When we think of muscles that can be affected by stiffness and slowness, the muscles you work out in the gym are probably the first to come to mind: legs, arms, maybe even abdominals. However, the same stiffness and slowness that can impact your walking and other activities can have more subtle impacts, as well. One of these is reduced facial expression, also called hypomimia or facial masking.
When the muscles of the face are stiff or take longer to move, it can be hard to smile, raise your eyebrows or otherwise express your feelings using your face, which is an important part of how we communicate.
Combined with Parkinson’s speech changes, such as low voice volume, facial masking can make it hard for others to interpret your mood and intentions. People might assume you’re upset or depressed all the time, which can be frustrating if they constantly ask, “What’s wrong?” when you are feeling fine. On the other hand, if you are experiencing symptoms of depression, talk to your doctor. Mood changes are common in Parkinson’s, and treatable.
Managing Facial Masking
Medications to treat movement symptoms should help with facial masking, as they alleviate rigidity.
It is also a good idea to ask your doctor for a referral to a speech-language pathologist. He or she can teach you facial exercises that may help with masking, as well as other issues you may be having, including speech and swallowing problems.
Finally, if you are having more frequent cases of people misinterpreting your mood or not believing you when you say how you are doing, try explaining the difficulty with muscle control and expression. This may help people to better understand how you are feeling, and also increase their awareness of Parkinson’s.
"I was diagnosed with an essential tremor, but things got worse from there. I started thinking slower and had less expression on my face."
Page reviewed by Dr. Kathryn P Moore, Movement Disorders neurologist at Duke Health, a Parkinson's Foundation Center of Excellence.