Did you know that your facial expressions alone can alter things like your heart rate, or even your skin temperature? There is a growing large body of psychological research supporting the “Facial Feedback Theory” – the hypothesis that facial expressions can affect and influence brain function every bit as much as does the brain in the way it directs and controls facial movements. The seemingly simple act of smiling apparently induces the releasing of certain chemicals in the brain that makes people feel better. And when people frown, increased levels of the chemicals leading to a depressed mood are circulating around. So did you frown because you were sad, or were you feeling sad because you frowned?
In the 1870’s it was Charles Darwin himself who proposed that it was possible that “you feel the way you look” just as much as “you look the way you feel” because of a feedback loop that supplies facial expression information back to the brain to tell it how it should be feeling. The brain then responds with the appropriate neurochemical releases – generating happy or sad feelings – as the face has suggested. A 1989 study had people watch a cartoon, then rate how funny they thought it was. Some of the study participants were asked to smile while watching whether the cartoon struck them funny or not. Those asked to smile consistently rated the cartoon funnier than those who were not asked to smile. Were the “smilers” more likely to be amused because they were in a happier state of mind? A 1991 study concluded that frown muscle activity was a reliable predictor of depression as well as depression therapy outcome. So even if you can’t muster up a fake smile, would those simply frowning less be less unhappy? What would happen if you could get someone to frown less?
Researchers realized that there was a tool that they could utilize to test that interesting question. The gold standard for definitively limiting the ability to frown and make other types of “negative” facial expressions- Botox®! Botox® – the great eliminator of the frowning, tired and stressed-out look for millions of people every year – long known to simultaneously boost the spirit and mood as well.
A 2006 study took patients in treatment for clinical depression and gave them all some Botox®. Almost all of the patients showed clear signs of improvement in their depression, independent of other factors, within the weeks following their Botox® session! Their symptom improvements paralleled the improvements in their appearance. Amazing! Still not convinced?
In March, 2012, at the 20th European Congress of Psychiatry, a similar study was presented which further supports the “Facial Feedback Theory” that facial musculature and expressions can both reflect and influence mood. Patients suffering from clinical depression and undergoing treatment were also treated with a single session of Botox®. An incredible 80% of the patients showed strong and sustained improvements in their depression, by both depression level testing scores and psychiatric interview scores. This included those patients who had responded poorly to their prior conventional treatments! 30% of the studied patients showed a full remission of all depression symptoms! The onset of alleviation of symptoms and the duration correlated with the onset (1 – 2 weeks) and duration (3 – 6 months) of the effects of Botox® in minimizing the frowning and wrinkling we associate with expressions of sadness, fear, anger, or stress. Positive effects on mood elevation were seen in nearly all the Botox® treated patients, including those with even modest softening of frown lines and wrinkles.
There is also the social feedback loop component to the “Facial Feedback Theory”. The “misery loves company” versus the “laugh and the whole world laughs with you” sort of thing. If you look happier, you “attract” happier people around you, which then makes you feel happier. The opposite certainly happens if you look sad or mad. And if you have too dark and too gloomy a look, it can really get bad as others tend to withdraw from you. You will likely end up alone and isolated, thereafter feeling even more dejected and sad. But clinical depression is an entirely different situation, where the chemical balances in the brain are off, and are biased in the “unhappy” direction. It seems incredible that a “forced change” in facial expression could affect those balances so significantly by a direct and somewhat mysterious connection between the face and the brain.
So, it is clearly not as simple as the concept that anything that makes us look better, such as any type of cosmetic surgery or procedure, will also be likely to make us feel better and happier. Apparently, we all have within us the ability to trick our very own brains into a better mood with our face, even if our face is “lying” to it. Then when our brain feels happier, we really are happier, and now the “lie” has becomes the truth. Wow! The brain has the face under constant surveillance, so it can figure out how it is supposed to feel. That means you can tell yourself how to feel. “Put on a happy face” has a whole new meaning, doesn’t it? And if you just don’t have it in you to smile more, at least try not frowning quite so much. A little Botox® sounds like a pretty good idea, too!
Dr. Lyle Back is originally from New York City, receiving his medical and surgical training at Rutgers Medical School, Cooper Hospital – University Medical Center, and Ohio State. He is Board Certified in General Surgery (ABS) and Plastic Surgery (ABPS). He is a Fellow of the American College of Surgeons (ACS), the American Academy of Cosmetic Surgery (AACS), and a longstanding member of the premier American Society of Plastic Surgeons (ASPS). He specializes in the full range of the most modern and state of the art facial cosmetic surgery procedures and non-surgical cosmetic enhancement techniques available today.
