Alexithymia: Symptoms, Causes & Treatment Options

Symptoms of Alexithymia

Some of the most common signs of alexithymia include:

• Difficulty identifying your emotions accurately or precisely. You may know that something doesn’t feel right, but not be able to distinguish it as fear, anxiety, disappointment, anger, and so on.
• Finding it very uncomfortable or even impossible to describe your emotions to other people. For instance, you may describe physical sensations or simply say you are “fine” or “tired” without knowing how to explain the emotions behind the sensations.
• Having a more practical way of communicating, like describing events, routines, or ordinary details of your day rather than thoughts or feelings.
• Finding it hard to read people’s facial cues, tone of voice, or body language, which can lead to misunderstandings or awkwardness in relationships and social interactions.
• Finding your emotions hard to process, which can lead to higher levels of stress, often manifesting in physical symptoms like headaches, fatigue, muscle tension, and stomach discomfort.

Many people find it hard to process or explain their emotions at times. So it’s important to remember that simply experiencing one or two of these characteristics does not mean a person has alexithymia.

Alexithymia is different because these symptoms are persistent and affect a person’s daily life and relationships. For example, a person with alexithymia might find it hard to understand why they feel overwhelmed or distressed, which can make it more difficult for them to communicate their needs or seek support in difficult times.

Sometimes, friends, partners, or loved ones of people with alexithymia can also mistakenly interpret their communication challenges as apathy or disinterest, even when the person may care deeply.

Can Alexithymia Be Diagnosed?

Since alexithymia is not listed as a condition in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition) and is not considered a mental health disorder on its own, it cannot be diagnosed through a single test.

However, a qualified mental health professional can assess whether someone shows significant alexithymic traits. For this, they usually perform a detailed clinical evaluation, in which they ask about the person’s:

• Emotional experiences.
• Coping strategies.
• Relationships.
• Symptoms of other mental health conditions.

In some cases, a clinician may also use standardized questionnaires to support their assessment.^[9] These may include the following:

• Twenty-Item Toronto Alexithymia Scale (TAS-20): A commonly used screening questionnaire that measures a person’s ability to describe and identify emotions, and whether they can distinguish emotions from physical sensations.
• Bermond–Vorst Alexithymia Questionnaire (BVAQ): A 40-item questionnaire measuring a person’s ability to identify, analyze, and verbalize emotions. It also measures emotional responsiveness and imagination.
• Observer Alexithymia Scale (OAS): An assessment completed by someone who knows the person well (rather than the person suspected of having alexithymia answering the questions themselves).

Usually, clinicians use these assessments to understand how emotional processing difficulties are affecting a person’s life, rather than assigning a formal diagnosis of alexithymia.

Also, since alexithymia often occurs alongside conditions like autism spectrum disorder, depression, or trauma, an assessment is important to determine whether another condition is contributing to someone’s difficulty with emotional processing.