Harper’s Bazaar (Malaysia)

A simple way to treat depression has been in our face all along. By Liz Krieger.

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A SWIPE OF LIPSTICK can put a smile on your face, but when it comes to beating true depression, beauty products usually don’t n’t do the trick. Enter Botox, the foreheadsm­oothing 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. She’d tried endless hours of talk therapy y as well as a raft of antidepres­sants. Though ugh the meds helped to some extent, her sadnessadn­ess remained dominant. That’s when a postcard arrived, seeking participan­ts for a depression­i studyd associated­i d 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 saline placebo injections in the “frown” muscles between the 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 participan­ts were able to sleuth out which 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 1870s, Charles Darwin theorised that our facial expression­s don’t just telegraph happy or sad to the world but that they can also create and enhance those emotions. Shortly after, the philosophe­r and psychologi­st William James wrote, “SmoothSmoo­th the brow, brighten the eye.” These guysguy were on to something, says Norman Ro Rosenthal, a professor of psychiatry at G Georgetown and the study’s other coauthor. The muscles of the face send feedback directly to the brain 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 m muscles of people’s faces don’t function, so they can’t smile or frown, he says. Becaus Because of this, it appears that “their capacity for happinessh­appine or sadness can be hampered.” Yet to some, thishi 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 performed in 2013 – and who knows how many patients actually felt it was a 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 not afraid to see what would happen if I stopped,” she says. “But I definitely don’t want to. My face just feels happier.”

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