High Levels of Anxiety Can Make You Misinterpret Facial Expressions

It may not seem entirely obvious, but being able to understand facial expressions is one of the most basic forms of communication that we have as humans. These expressions allow us to infer thoughts, intentions, and emotional states of others that can influence how we act around them^1,2. You may say “hello” to a fellow coworker but infer from their facial expressions that they have had a rough day; this may make you more sympathetic when interacting with them.

While this is information that many of us innately perceive and react to, we do not all get the same information from the same emotional expressions. Scientific studies have looked at how individuals with autism spectrum disorder³, childhood antisocial behaviors⁴, schizophrenia⁵, and other extreme social disorders affect how they perceive emotions. The failure to properly recognize and categorize emotions (i.e., recognize a smile as happy) is believed to be a root cause of many behaviors associated with these social disorders. When we discuss people not reading emotional facial expressions, we tend to assume that one of these social disorders is at work — most likely autism spectrum disorder. However, anxiety, anxiety disorders, and other mood disorders such as major depression also influence how we read emotional faces^6,7. Specifically, people who have high levels of anxiety or depression often categorize faces as fearful or angry.

The Science Behind Emotional Face Processing

Studies of emotional face processing often use a version of a forced-choice task: Participants are presented with a face on the screen and asked to categorize the emotion. Common facial expressions tested are fear, happiness, sadness, surprise, disgust, and anger. For each one, the face is digitally manipulated to show levels of the emotion. Through several trials scientists can determine how sensitive a person is to certain emotions. The picture below (reproduced under Creative Commons license) shows such examples for disgust and anger⁸.

The step number at the bottom (3, 7, 11, 15) identified is the sensitivity to that emotion. When an emotion is incorrectly identified, it is considered miscategorization. Scientists use this information to determine emotional face recognition. Then they will examine whether personality traits can explain differences or stress the body more in some way (for example, by reducing the oxygen in the air). This method is shown to be a reliable way to measure emotional processing. (Its main limitation is that there’s no known facial movement that also provides information. Despite this, a study of this type can be reliably replicated, meaning that several scientists will show the same results.)

Scientific Results and What They Reveal

Many studies have shown that adults with clinically diagnosable anxiety generally have worse emotional recognition⁶. If we look at specific types of anxiety, we see some differences in how emotional faces are interpreted. People with social anxiety disorder are more sensitive to anger and disgust. Also, they are more likely to falsely attribute another emotion; for example, that a surprise face shows anger or disgust^11,12,13. Even in healthy adults without clinically diagnosable anxiety, studies have shown that those who rate anxiety more highly on a personality test were more sensitive to fearful faces^9,10.

These studies have changed how some psychologists and other scientists think about anxiety disorders. As researchers further study this relationship between anxiety and emotional recognition, they view the misinterpretation of emotion less as a symptom of anxiety and more of an initiating cause¹⁴.

This suggests that when a person becomes more sensitive to emotions such as anger, fear, or disgust, they’re also more likely to attribute different expressions to them, which may cause greater anxiety. Think of it as accidentally spilling a drink on the floor at a party. In reality people are being kind and trying to help you, but you may misidentify their facial expressions and think they are angry. This makes you more anxious and less likely to go to a party in the future, negatively feeding into your social anxieties.

What This Means for Anxiety Treatment

Modern anxiety treatment techniques focus on breaking this cycle. They teach people to have more conscious awareness of negative thoughts and to form a habit of reframing them positively.

The studies of emotional face processing help us understand another piece in the negative cycle of anxiety. The findings suggest that a very fundamental negative thought in those who have anxiety disorders is perceiving anger, fear, or disgust in others even when those emotions are not present. Nobody can fully understand another person’s state of mind, but those with anxiety disorders may automatically assume the worst. Armed with this knowledge, it’s important to be more mindful of how anxiety affects the recognition of emotions and help curb negative perceptions and behaviors.