It has been said that if one looks better, one feels better. If fact, studies in the USA have shown a definite link between depression and low self-esteem.
Now, in the first study of its kind in South Africa, researchers at the University of the Western Cape are testing this theory with a clinical trial, measuring the symptoms of depression sufferers while boosting self-esteem. In the six-month, double-blind study, researchers injected one half of patients with a muscle relaxant in their facial frown area, while the other group (control group) was injected with a placebo substance. The treatment will be repeated in three months’ time.
The hypothesis is that improving facial appearance will combat depression by boosting self-esteem. Professor André Oelofse from the Department of Medical Biosciences at UWC says that existing data indicates that individuals receiving treatment, which relaxes the facial frown lines, have significantly improved depressive symptoms.
“It has been suggested that the mechanism related to a positive feedback system, which is described as the facial feedback hypothesis, maintains that facial expressions send information back to the brain, consequently affecting emotional experiences positively or negatively,” he told TygerBurger.
This implies that voluntary contraction of facial muscles into a smile or a frown can lead to feelings of happiness or sadness respectively.
Oelofse says the facial feedback theory implicates a mutual interaction between emotional experience and facial muscular activity.
“This theory predicts two parallel effects. Firstly, expressing a facial expression should increase the strength of that emotion, and inhibiting a facial expression should decrease the intensity of that emotional experience,” he says.
Oelofse says it is possible that improved productivity at work, increased quality of life and self-esteem, as a result of the positive effect on depression symptoms, are also linked with this treatment.
Unlike conventional medication, this treatment has minimal to no side-effects.
“The long-term effect of one dose should also help with compliance with traditional antidepressant medication. Compliance can often be problematic in the treatment of depression. Because of long-treatment intermissions of approximately three months before a second treatment is needed, it makes it reasonably cost-efficient,” he says. It is important to note that this treatment is not a replacement for antidepressant medication, he says.
However, should the research prove positive, it can be used as an adjunct treatment to improve overall treatment compliance, with possible symptom improvement. During the six-month research period, subjects will complete questionnaires to monitor their mood and depression symptoms.
“If our theory is correct, depression symptoms will improve in patients receiving the treatment.”
Oelofse says there is a critical need for further research on cost-effective and perhaps adjunct methods in the treatment of depression to improve outcomes.
Major Depressive Disorder is a mood disorder distinguished by one or more major depressive episodes. The World Health Organization (WHO) has confirmed that depression is a major cause of disease burden and disability worldwide. According to the WHO, an estimated 350 million people globally are affected by depression, which is coupled with functional impairment, high medical costs, and poor quality of life.
“Approximately 50% of patients with a depressive disorder will respond to antidepressants at the start of treatment, and only one in three will reach remission. In addition to this, troubling side-effects are associated with current antidepressants,” he says.
“Direct costs of treatment include the cost of antidepressants and clinical visits. Indirect costs range from decreased productivity at work and absenteeism from employment, to early death. In addition, diminished self-esteem and damage to relationships can also occur.”
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