Can Botox Turn a Depressed Woman’s Frown Upside Down?

Illustration for article titled Can Botox Turn a Depressed Woman’s Frown Upside Down?
Photo: iStock

Botox just might be able to make you feel a little happier beyond its ability to erase crow’s-feet and lift a sagging turkey neck.


Botox has shown some promise in treating depression, according to clinical trials conducted by Botox’s parent company, Allergan. How? By temporarily freezing the frowning muscles between the eyes and the forehead, it may block signals of distress from entering the nervous system, thus possibly affecting the production or use of serotonin, the chemical that corresponds to pleasure in the brain.

A report from Fortune magazine, detailing the study for this new off-label use of Botox, outlines both the evidence and the questions still remaining regarding its use as a treatment for depression:

Depression is scored using a metric called the Montgomery-Asberg Depression Rating Scale (MADRS). Allergan tested two different doses of Botox via injections to the face and compared them against placebo in 258 patients. The results were a mixed bag. At the lower 30-unit dose, trial participants given Botox saw their MADRS score cut by 3.6 points (meaning they exhibited fewer depression symptoms) compared to placebo after six weeks of treatment. The higher 50-unit dose, however, didn’t outperform the placebo. Both dosage levels were well-tolerated by patients.

Although the jury is still out on whether Botox insta-lifts your mood—I’m told that results from the final round of clinical trials could be in within the year—there may be something to it. I, for one, discovered Botox when my mother was dying after a protracted illness. I was caring for two kids under 3 years old and my marriage was failing. My resting bitch face was so tightly coiled all the time, it looked like a prizefighter’s fist. I was in my mid-30s at the time, and if I had stopped treating the vertical line between my eyebrows—commonly called “the 11” in dermatology—it would have looked like the slot on a parking meter or a piggy bank.

Looking more relaxed, I found, made it easier to go through my day without the frequent, mostly well-intentioned remark, “You look so stressed.” (That was, nonetheless, a trigger and a reminder.) Not hearing that question or seeing that “Dang, girl what’s up?” look on people’s faces who where looking back at mine gave me a mental home-court advantage in keeping my game face together.


While my personal Botox mood-shifting experience is not scientific, and I have to add that I was also working out five days a week to ward off anxiety and depression, there may be a shot at some real relief for depression in women—who are twice as likely as men to experience depression—at the end of a needle.

American Psychiatric Association President Dr. Altha Stewart has reported that depression in African-American women is an insidious and often undiagnosed disease. Stewart cautioned, “There is also a risk of increased depression in African-American women related to psychosocial, economic, and environmental stressors.”

Illustration for article titled Can Botox Turn a Depressed Woman’s Frown Upside Down?
Photo: iStock

Understanding why women are twice as likely as men to suffer from depression has to do with multiple contributing factors, some of which are listed on the Mayo Clinic website:

Unequal power and status. Some women face added [workplace] stress from racial discrimination. These issues can cause feelings of negativity, low self-esteem and lack of control over life.

Work overload. Many women deal with the challenges of single parenthood, such as working multiple jobs to make ends meet. Caring for a sick or elderly parent at the same time is also a contributing factor.

Sexual or physical abuse. Women who were emotionally, physically or sexually abused as children or adults are more likely to experience depression at some point in their lives than those who weren’t abused.


Social worker Terrie M. Williams, author of Black Pain: It Just Looks Like We’re Not Hurting, writes that African-American women are saddled with a “supposed birthright to strength—we’re supposed to be strong, nurturers, caretakers, and healers of other people.” Which leads, in her opinion, to a reality where “[as black women] we really don’t know what our pain looks like ... or what it feels like.”

Symptoms of depression, such as changes in sleep, appetite, loss of interest in hobbies, irritability and feeling overwhelmed by simple tasks, can creep up slowly. If these last only a few days, it’s likely just a normal case of the blues. Blues that last more than a few days and involve feelings of hopelessness are sure signs of depression. Talk therapy and/or antidepressants are first-line defenses.


Here’s what dermatologist Dr. Michelle Henry has to say about Botox therapy for depression: “Regarding using it as a primary treatment, I don’t typically. I mention it to depressed patients who present with cosmetic concerns and already have a psychiatrist on board. It too risky to do so as a primary without the FDA approval or larger scale studies, but I always mention the potential benefits.”

Veronica Webb loves Detroit, speaks French, is addicted to French fries, French fashion, runs an 8 minute mile and can never find her keys.



I’m really intrigued by this new study. I have this just bone deep aversion to botulism in my face (in my face!) even though intellectually I know it’s reasonably safe. But I’ve gotten over other aversions for less benefit (mussels lol).