Immobilizing Frown Muscles Reduces Depression

Temporomandibular Joint (TMJ) Disorders May Increase Depression

The Facial Feedback Hypothesis states that facial expressions intensify emotions. Charles Darwin and William James (the father of psychology) were the originators of this concept. It has proven correct in multiple research studies beginning in the 1970s. More recent discussion regarding the facial feedback hypothesis has centered around a plausible explanation for the reduced depression found in patients who received cosmetic botulinum toxin injections (BTX) to reduce frown lines. BTX treatment for frown lines immobilizes the corrugator muscle—the frowning muscles between the eyebrows (Sommer et al., 2003; Lewis, 2018; Coles et al., 2019). While there could be several explanations for the reduced depression, most researchers assume it is due to the reduced facial feedback from frowning because, after BTX treatment, the patient is unable to frown (Lewis, 2018).

Little research has directly examined the influence of facial feedback on mental health. However, the discovery of depression reduction from BTX suggests that intensified emotions from facial feedback during distress might contribute to mental health disorders. Additionally, people with facial injuries, such as temporomandibular joint (TMJ) disorders and other temporomandibular disorders (TMD), often have depression and anxiety disorders (Wieckiewicz et al., 2022). The reason for this high correlation has not been examined. However, it’s possible that TMD alters normal facial feedback, contributing to the development of depression and anxiety symptoms. More research is needed to clarify the role of facial feedback in mental health disorders and the possibility that TMD treatments would also help heal depression and anxiety.

This website will highlight information from two recent literature reviews written by Katherine Wright examining facial feedback’s contribution to mental health. The first literature review was written by Wright as an undergraduate student at the University of Utah: Facial Feedback and Affective Dysfunction: The Impact of Facial Expression on Mental Health, which summarizes the Facial Feedback Hypothesis. The second literature review was written by Wright, as a postgraduate Harvard-Extension student: Exaggerated Facial Feedback from Temporomandibular Disorders May Contribute to the Pathophysiology of Depression, which discusses facial feedback and the high rate of depression and anxiety of those with TMD.

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References

Coles, N. A., Larsen, J. T., Kuribayashi, J., & Kuelz, A. (2019a). Does blocking facial feedback via botulinum toxin injections decrease depression? A critical review and meta-analysis. Emotion Review, 11(4), 294–309. https://doi.org/10.1177/1754073919868762

Lewis, M.B. (2018). The interactions between botulinum-toxin-based facial treatments and embodied emotions. Scientific Reports, 8(1), 1-9. https://doi.org/10.1038/s41598-018-33119-1

Sommer, B., Zschocke, I., Bergfeld, D., Sattler, G., & Augustin, M. (2003). Satisfaction of patients after treatment with botulinum toxin for dynamic facial lines. Dermatologic Surgery, 29(5), 456–460. https://doi.org/10.1046/j.1524-4725.2003.29113.x

Wieckiewicz, M., Jenca, A., Seweryn, P., Orzeszek, S., Petrasova, A., Grychowska, N., Winocur-Arias, O., Emodi-Perlman, A., & Kujawa, K. (2022). Determination of pain intensity, pain-related disability, anxiety, depression, and perceived stress in Polish adults with temporomandibular disorders: A prospective cohort study. Frontiers in Integrative Neuroscience, 16, 1026781–1026781. https://doi.org/10.3389/fnint.2022.1026781