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Botox is Like Laughter: How Botox May Help Depression

My friend Jennifer used to laugh at everything. Everything. Even if I was recounting something that really annoyed me. She would laugh. Sometimes I would think, Does she think it’s stupid what I’m saying? Is it really not important? And then one day I decided, I’m going to try that: I’m going to laugh instead of get annoyed. When the guy cuts me off on Mopac I’m going to laugh at him for being so ridiculous instead of being affected by his anger. When the end of a stressful day is accentuated by a new mess from the dogs, or maybe a temper tantrum from the child….laugh at how crazy life can be instead of fill with anger.

It was a pretty amazing feeling, and that laughter creates its own momentum of happiness and release in your body. When I hear myself laugh, when I see that smile on my face and experience the feeling it brings inside, the annoyance leaves and the anger melts and it feels GOOD to laugh and smile. Laughter and smiling breed more positive emotions. They lighten your mood and make you happier. Apparently Botox is like laughter too.

Wait, what?

I heard a few weeks ago that Botox can make you happy. My first thought was, Well, I guess if having less wrinkles makes you happy, sure, that makes sense. Or maybe you’re just happy that you have enough money to pay for the Botox. That’s good too. So, I decided to do some reading and see what this is all about.

Here’s the general idea behind the link between Botox and mood improvement:

A popular place to have Botox injected is in the forehead to lessen frown lines. The way Botox works is that it inhibits nerve transmission and keeps the muscle which is injected from firing. When injected into the forehead, you are unable to produce much of a frown. That muscle is also involved in expressing not just sadness, but also anger and fear. So the idea is that emotions are expressed by facial muscles, which in turn send feedback signals to the brain to reinforce those emotions. Treating facial muscles with Botox breaks this cycle. Think of it as a feedback loop: the act of frowning reinforces negative emotion. The act of smiling reinforces positive emotion. The less you frown, the less negative feedback your brain receives.

Sound pretend? Too good to be true? It’s not really all that far-fetched when you think about it. Ever heard of “fake it ‘til you make it”? Or what about cognitive behavior theory (altering your behavior to produce change in your emotions)? Many studies have shown that displaying positive emotion can put you in a good mood. And this is not a new idea.

Some Botox/mood research: Nearly 150 years ago, Charles Darwin recognized that facial expressions not only communicate the emotions we feel but intensify them, by sending cues back to the brain. Over the years, research has repeatedly shown that we can influence the way we feel by what our face projects. Smiling can help us feel happier. Frowning can make us feel angrier.

Botox for depression was first in the news because of the research of Dr. Eric Finzi, a dermatologist, who noticed that some of the patients whose brows he injected with Botox, to remove wrinkles, began to feel relief from depression. Almost a decade ago, he took his idea to psychiatrist Norman Rosenthal, who researches how light and odors affect our moods. In fact, Rosenthal was the one who proposed the idea of seasonal affective disorder nearly 30 years ago. And if Botox for depression seems like a silly idea, Rosenthal said people laughed at the idea of light therapy for people depressed during the dark months of winter. Now that therapy is standard.

I personally have struggled with depression for most of my life. After trying many ways to deal with it, including various medications, I finally settled on Wellbutrin and have taken it for 15 years. I have tried getting off of it at various times, never with good results. Lately, within the last month, I’ve realized I haven’t been good about taking it. In fact, I think I’ve probably been taking three a week, instead of one each day. Kind of a gamble. I haven’t been doing it on purpose…I’ve just been neglectful. I’ve also realized I haven’t been struggling with the same depression that is pretty much a part of me.

Smack on the head. I got Botox about a month ago!

It never occurred to me that this whole facial feedback could be a part of why I have been feeling less depressed. For me personally, I do feel happier when I look in the mirror and see that I look more rested. That in itself is feedback. I honestly have felt so tired and worn out for several years, and my face, to me, has reflected that in the mirror. But now, I look in the mirror and see a more rested face looking back at me. Positive feedback. I am really becoming a believer here. I’m definitely not the only one experiencing this.

Studies on Botox for depression have been ongoing for about a decade. But a most recent one, which was a randomized, double-blind, placebo controlled trial (translation: the gold-standard of research studies), published in the Journal of Psychiatric Research, found that the majority of the depressed patients injected with Botox saw their mood improve: findings showed a 52 percent reduction in depression for patients injected with Botox, compared to 15 percent in the ones who received the saline placebo.

Don’t get me wrong. I’m not saying Botox cures depression. And personally, I’m not gonna stop taking my Wellbutrin. That would just be kooky talk. But I think my personal experience reflects what the studies are showing: that Botox is helpful in enhancing mood and giving the brain different- and more positive - feedback.

Botox, which is currently used off-label for depression, is now in phase 2 clinical trials for FDA approval.

Botox like laughter.

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