Is your sister really depressed or does she have what's called 'pseudo depression'? ie looks like depression, but is actually other things. A cognitive rehabilitation specialist - a speech therapist or a neuropsychologist - can work with your sister and with those around her to help her better express some emotion nonverbally, a step toward ensuring improved acceptance and integration into social activities and closer interpersonal relationships. As with any other cognitive function following brain injury, intervention includes a combination of psychoeducation, remedial training/rehabilitation, teaching of compensatory strategies, and family/friend participation. She can then learn and practice varying emotional expressions to show how she is feeling and how she wants others to perceive her. For some people, however, flat affect can be permanent.ĭepending on your sister’s level of awareness, intervention may involve teaching her to recognize what her level of emotional expressiveness is and how others may read it. Also, recovery is still occurring at six months post injury, so you may see more improvement over time. As the depression is treated, through therapy and/or medication, you may see some lifting of the flatness as your sister becomes more emotionally responsive. A careful assessment by a neuropsychiatrist or neuropsychologist is often necessary to tease out just what the level of the person’s emotional experience is.įlat affect can be a factor of both the depression (also a common symptom after TBI) and the brain injury itself. In the brain, expression of affect occurs in the frontal lobe function, with specific localizations within the right hemisphere, cingulate cortex, limbic system, and in other areas that are involved in arousal.įor someone like your sister, flat affect may or may not occur in conjunction with deficits in her ability to actually feel different emotions and/or her ability to identify and label her emotions. They may also appear nonresponsive to the emotions of others. People with flat affect may not show the normal signs of emotion, may appear apathetic, may speak in a monotone, and may not change the expression of their emotions in response to varying situations as we expect them to. Affect refers to our emotional expressiveness - the degree to which our facial expression and demeanor reflect what we are feeling. “Flat affect” is a common symptom after a traumatic brain injury.
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