Wow, it sounds like a tough situation. It can take forever to figure out which combination of meds work, and then after awhile they might not work as well. What type of disorder is your husband being treated for? Mood? Psychotic? My mom goes through similar struggles with my dad who has schizoaffective disorder (psychotic with mood). If the voices are telling him that nobody can know he can hear them, then he won't say.

Are you asking what a blunted affect is? It's in the title, but not your post. As I understand it, affect refers to one's emotional presentation and experience of emotions. So a person with a blunted affect would likely not have much range of emotion and appear flat or vacant. When I was at the worst of my depression, I experienced utter emptiness. An art therapist asked me to draw what I was feeling. I had such difficulty talking at the time, that I couldn't explain that the blank, empty page perfectly expressed how I was feeling. This is what I associate with the term "blunted affect". I don't think though that it has to be as extreme as my experience to be considered blunted though.

I think it's hard not to worry and think "here we go again." Your experience shows that there is valid reason for concern. Just brainstorming, one idea might be to write down things you notice that are concerning to you. Has your husband signed a release for you to exchange information with his therapist and his psychiatrist? Even if he hasn't, you can always call either of them to share information and express your concerns. Whether or not they can provide you with information depends on whether or not he has signed the release. They might be able to help you understand and decide if there is a problem.

Is your husband consistent with taking his medication? I assume there is concern for his own safety, what about your safety and the safety of others? Do you have a safety action plan? Does your husband have a mental health advance directive? (I don't know if that's the right term, but it's basically a plan that he would develop with you and his therapist and doctor that states what he would want in case of hospitalization, etc..)

I can imagine it's frightening. Do you feel like if you ask too much, it upsets him and could trigger something? like if there is a problem, he's not going to tell you because--well, for many reasons that I can think of...

I'm so sorry you're going through this. Take care of yourself.

-Sara