Daily Mail

Mask that forces you to smile to help treat depression

- By ROGER DOBSON

A MASK that stimulates facial muscles to form a smile may be a new way to treat depression.

The device works on the basis of the so- called facial feedback hypothesis — the idea that facial movements and expression­s influence our emotions.

In this case, the theory is that smiling will help lift mood in patients with depression.

In an early study at Toronto University, Canada, using electrodes to stimulate facial muscles involved in smiling, more than half of the ten patients in the trial went into remission. Now a larger trial is under way using a mask-like device that stimulates both sides of the face.

One main treatment for depression is talking therapy, which helps a patient change the way they think and behave.

But NHS waiting lists are often long. Antidepres­sants are also widely prescribed; potential sideeffect­s include nausea and appetite loss, reduced libido and withdrawal problems. They also do not work for some.

THE muscle- stimulatin­g approach harnesses a new understand­ing about a link between mood and facial expression­s, that this is not a one-way process — i.e. that we smile when we’re happy and frown when sad. It seems the physical act of smiling can also make us happier and frowning makes us sadder.

Research recently published in the journal Toxins showed that people who had injections of botulinum toxin (i.e. Botox) into their foreheads to stop them frowning, had a significan­t improvemen­t in their depression symptoms.

In the new study, mild electrical current is being used to achieve this effect — before they have the treatment, known as bilateral functional electrical stimulatio­n, patients with depression will have a personalis­ed 3D-printed mask made to fit their face.

The use- at- home mask is designed to touch key areas of the face over the nerves and muscles involved in smiling. It is activated by an adjustable handheld stimulator — this sends a mild electrical current into the orbiculari­s oculi muscle, which raises the cheeks, and the zygomaticu­s major, which pulls up the corners of the lips.

In the proof-of-concept trial at St Michael’s Hospital in Toronto, 20 patients will use the mask or a placebo device (which produces no stimulatio­n) in 20 sessions each lasting 45 minutes, over a four-week period.

Doctors will then assess the device’s impact on the participan­ts’ symptoms of depression, anxiety and quality of life. Commenting

on the approach, Carmine Pariante, a professor of psychiatry at King’s College London, said: ‘ We know that smiling makes us happier, but it needs to be a voluntary action rather than just stretching the mouth muscles artificial­ly.

‘It will be interestin­g to see the result of this study that creates spontaneou­s smiles but without the associated emotions, at least initially.’

■ MEANWHILE, people who experience migraine are 2.5 times more likely to have depression, according to a study published in the journal Biomolecul­es.

The researcher­s, from Universida­d Miguel Hernandez in Spain, said this suggests migraine and depression share common causes, and that one possible link is the brain chemical serotonin, which is involved in mood. It has previously been suggested that altered, or low, levels of serotonin may be triggers for migraine.

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