In the past year I have begun clenching and popping my jaw and I just found out how noticeable it is to others. Apparently I also widen my eyes and jut out my jaw. My cousin showed me a picture she had taken and I am in the background obviously doing it. It has also caused me to have a deep wrinkle under my chin. I am mortified now about it, especially at work. I take 200 mg of Zoloft every morning as well as 15 mg of Adderall twice daily and a 1 mg Klonapin at night. I am under a psychiatrist’s care for depression, anxiety, PTSD and ADD and have been for 8 years. I have also been in an inpatient facility twice, most recently in 2011. I am isolating myself because I am embarrassed of what I’m doing with my jaw and eyes. After seeing the picture I know how strange I look. Thank you for any help you can give.

A. It may be important to receive a medical evaluation to rule out a physical cause. The jaw clenching is likely related to anxiety and stress but without further investigation, you cannot be certain. You may want to consult either your primary care physician or a dentist.

You’ve been taking medication for a variety of mental health problems for nearly a decade. The jaw clenching might be a sign that your anxiety is not well controlled and that your medication needs to be adjusted. Have you ever considered counseling in addition to the medication?

You have become self-conscious about the photo and have begun to isolate. You may not be making the jaw-clenching face as much as you think. It may have just been one bad picture. Keep in mind that most people are unhappy with their photos because they’re overly self-critical. This may be the case with you. Also, even when photographers work with professional models, most of the pictures are unusable. Photographers often have to take many pictures, perhaps hundreds of pictures, to get the right shot. They recognize that of the hundreds of photos snapped, only one or two may be good. You may be overly self-critical.

Comprehensive mental health treatment typically requires both medication and psychotherapy. Many people find that one without the other just isn’t enough. Counseling could help you to deal with the root cause of your psychological problems. Counseling may be what’s missing from your treatment. Please take care.

Dr. Kristina Randle