, and in other forms of communication.

The blunted affect that accompanies emotional blunting is particularly common in people who also have moderate to severe depression.(6) It sometimes also appears with post-traumatic stress disorder (PTSD) or schizophrenia.(7, 8, 9)

When people show emotions in a manner that other people would say to be limited, experts sometimes call this as the flat affect.(10)

Emotional blunting is known to be associated with the following symptoms:(11)

  • Restlessness
  • Inability to feel sadness and happiness
  • Difficulty speaking
  • Feeling disconnected from the mind and/or body
  • Loss of sexual drive
  • Lack of motivation
  • Fatigue
  • Difficulty feeling affection or love towards self or others
  • Difficulty socializing, maintaining, and forming relationships
  • Feeling of indifference, even towards activities that a person once found important
  • Difficulty concentrating along with forgetfulness
  • Having a compulsion toward reckless behavior or self-harm in an attempt to feel something

What are the Causes of Emotional Blunting?

Emotional blunting is not considered to be a particular mental health condition. It is seen as a symptom of another condition. Due to this, there can be a variety of possible causes, including:

  • Alexithymia: This is a rare mental health disorder that is not understood very well. It is marked by a difficulty in recognizing and feeling emotions.(12)
  • Depression medication: Research has shown that many people who are on antidepressant medications like SSRIs (selective serotonin reuptake inhibitors) experience a reduction in their ability to feel emotions.(13)
  • Major depressive disorder: Depression, as well as the medications commonly prescribed to treat it, can cause some people to experience feelings of emptiness. It also makes it challenging to feel both positive and negative emotions.(14)
  • Schizophrenia: People who have been diagnosed with schizophrenia, a mental disorder, often tend to experience negative symptoms that make them reduce or completely lose their ability to function normally. This also includes their ability to experience emotions.(15, 16)
  • Drug use: For some people who are living with substance use disorders, the consumption of drugs like cannabis or opiates such as heroin can be a cause of emotional blunting. This happens because certain drugs, including alcohol, can repress the central nervous system.(17)
  • Alcohol use disorder: Alcohol is a known central nervous system depressant. It has a strong impact on a person’s mood, and for those people who have alcohol use disorder, alcohol can create feelings of emotional numbness.(18, 19)
  • Post-traumatic stress disorder (PTSD): People with PTSD or even complex PTSD may also experience dissociation from their emotions, especially when they have flashbacks to their trauma or come face to face with triggering conditions.
  • Borderline personality disorder (BPD): This is a personality disorder that is characterized by intense and sudden changes in mood. However, during moments of serve stress, people with a borderline personality disorder may also experience dissociation, detachment, or emotional numbness from their body and mind.(20, 21)

How is Emotional Blunting Diagnosed?

It is important to know that emotional blunting is considered to be a mental health condition. However, it is considered to be a symptom of a mental cause or an underlying physical condition. If you are experiencing emotional blunting, it is a good idea to seek an appointment with a mental health professional. They will screen your symptoms and go over your mental health and physical health history to understand what your unique circumstances are and what medical condition could be causing this emotional blunting.

Risk Factors for the Development of Emotional Blunting

It has been observed that certain people are more at risk of experiencing emotional blunting than others. Some of the common risk factors that can increase the likelihood of developing emotional blunting include:

  • Diagnosis of borderline personality disorder
  • Diagnosis of schizophrenia
  • PTSD or complex PTSD
  • History of alcohol or drug use
  • Taking certain medications like antidepressants(22)
  • Current diagnosis or a past history of anxiety or depression

What is the Treatment of Emotional Blunting?

There are two sides to how emotional blunting is treated. One option involves working with a mental health professional, while the other involves doing whatever you can do to manage it on your own.

So how can a mental health professional help you? Well, a mental health professional can help treat emotional blunting by addressing the underlying cause. This is why it is important to consult a therapist if you are experiencing the symptoms of emotional blunting. Some of the potential treatment options that your mental health professional may recommend include:

  • Talk Therapy (psychotherapy): This type of therapy helps address any mental health conditions that are the underlying cause of emotional blunting, including depression, PTSD, complex PTSD, or borderline personality disorder.
  • Medication or dose adjustment: This is for those people whose emotional blunting seems to be caused by psychiatric or other prescription medications, especially antidepressants.

And how can you, yourself manage this condition? So while emotional blunting and the underlying causes should ideally be treated by a licensed mental health professional, there are a lot of things you can also do on your own to find relief from emotional blunting. These include:

  • When you feel empty or numb, try to stimulate one or more of your senses. This may include taking a warm shower or bath, cuddling a stuffed animal, eating spicy food, or even holding a piece of ice.
  • Try to engage in activities that you used to enjoy earlier. Even if you don’t feel any amount of happiness doing them now, but these activities can still help open up your emotional range and enhance your mood.
  • If the underlying cause of your emotional blunting is due to a substance or alcohol abuse, you should consider joining a support group or program that helps address these issues.
  • If you have been diagnosed with a mental health condition, it may help to join a support group or have your own support system to help cope with the diagnosis.

Conclusion

Emotional blunting is not a separate condition. It is considered to be an unpleasant symptom of various conditions. Treating the underlying cause of your emotional blunting can help reduce the severity and frequency of this lack of emotion in your day-to-day life. If you are seeking treatment, keep in mind that it may take some time to start seeing the positive impact of treatment. Changing your medication dose, joining a substance use support group, or going to psychotherapy, will help you deal with emotional blunting, but it won’t make the symptoms disappear overnight.

With the right treatment and time, it is possible to deal with emotional blunting and get back to living life with a full range of emotions.

References:

  1. Abrams, R. and Taylor, M.A., 1978. A rating scale for emotional blunting. The American Journal of Psychiatry.
  2. Opbroek, A., Delgado, P.L., Laukes, C., McGahuey, C., Katsanis, J., Moreno, F.A. and Manber, R., 2002. Emotional blunting associated with SSRI-induced sexual dysfunction. Do SSRIs inhibit emotional responses?. International Journal of Neuropsychopharmacology, 5(2), pp.147-151.
  3. Goodwin, G.M., Price, J., De Bodinat, C. and Laredo, J., 2017. Emotional blunting with antidepressant treatments: a survey among depressed patients. Journal of affective disorders, 221, pp.31-35.
  4. Winterich, K.P., Han, S. and Lerner, J.S., 2010. Now that I’m sad, it’s hard to be mad: The role of cognitive appraisals in emotional blunting. Personality and Social Psychology Bulletin, 36(11), pp.1467-1483.
  5. Berenbaum, S.A., Abrams, R., Rosenberg, S. and Taylor, M.A., 1987. The nature of emotional blunting: A factor-analytic study. Psychiatry Research, 20(1), pp.57-67.
  6. Christensen, M.C., Fagiolini, A., Florea, I., Loft, H., Cuomo, A. and Goodwin, G.M., 2021. Validation of the Oxford Depression Questionnaire: Sensitivity to change, minimal clinically important difference, and response threshold for the assessment of emotional blunting. Journal of Affective Disorders, 294, pp.924-931.
  7. Pietersen, C.Y., Bosker, F.J., Doorduin, J., Jongsma, M.E., Postema, F., Haas, J.V., Johnson, M.P., Koch, T., Vladusich, T. and den Boer, J.A., 2007. An animal model of emotional blunting in schizophrenia. PLoS One, 2(12), p.e1360.
  8. Henry, J.D., Green, M.J., de Lucia, A., Restuccia, C., McDonald, S. and O’Donnell, M., 2007. Emotion dysregulation in schizophrenia: reduced amplification of emotional expression is associated with emotional blunting. Schizophrenia Research, 95(1-3), pp.197-204.
  9. de Leon, J., Peralta, V. and Cuesta, M.J., 1993. Negative symptoms and emotional blunting in schizophrenic patients. The Journal of clinical psychiatry.
  10. Gur, R.E., Kohler, C.G., Ragland, J.D., Siegel, S.J., Lesko, K., Bilker, W.B. and Gur, R.C., 2006. Flat affect in schizophrenia: relation to emotion processing and neurocognitive measures. Schizophrenia bulletin, 32(2), pp.279-287.
  11. Stanton, B.R., Leigh, P.N., Howard, R.J., Barker, G.J. and Brown, R.G., 2013. Behavioural and emotional symptoms of apathy are associated with distinct patterns of brain atrophy in neurodegenerative disorders. Journal of neurology, 260(10), pp.2481-2490.
  12. Lane, R.D., Ahern, G.L., Schwartz, G.E. and Kaszniak, A.W., 1997. Is alexithymia the emotional equivalent of blindsight?. Biological psychiatry, 42(9), pp.834-844.
  13. Goodwin, G.M., Price, J., De Bodinat, C. and Laredo, J., 2017. Emotional blunting with antidepressant treatments: a survey among depressed patients. Journal of affective disorders, 221, pp.31-35.
  14. Silton, R.L., Kahrilas, I.J., Skymba, H.V., Smith, J., Bryant, F.B. and Heller, W., 2020. Regulating positive emotions: Implications for promoting well-being in individuals with depression. Emotion, 20(1), p.93.
  15. Detach, H., 2007. Some forms of emotional disturbance and their relationship to schizophrenia. The Psychoanalytic Quarterly, 76(2), pp.325-344.
  16. Kohler, C.G. and Martin, E.A., 2006. Emotional processing in schizophrenia. Cognitive Neuropsychiatry, 11(3), pp.250-271.
  17. Changeux, J.P., 1998. Drug use and abuse. Daedalus, 127(2), pp.145-165.
  18. Eckardt, M.J., Harford, T.C., Kaelber, C.T., Parker, E.S., Rosenthal, L.S., Ryback, R.S., Salmoiraghi, G.C., Vanderveen, E. and Warren, K.R., 1981. Health hazards associated with alcohol consumption. Jama, 246(6), pp.648-666.
  19. Schuckit, M.A. and Monteiro, M.G., 1988. Alcoholism, anxiety and depression. British Journal of Addiction, 83(12), pp.1373-1380.
  20. Sansone, R.A. and Sansone, L.A., 2010. Emotional hyper-reactivity in borderline personality disorder. Psychiatry (Edgmont), 7(9), p.16.
  21. Vermetten, E. and Spiegel, D., 2014. Trauma and dissociation: implications for borderline personality disorder. Current psychiatry reports, 16(2), pp.1-10.