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    Tanse Upper Lip Muscles in Social Situations (with pics)
    An_249741 posted:
    I have a strange issue that eluded me for many years (about 15 years now). I would be grateful to get some answers; or at least get it issue classified.
    Occasionally, the muscles under my upper lips (mustacle area) get tense as if I am contracting them deliberately. The contraction is not repeating; i.e. not a twitch, but rather a fixed tension that lasts for 10-15 minutes and slowly loosens and gets back to normal.
    Depending on the severity, this is sometimes accompanied by similar but slight contractions in my eyelids (as if looking at a distant object). I have a very slight ptosis(one eyelid slightly shut more than the other while open) and it seems to get worse during the time of this problem. Sometimes there is also contracting hands (similar to making a fist, but not as fully closed).
    The issue occurs when I am in a social environment; typically in a dinner of coffe table; while having conversation with other people. I do not remember it ever occuring when I was alone; so it seems to be related to social context. It does seem to occur more often around people that I am not very keen on, i.e. those that I have some degree of tension or ideologic difference etc. It also did occur while sitting around a dinner table with family members where the conversation was not particularly interesting. It seems to occur more frequently when I am trying to describe something to other people in less-than-ideal circumstances in terms of rapport.
    Maybe it has to do with being to center of attention? Maybe some kind of feeling threatened in a way? I do not know.
    I am a healthy 29 years old male who gets regular exercise. As fas as I know I do not have any underlying health issues. The frequency highly depends on 'social exposure' apparently. There have been times that I did not experience the issue for 6 months, but also times when I got it 2-3 times in one day. Note that I am a working individual with pretty normal degree of social activity. I am not overly anxious in social situations in general; and am a reasonably calm guy in general.
    A photo is attached, showing both states.

    Any help would be greatly appreciated.
    Patricia Farrell, PhD responded:
    It sounds like some sort of anxiety response, but I'm not sure and I'm not an MD, so I don't know if it might be neurologic in nature. The ptosis is something which might be helpful to have evaluated by a neurologist.

    Some people in social situations can develop a type of psychogenic seizure (don't worry, it's not serious) and it is a response to excessive stress of some type. Even being bored can be stressful.

    I suggest you run this by your PCP and see if a referral would be wise.
    bluebyte replied to Patricia Farrell, PhD's response:
    Thanks Ms. Farrell, I guess I will first try to pin-point and solve any issues 'in my head'...

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