By Liz Krieger
A swipe of lipstick can put a smile on your face, but when it comes to beating depression, beauty products usually don't do the trick. Enter Botox, the forehead-smoothing toxin that can erase fine lines, stop sweating, and even squelch migraines. It turns out that a vial may have the power to make you happier—and not just because your wrinkles have disappeared.
Sarah, 47, had struggled with major depression since she was 21 years old. She'd tried endless hours of talk therapy as well as a raft of antidepressants. Though the meds helped to some extent, her sadness remained dominant. That's when a postcard arrived in the mail, seeking participants for a depression study associated with Georgetown University that involved using Botox. Despite having few frown lines, Sarah was interested and enrolled. Within a week or two of getting what ended up being Botox, not the placebo, she says she felt something she could describe only with a word that might seem impossible to anyone living under a cloak of despair: "lighthearted."
And Sarah wasn't the only one smiling thanks to a syringe. Of the 74 people in the study—all of whom had been diagnosed with major depression—half were given Botox and the other half were given saline placebo injections in the "frown" muscles between their eyebrows. Six weeks later, 52 percent of patients who'd been injected with Botox felt significantly better, compared with just 15 percent of patients who didn't get the real stuff. In fact, the scores of the Botox recipients on a depression-rating scale were down almost 50 percent, compared with 21 percent for the group who could still scowl. Surprisingly, even when study participants were able to sleuth out which type of shot they'd received—and only about half could tell—it had no bearing on whether or not they felt better. In short, if you can't frown, you can't feel down.
The notion that a grin or a grimace can actually influence your emotions is nothing new, says Maryland dermatologic surgeon Eric Finzi, a co-author of the Georgetown study and author of the 2013 book The Face of Emotion: How Botox Affects Our Mood and Relationships. Back in the 1870's Charles Darwin theorized that our facial expressions don't just telegraph happy or sad to the world but that they also create and enhance those emotions. Shortly after, the philosopher and psychologist William James wrote, "Smooth the brow, brighten the eye."
These guys were on to something, says Norman Rosenthal, a professor of psychiatry at Georgetown and the study's other co-author. The muscles of the face send feedback directly to the bran via the cranial nerves, not through the spinal cord. "I call these the 'hot wires' to the brain," says Rosenthal. There's even more compelling evidence in a rare neurological condition called Moebius syndrome, wherein certain muscles of people's faces don't function, so they can't smile or frown, he says. Because of this, it appears that "their capacity for happiness or sadness can be hampered."
Yet to some, this may seem like a vastly oversimplified way to explain depression, which, after all, can be so complex, says Josie Howard, a psychiatrist in San Francisco. That's why people who have serious depression shouldn't toss their meds and abandon therapy just yet, says New York psychiatrist and dermatologist Amy Wechsler. "Depression has always been something that's best treated by a range of things, and I think this may well be a powerful new tool in our arsenal," says Wechsler.
Many doctors also note that they've had patients say that they've noticed a mood boost after getting their forehead smoothed. More than six million cosmetic Botox procedures were preformed in 2013—and who knows how many patients actually felt it was twofer. "I could see this becoming something that many women seek out to erase wrinkles and feel a bit happier," Howard says.
But for the nearly 15 million Americans who suffer from depression, this could be the biggest thing since Prozac, not to mention a lifesaver, says Finzi. He recalls one patient who credited Botox with zapping suicidal thoughts—urges that returned as soon as the treatment wore off. To that end, Botox's parent company Allergan, is currently in Phase II clinical trials for its use in treating major depressive disorder in women. The bottom line: Rosenthal predicts that Botox will become a "standard treatment for depression in the future." For her part, Sarah relished the results so much that once they began to wear off, she went back to Finzi for more shots, and has done so ever since. "I'm afraid to see what would happen if I stopped," she says. "But I definitely don't want to. My face just feels happier."