Can our moods be affected by Botulinum Toxin?


Did the chicken or egg come first?

Does our mood reflect our facial expressions or do our facial expressions reflect our mood? We assumed that our emotions directed our facial expressions, but studies have suggested it is in fact our facial expressions that determine our emotions.

You cannot feel depressed if you are smiling and being expressive with your face. To feel depressed you need to have little expression on your face, look sad, look down and curl up your body. Whenever my children are upset or start crying, the first thing I do is to get them to open their body up, look towards the sky and crack a joke to get them to smile, and it works every time. Researches also understood the above strategy and started asking themselves if we presented a negative facial expression, such as frowning, could we change that persons mood and help depression.

William James an American philosopher postulated in 1890 that the common sense of viewing emotions is wrong. He went on to say without our bodies ability to express an emotion, it ceases to exist. For example, we cannot experience fear without faster heart beats, more shallow breathing, trembling lips, weak at the knees, goosebumps, etc.

Our facial expressions have evolved over millions of years. Charles Darwin in 1872 wrote, ‘A man may be absorbed in the deepest thought, and his brow will remain smooth until he encounters some obstacle in his train of reasoning, or is interrupted by some disturbance, and then a frown passes like a shadow over his brow’.

We can all tell if someone is angry by the negative facial expression such as frowning. We know the opposite to the negative frown is the positive smile.

‘A smile cures the wounding of a frown’ - Shakespeare

There are different types of smiles and a true genuine smile has been classified as the Duchenne smile. In this smile, Duchenne a French anatomist in 1860, observed the ‘smile of joy’ where the orbicularis oculi is activated and contracts to produce the crows feet. This is in stark contrast to the ‘Mona Lisa smile’ where the eyes are not involved at all when smiling. This can be used to our advantage, very few people can fake a genuine eye smile. If they don’t create lines around their eyes when they smile its either because it not a genuine smile or they've had Botulinum Toxin. Smiling is good for us. Smiling creates positive emotions and thus leads to a reduction in stress related hormones.

A third type of smiles is known as the Hawthorne’s ‘sad’ smile. This is where you are experiencing a sad/depressing event, lets say a funeral and you see a relative who is struggling to cope with the circumstances, you may just give them a small smile to indicate we are in this together and we will be okay.

Lets go back and look at the negative facial expression of frowning. There are different types of frowns (sad versus angry) depending on which muscles are recruited, and each one has a different meaning. If the inner part of your eyebrows point upwards whilst frowning, you will look sad. If however the eyebrows are drawn together and down whilst frowning, you will look angry.

Frowning occurs by the contraction of the glabellar muscles, of which there are two major ones - the corrugator supercilii and the procerus. It is the corrugator supercilii that contributes more to the frown. Translated from Latin, corrugator supercilii literally means ‘the wrinkler above the eye’ and the contraction of this muscle draws the eyebrow together to create the frown. We all know that the appearance of a frown will tell others exactly what you are feeling, but lets take it a step further, the actual process of frowning will tell you what you are feeling and this creating a state in your conscious mind and this will influence your decisions and your results.

Recent research has put flesh on the bones of these musings. Neurobiologists such as Antonio Damasio of the University of Southern California have demonstrated that emotions begin with actions - rapidly increased heart rate, for example - and end with the perception of those actions - the sensation of fear or anger. Damasio calls this the "body loop": the brain learns of the body's response to change via chemical and electric signals conveyed by the bloodstream and nervous system. Thus feeling follows behaviour; the mind follows the body.

I break this down using acronym T.E.A.R - Everything starts with Thoughts. This sparks off certain Emotions, which lead us into Action, which eventually determines our Results. We can see that our initial thoughts determine the results we achieve in life.

If we are postulating that its your facial expressions that determine your emotions and mood at any given time, then where we can seek this evidence. Hollywood. Actors have to take up their various roles and associated moods on a regular basis. As far back as the 18th century, a German dramatist Gotthold Ephraim suggested that, ‘the actor properly imitates all the external signs..and all the bodily...expressions of a particular (inner) state’ and therefore they will recreate this internally all the exact same emotions, thoughts and feelings of the acted part. This began the research into ‘facial feedback’.

Charles Ball in Essays on the Anatomy and Philosophy of Expression wrote, ‘by the actions and expressions of the body betraying the passions of the heart we may be startled and forewarned, as it were, by the reflection of ourselves, and at the same time learn to control our passions by restraining the expression of them’.

Charles Darwin then described, ‘the intimate relation which exists between almost all the emotions and their outward manifestation and partly from the direct influence of exertion on the heart, and consequently on the brain’.

In 1890 William James, a Harvard psychologist in his work ‘Principles of Psychology’ suggested that our muscles contribute to our emotions and that changes in the muscles are occurring all the time to suit the emotions of the moment even if we are consciously unaware of them.

More recent studies have shown a correlation between the intensity of the smile and the internal emotion it produces.

We all want to be happier and reduce the amount of stress we experience. How can we do this?

After reading this one simple way is to smile more and have more positive thoughts, this will lift your mood and decrease you producing any negative facial expressions.

What about the use of Botulinum Toxin?

Eric Finzi carried out Botulinum Toxin treatments on his patients that were depressed but showed no visible frowns. On review he noticed that these patients felt a marked improvement in their emotional state. He postulates that the contraction of these frown muscles are sending negative emotional signals to the brain and the brain is measuring the strength of the frown muscle contraction, weighing it against the strength of the smile and this deciding which emotion to produce.

My patients come in for a number of reasons, some cosmetic and some to improve their confidence. I would say it probably does put you in a better mood if you feel better about the way you look. It's like doing your hair, your teeth, whatever else.

It is not what happens to you that is important, it is what you feel and do about what has happened to you.
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