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Why Do I Feel Numb?

Feeling numb can be very distressing. It’s usually caused by PTSD, depression, anxiety, substance abuse, and other conditions.

What is emotional numbness?

Emotional numbness is when a person feels numb to emotions and doesn’t experience a range of feelings. People describe it as feeling empty on the inside, unmoved by experience, and flat. Realizing you don’t feel as sad or as happy as you should can be distressing.

Emotional numbness is usually a symptom of another mental illness, like depression, post-traumatic stress disorder (PTSD), or substance abuse.

It is often a protective response. When you experience something traumatic (like a car accident), the brain may shut down the intense memories and feelings. That leaves you emotionally numb. This can happen with depression and anxiety too.

Emotional numbness may also be a response to brain cell death due to substance abuse or dementia. Some antidepressants and medications that target brain chemicals involved with emotion can also cause numbness.

Common treatments include therapy and sometimes medication, and treating the underlying cause.

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What is causing your emotional numbness?

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1. Post-traumatic stress disorder & acute stress disorder

Pro Tip

Emotional numbness is often a normal response to an abnormal event. Often, it can be protective, depending on the cause. When the brain is emotionally overloaded, it protects itself and shuts down the emotional experience, which results in numbness. —Dr. Bobbi Wegner

Symptoms

  • Feelings of emotional detachment.
  • Intrusive symptoms (disturbing dreams, flashbacks of trauma).
  • Negative mood.
  • Feeling like you or your surrounding areas are not real or distant (called dissociative symptoms).
  • Desire to avoid people, locations, and other things associated with the trauma.
  • Trouble concentrating, sleeping, or strong emotional responses (e.g., easily irritated).

Post-traumatic stress disorder (PTSD) can occur after witnessing or being a victim of trauma, especially a violent attack like a robbery, assault, or combat. Symptoms that appear within days of the traumatic experience are considered acute stress disorder. When symptoms do not go away, it’s known as PTSD.

The brain copes by disconnecting from the traumatic event—causing emotional numbness. People describe feeling disconnecting from events, as if they are watching their life from far away as an observer. Their life can seem unreal or dream-like. These symptoms are called depersonalization and derealization.

Treatment options include a combination of cognitive behavioral therapy and medications.

2. Depression

Symptoms

Depression is when a person feels persistently sad, hopeless, and discouraged. They lose interest in activities and life on more days than not. These symptoms get in the way of daily life, work, and friendships.

When depression is severe, people may feel emotionally numb. Their mood is so low that they become flat (without emotion) and uninterested in most things.

When someone is this depressed, they often are unable to get help themselves. Family and friends may need to help get them in touch with a mental health provider.

Depression is treatable with talk therapy, exercise, and sometimes medication.

3. Dementia

Dr. Rx

Be honest with your doctor. They will be trying to assess whether or not the emotional numbness is due to a physical issue (like a brain injury, a hormonal issue, etc) or a mental health issue (like depression, PTSD, etc). The treatments are very different, so it is important they know about everything, including substance use or abuse. —Dr. Wegner

Symptoms

Dementia is the decline in cognitive abilities such as memory, organization, language, problem-solving, and concentration. It is caused by brain cell damage and gets worse over time. There are many causes of dementia. Certain dementias are genetic, while others are not.

People with a type of dementia called frontotemporal dementia sometimes experience “emotional blunting,” where their range of emotions is very limited. Their affect (emotional expression) is flat.

Although there are some treatments that can slow the progression and improve quality of life, there is no cure for dementia. Treatments include talk therapy, occupational therapy, and medication that improves your cognition. Antidepressants are sometimes prescribed if dementia is causing mood changes.

4. Substance use disorder

Symptoms

Symptoms of substance use disorder vary by substance, but it usually causes a certain level of disruption in a person's life.

  • Recurring physical or psychological problems due to substance use
  • Relationship issues issues related to substance use
  • Disruption in your ability to manage responsibilities (work, home, relationships)
  • Taking more substance than you want or meant to
  • Unable to cut down

Substance abuse refers to an overuse of substances (such as alcohol, stimulants, pain medication, etc.) in a way that disrupts life. Because substances affect the brain and its functioning, emotional numbing can be a side effect of overuse. Substances kill brain cells and cause emotional, physical, and behavioral issues.

Substance abuse is treatable with talk therapy and sometimes medication. The effect of substances on the brain can sometimes be reversed, depending on the type of use and abuse.

So... which condition is actually causing your emotional numbness?

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Other possible causes

Other causes of emotional numbing include a side effect of a medication (like antidepressants), brain injury, neurological issues, and hormonal imbalance.

When to call the doctor

Pro Tip

The best place to start is with your primary care physician. They will help point you in the right direction in terms of next steps. —Dr. Wegner

Emotional numbness is not something that happens suddenly. It usually slowly builds over time as an underlying disorder worsens (like depression or dementia).

If you are concerned about emotional numbness or have any of the following symptoms, call your doctor or a mental health professional.

  • You are distressed.
  • You are having difficulty interacting with other people.
  • You have been diagnosed with a mental health illness and symptoms are getting worse.
  • You are having cognitive difficulties like forgetting recent events.

Should I go to the ER for emotional numbness?

You may experience sudden emotional numbness after exposure to a trauma or after a stroke. Go to the emergency room if you have any significant changes in your emotions or functioning without explanation.

If you have any thoughts of hurting yourself or anyone else, call 911 or go to your local emergency room immediately.

Emotional numbness treatments

  • Emotional numbness most often is a symptom of other conditions like depression, PTSD, or dementia. Seek treatment for these disorders.
  • Common treatments include talk therapy, cognitive behavior therapy, and sometimes medication (or adjusting the medication you’re taking).
  • Talking with others, getting exercise, and staying connected through community, are a few ways to help manage emotional numbness.
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