By Sasha Klemawesch, M.D.
When a patient recently told me that she was getting Botox for her depression, not for cosmetics, my initial reaction was: “Sure, and your rhinoplasty was for a deviated septum.” But is turns out the joke was on me.
Botox has been explored as an alternate therapy (to drugs) for clinical depression. Charles Darwin was one of the earliest with the theory that facial expressions are not only manifestations of emotions, but also have a direct impact on them. This “Facial Feedback Hypothesis” is now widely established by modern psychiatry.
As it turns out, the part of the brain responsible for fear, anger, sadness and other negative difficult emotions is part of a feedback loop that includes facial muscles – especially the glabella (spot between your eyebrows that scrunches up when you frown.) Using Botox in this area has led to 60 percent of patients in a clinical trial having marked reduction in depression after a single treatment. Of note, the benefit from a single treatment lasted three to six months, independent of the cosmetic benefits.
The trial included a number of severely depressed individuals who seemed resistant to various medications. New trials are underway addressing depression, plus expanding to social anxiety and bipolar disorders.