Emotional Blunting: What It Is, Causes and Treatment

What Is Emotional Blunting?

Emotional blunting is when the emotions you feel become narrower and less intense than they used to be. It affects both ends of the scale, meaning the good feelings are dulled as well as the difficult ones. Some people who experience blunting report losing emotional reactions like the ability to cry when situations are sad or, at the opposite end of the spectrum, to feel enjoyment when things are going well.¹

If you’ve been researching this topic online, you may see emotional blunting described as emotional numbness or emotional indifference, which mean the same thing.¹ When emotional blunting is linked to antidepressants, you might also see it described as SSRI-induced apathy.²

Emotional blunting isn’t something you can be diagnosed with on its own. Instead, it’s usually a symptom of a mental health condition or a side effect of medication, and in some cases it can be a mix of both. This is why working out where these feelings stem from is one of the first steps toward feeling more like yourself again.

What Does Emotional Numbness Feel Like?

We’ve all had days where we feel a bit flat, like when a long week of work finishes and you’re too tired to care about much of anything. Emotional numbness is different because it sticks around, and it can start to change how you experience the people and things in your life.

When researchers built a questionnaire from the way people taking antidepressants describe emotional blunting, four main experiences stood out:³

• A general reduction in all of your emotions
• Fewer positive emotions
• Feeling emotionally detached
• No longer caring about things the way you used to

Some people also say their emotions start to feel more like thoughts than feelings. If you’ve never experienced emotional blunting, that might sound a little confusing, but for those living with it, it can be the clearest way to put it into words. They can still respond to emotional moments in the right way, but without what feels like real feeling behind it.⁴

For example, imagine your partner shares some exciting news with you. You know you should feel happy for them, but the feeling never quite lands. You say the right things and smile in the right places, but inside, very little is happening.

How Is Emotional Blunting Different From Similar Experiences?

Several experiences sound, and perhaps even feel, a lot like emotional blunting, and it’s easy to mix them up when you’re trying to put a name to what you’re feeling. Knowing the difference can help you describe what’s happening when you speak to a professional.

Anhedonia

Anhedonia is a loss of interest or pleasure in the things you used to enjoy, and it’s one of the core symptoms of depression.⁵ It shares similarities with emotional blunting, but the main difference is that blunting can dull difficult emotions too, like sadness, as well as the enjoyable ones.¹

Alexithymia

Alexithymia is difficulty identifying and describing your own emotions, and it affects around 10% of the general population.⁶ Emotional blunting is a change from how you used to feel, whereas alexithymia is usually considered a long-standing personality trait.⁶

Depersonalization and Derealization

Depersonalization is when you feel detached from yourself, as if you’re watching your life unfold from the outside. Derealization is the feeling that the world around you isn’t real. Emotional numbness can be part of depersonalization-derealization disorder, which is why it’s important to seek professional help if you notice these kinds of feelings.⁷

Blunted Affect

Blunted affect is something you may notice in other people, so it’s worth understanding if you’re reading this because you’re worried about someone you care about.

Emotional blunting describes what you feel on the inside, whereas blunted affect describes what other people can see on the outside. It refers to reduced emotional expression, like fewer facial expressions or a flatter tone of voice, and it’s a recognized symptom of schizophrenia.⁵ This means someone can look emotionally blank to others but still feel plenty inside.⁸

Which Mental Health Conditions Are Linked to Emotional Blunting?

As we covered earlier, emotional blunting isn’t a standalone diagnosis. It’s a symptom that can show up in different mental health conditions. If you haven’t been diagnosed yet, it can be hard to know where your numbness is coming from. Looking at the conditions it’s linked with may help you recognize some of your own experiences and give you a good starting point for a conversation with a mental health professional.

Depression

Feeling flat or empty is common in depression. Its core symptoms include a low or empty mood and losing interest or pleasure in things, so you may stop looking forward to things or feel less connected to the people you love.⁵

So can depression itself cause emotional blunting? Research suggests it can. In one survey of people taking antidepressants for depression, those with more severe depression symptoms reported more emotional blunting.¹ This led the researchers to conclude that blunting is a symptom of depression as well as a possible side effect of medication.¹

Aside from medication, lab studies have found that people with depression react less to both positive and negative emotional material, with the biggest drop seen for positive material.⁹ One theory is that low mood reduces your drive to act and turns your attention inward, which may dull your reactions, especially to things that don’t feel personally important.¹⁰

Anxiety

If you’ve only just learned that anxiety and emotional blunting can be linked, it would make sense to assume the anxiety is what’s fueling the numbness. The research points somewhere else. In one survey of people taking antidepressants for depression, how strong their emotional blunting was tracked with their depression scores, but not with their anxiety scores.¹

The clearer link is with medication. Emotional blunting has been reported with antidepressants, especially SSRIs, which are also widely prescribed for anxiety, and it has been seen in people treated for anxiety disorders as well as depression.² One explanation is that SSRIs raise serotonin levels in the brain, which can change how dopamine works.¹¹ Dopamine helps your brain respond to both rewarding and unpleasant experiences, so when these responses are dampened, both ends of your emotions can flatten.¹¹

This may show up as no longer caring about things that used to make you anxious, or as a more general numbness.^2,16

PTSD

After a traumatic experience, some people develop PTSD. Its symptoms can include feeling numb, being unable to have positive or loving feelings toward other people, and losing interest in things you used to enjoy.¹²

Many trauma survivors report these changes in their emotions, and feeling detached from others and being unable to feel positive emotions are part of the official diagnostic criteria for PTSD.^5,14

One explanation is that PTSD keeps your body in a high-alert state, and staying in that state for a long time can drain your emotional resources.¹³ A study of Vietnam combat veterans found that hyperarousal symptoms, like feeling constantly on edge, were the strongest predictor of emotional numbing.¹³

Researchers have also suggested that people with PTSD may need more intense positive experiences to feel the full range of pleasant emotions. This means everyday moments of happiness may not register as strongly as they once did.¹⁴

Schizophrenia

Blunted affect, which we covered earlier, is one of the main negative symptoms of schizophrenia.¹⁵ Researchers are still working to understand what causes negative symptoms like this, but problems with the brain’s reward and motivation systems are thought to play a part.¹⁵

What may surprise you is that people with schizophrenia often report feeling emotions just as strongly as other people, and sometimes more so. The difficulty seems to be more about looking ahead, as people with schizophrenia may find it harder to anticipate that future experiences will be enjoyable.⁸

The side effects of antipsychotic medication can also play a role, as heavy sedation or movement-related side effects can flatten emotional expression.¹⁵ If these side effects are mistaken for the condition getting worse, it can lead to the wrong treatment approach, including more antipsychotic medication.¹⁵ This is why a full assessment by experienced mental health professionals is so important for people with schizophrenia.

Can Antidepressants Cause Emotional Blunting?

As the last section showed, medication can play a big part in emotional blunting across different mental health conditions. Much of what we know comes from research on people taking antidepressants for depression, so that’s what we’ll use to explain the link below.

One survey found that 46% of people taking an antidepressant for depression reported emotional blunting,¹ which raises the question: is it the medication itself or the condition causing it?

Is It the Medication or the Depression?

Because both depression and antidepressants are linked with emotional blunting, it can be difficult to know which one is behind it. In one survey, people still taking antidepressants who had few depression symptoms left reported more blunting than people who had recovered and stopped their antidepressants at least two months earlier.¹ This suggests the medication can play a role in emotional blunting, even when the depression itself has eased.

In one small interview study, most people taking SSRIs felt they could tell the difference between emotional side effects and their depression.¹⁶ Clues they described included:

• Numbness that continued even after other symptoms of depression had improved
• Changes in how they felt after a change in their dose or medication

If you’re unsure, these are good questions to think about before speaking with your prescriber.

Does Emotional Blunting Happen With Every Antidepressant?

In one study of people whose depression was in remission, emotional blunting was reported at similar rates with most antidepressants, but some stood out. It was least common with bupropion (31.82%) and most common with duloxetine (73.68%). The researchers noted that their study was small and that more research is needed before drawing firm conclusions.¹⁷

Even at the lower end, that’s nearly a third of people, so it’s important to let your care team know how you feel.

Research on antidepressant-related apathy, which includes emotional indifference, also suggests it’s dose-dependent and reversible.² This means higher doses may make blunting more likely, and it can ease when the dose is lowered or the medication is changed under a prescriber’s guidance.²

What Can Be Done?

If you feel your medication is behind your emotional numbness, the first step is to speak with your prescriber, and not to stop or reduce a dose on your own. Stopping or reducing some antidepressants suddenly can cause withdrawal symptoms, so any changes should always be made with their support and guidance.

If you and your prescriber decide something needs to change, the main approach for antidepressant-related emotional blunting is lowering the dose.² In some cases, you may be switched to a different type of antidepressant, or another medication may be added.² Adding a medication might sound like the opposite of what you’d want, but some research suggests certain medications may help with this side effect when taken alongside your antidepressant, though the evidence is still limited.²

Again, it’s important to let your prescriber know if you’re experiencing emotional numbness, even if your medication is helping in other ways. Stronger emotional blunting has been linked with a less complete recovery from depression,¹ but it’s something mental health professionals can help with.

How Is Emotional Blunting Treated?

How emotional blunting is treated depends on what’s behind it, and on where you are right now. Understanding the cause always comes first, but how you get there depends on whether you’ve already been assessed or are already taking medication.

If You Haven’t Had an Assessment Yet

If you’ve noticed emotional numbness but haven’t spoken to a professional about it, the first step is a psychiatric evaluation. The term can sound worrying at first, but it’s a conversation with a mental health professional. You’ll talk through your mood and how you’ve been feeling, when the numbness first started, your health and medication history, and what you’d like from treatment.¹⁸ It’s a chance to feel heard and understood.

If You’re Already Taking Medication

If you’re already in treatment and the numbness started after you began your medication, a medication review can help your prescriber work out what’s causing the feeling.

From there, they may discuss options like lowering your dose or switching to a different medication, as we covered earlier.² If you feel your concerns haven’t been heard by your current provider, a second opinion can give you a fresh perspective.

Therapy

Whatever your situation, therapy is a core part of mental health treatment, and some approaches focus directly on helping you feel positive emotions again. One therapy, positive affect treatment, focuses on building positive feelings rather than only reducing negative ones. A trial in people with depression or anxiety found that it led to greater improvements in positive emotions than a therapy focused on reducing negative emotions.¹⁹

If your emotional numbness is linked to trauma, trauma-focused therapies like cognitive processing therapy, prolonged exposure and EMDR are among the most effective treatment options for PTSD.²⁰

When Should You Get Help for Emotional Numbness?

Everyone feels flat from time to time, but when emotional numbness starts to affect your daily life, it’s a sign to reach out for help.

Ask yourself the following questions:

1. Do you feel distant from the people closest to you?
2. Has your academic or work performance started to slip?
3. Are everyday tasks too difficult to complete?
4. Have you felt “not like yourself” since starting a new medication?
5. Have you thought about stopping your medication because of how it makes you feel?
6. Does your numbness come with hopelessness or the feeling that nothing matters?

Answering yes to any of these is a good reason to speak with a mental health professional, who can help you understand the root cause and find the right way forward.

How Peak Mental Healthcare Can Help

If your emotions have started to feel muted, or something hasn’t felt right since you began a new medication, Peak Mental Healthcare can help you understand why this is happening and what can help.

Care at Peak starts with a psychiatric evaluation, a one-on-one conversation with a licensed psychiatric nurse practitioner. Together, we’ll look at your symptoms and health history, along with any current and past medications, to understand what could be contributing to your emotional numbness.

If medication is part of your treatment plan, our medication management service supports you from there. We’ll discuss possible side effects with you and provide regular check-ins to see how the medication is working for you. If something isn’t working, we can adjust your medication plan based on what’s best for your situation.

While our providers focus mainly on medication management, they may offer brief supportive therapy during your follow-ups. If you’d benefit from regular therapy sessions, Peak can refer you to trusted therapists in your community.

Find your nearest Peak location in Arizona or Colorado and book your evaluation, which takes just a few minutes to complete online. Same-day appointments are often available, so you can start getting support sooner.