Washington-based dermatologist Dr. Eric Finzi has released what The New York Times has praised as “the first authorized biography” of Botox, a book investigating how a traditionally cosmetic treatment could be actually be a depression cure.
In The Face of Emotion, Finzi suggests that up to half of all wrinkle-busting procedures can dramatically improve moods, as well as our relationships with others.
And I absolutely agree with his theory — I’ve been researching this link myself since 2008.
Botox is a cosmetic dermatology practice, where Botulinum Toxin A (Botox is just one brand of this) is injected into frown muscles. This paralyzes them for up to six months. Patients can expect to see smoother, less-lined foreheads, with wrinkles seemingly disappearing to reveal a more youthful look.
Frown muscles are responsible for lines, but are also important in expressing normally negative emotions such as sadness, fear, anger and distress. A Botoxed patient can’t physically form the expressions necessary to portray these emotions; the procedure renders it impossible.
Five years ago, working with Dr. Michael Lewis, I tested a theory that dates back as far as Charles Darwin in the 17th century in order to assess what this means for patients.
Darwin suggested that facial muscles aren’t only responsible for the expression of emotion, but also in our experience and perception of it. His argument put forth the idea that if we limit the illustration of our feelings, then we limit physical response; i.e., reducing frowning in turn reduces feeling sad or angry.
We noted the mood of 25 female Botox patients, and compared their mood after Botox treatment with the moods of patients who had experienced other cosmetic treatments.
The patients treated with Botox for ‘glabellar’ frown lines showed a markedly significant difference in mood. They were measurably less negative than their non-Botoxed counterparts.
At first we attributed this to feelings of attractiveness after treatment, but further research led us to conclude that this was not an explanatory variable.
By 2009 Dr. Lewis and I had published a study in the Journal of Cosmetic Dermatology demonstrating that paralyzing frown muscles in the forehead leads to weaker facial feedback for negative emotions. We wrote that this means a negative mood is then harder to maintain, and that’s why Botox patients find themselves more positive.
The research into the link between Botox and depression is an important one. Far beyond the “feel-good” factor that cosmetic treatments can provide, it’s important to explore the psychological mechanisms that cosmetic doctors can affect.
Treatments can trigger more than a simple confidence boost. They may affect risk evaluation, empathy, and communication, too. Botox has potential to be about much more than vanity.
Hexsel D, Brum C, Siega C, Schilling-Souza J, Forno TD, Heckmann M, Rodrigues TC. (2013). Evaluation of Self-Esteem and Depression Symptoms in Depressed and Nondepressed Subjects Treated with OnabotulinumtoxinA for Glabellar Lines. Dermatol Surg. doi: 10.1111/dsu.12175.
Lewis MB, Bowler PJ. (2009). Botulinum toxin cosmetic therapy correlates with a more positive mood. J Cosmet Dermatol., 8, 24-6. doi: 10.1111/j.1473-2165.2009.00419.x.
Wollmer MA, de Boer C, Kalak N, Beck J, Götz T, Schmidt T, Hodzic M, Bayer U, Kollmann T, Kollewe K, Sönmez D, Duntsch K, Haug MD, Schedlowski M, Hatzinger M, Dressler D, Brand S, Holsboer-Trachsler E, Kruger TH. (2012). Facing depression with botulinum toxin: a randomized controlled trial. J Psychiatr Res, 46, 574-81. doi: 10.1016/j.jpsychires.2012.01.027.