Flat

Joel Dean
Joel Dean, Founder of Joyful

Feeling flat means low feeling and low energy, as if someone turned the volume down on everything. Good news lands softly, bad news lands softly, and the days blur. On Joyful's wheel, flat is one of the seven core feelings, and it holds four kinds: numb, apathetic, bored and drained.

  • On the wheel: One of seven core feelings
  • Kinds of flat: Numb, apathetic, bored, drained
  • Nearby: Sad, calm
  • Often points to: Too much for too long, too little that engages you, or a change in health or medicine

Funny in theory

Flat isn't sad, exactly. It's an absence. Your favorite meal tastes fine, a friend's joke is funny in theory, and you do what's on the list and feel little about any of it.

"I'm fine," you say, because nothing is wrong enough to name.

That is part of why flatness can go on for a long time without anyone noticing, including you.

"My team hit the target we'd chased all year. Everyone was cheering. I smiled and clapped and thought, okay, what's next. I didn't feel anything I could point to."

Which flat is it?

Each kind of flat is missing something different, and each one has a different next step.

Numb
What's missing:
Feeling itself
Sounds like:
"I don't feel anything."
Read more:
Numb
Apathetic
What's missing:
The wish to act
Sounds like:
"What's the point?"
Read more:
Apathy
Bored
What's missing:
Something worth your attention
Sounds like:
"Nothing holds my interest."
Read more:
Bored
Drained
What's missing:
Energy
Sounds like:
"I've got nothing left."
Read more:
Drained

They overlap. Start with the one that fits best today.

If you've started a new medicine

One cause is easy to miss: some people who take SSRI antidepressants report that their emotions feel blunted.1

It isn't rare. In an online survey of 669 people being treated for depression, 46% reported emotional blunting.2

If you've felt flat since starting or changing a medicine, tell the doctor who prescribed it, and don't stop or change the dose on your own; the National Institute of Mental Health advises talking to a health care provider before starting or stopping any medication.3

When flat might be depression

The National Institute of Mental Health lists loss of interest or pleasure in activities, fatigue and a persistent "empty" mood among the signs of depression.3 They're a concern when they last most of the day, nearly every day, for two weeks or more.3 If that fits, see a doctor.

If flatness ever comes with thoughts of not wanting to live, call or text 988 in the US, or see crisis resources.

Turning the volume back up

  1. Pick the kind. Numb, apathetic, bored or drained? Each page in the table has steps for that one.
  2. Act before you feel like it. With feeling turned down, waiting for motivation can take a long time. Small actions first and feeling later is the order behavioral activation uses, a depression therapy with trial support behind it.4
  3. Add one strong sensation. Cold water on your face, a spicy meal, loud music you love, a steep walk. It gives you something clear to notice when feelings are hard to find.
  4. Look at what changed. New medicine, less sleep, a long stretch of stress, a quiet season? Write down when the flatness started.

When did you last feel something strongly, and what was going on then? Write it down, then write one piece of it you could bring into this week.

Answer this with Joy

Questions people ask about feeling flat

Is it the medicine or the depression?

In interviews with people taking SSRIs, most felt able to tell the blunting apart from the symptoms of their depression.1 Your prescriber can help you sort out which one you're noticing.

What's the difference between flat and calm?

Calm is settled, and you can still feel. Flat is turned down, and feeling is hard to reach.

  • Numb: when feeling itself goes quiet.
  • Apathy: when the wish to act is missing.
  • Bored: when nothing holds your attention.
  • Drained: when your energy is used up.

Sources

  1. Price J, Cole V, Goodwin GM. Emotional side-effects of selective serotonin reuptake inhibitors: qualitative study. British Journal of Psychiatry, 2009;195(3):211-217. https://doi.org/10.1192/bjp.bp.108.051110
  2. Goodwin GM, Price J, De Bodinat C, Laredo J. Emotional blunting with antidepressant treatments: a survey among depressed patients. Journal of Affective Disorders, 2017;221:31-35. https://doi.org/10.1016/j.jad.2017.05.048
  3. National Institute of Mental Health. Depression. https://www.nimh.nih.gov/health/publications/depression
  4. Ekers D, Webster L, Van Straten A, Cuijpers P, Richards D, Gilbody S. Behavioural activation for depression; an update of meta-analysis of effectiveness and sub group analysis. PLoS ONE, 2014;9(6):e100100. https://doi.org/10.1371/journal.pone.0100100