It does look that way, but I speculate that it is not tilted down, or if it is, it is slightly tilted, but not enough to warrant a new image.
To stand without a constricted feeling I have to either tilt my head up, or stand with forward head posture. It is a huge relief to stand with my head somewhat level and directly above my neck so the weight of my head is supported properly. The problem is that doing so creates a constricted feeling.
I was laying down when that image was taken. Look at the soft tissue below my chin. Look how steep my mandibular plane is. How can I get this resolved? Something is unequivocally inadequate about the results.
Would ccw help? more straight advancement?
I am at my wits end. This is most certainly not a psychological fabrication.