Women on Botox Happier

woman botoxNat King Cole knew more than we realised when he sang “Smile, what’s the use of crying, You’ll find that life is still worthwhile, If you just smile.”

That’s because science is increasingly finding that changing expressions can influence mood, although scientists still don’t fully understand why.  But they are beginning to suspect a neurological link between facial muscles and brain activity.

People asked to smile while watching a cartoon, for instance, report it is funnier than people who are not asked to smile.

Botox Lifts Depression

Now a series of studies seem to show that women who have Botox treatments are happier – and it has nothing to do with increased self confidence because they look better.

First (in 2006) a Botox-happy cosmetic surgeon reported a  small study which claimed that filling out depressed women’s frown lines so they couldn’t wrinkle their brows helped lift their depression.

The pilot study of 10 patients was the first to provide empirical support for what a number of clinicians say they have noticed anecdotally: People who get their furrowed brows eliminated with Botox (botulinum toxin A) often report an improvement in mood.

Washington dermatologist Eric Finzi’s study found that even patients who were not seeking cosmetic improvement showed a dramatic decrease in depression symptoms.

Not Just Self Confidence

And a follow up study reported in Time magazine suggests that Botox may lighten people’s moods by literally wiping the frowns off their faces.

The study, published in the Journal of Cosmetic Dermatology, followed 25 cosmetic-surgery patients, 12 of whom received injections of Botulinum Toxin A or similar neurotoxins, the others receiving fillers, peels or other cosmetic treatments for wrinkles.

Two weeks after the treatments patients filled out a questionnaire for depression and anxiety.

“The Botox patients scored much lower on measures of depression, anxiety and irritability,” explains Michael Lewis, a psychology professor at the University of Cardiff and lead author of the study. “Crucially, there was no significant difference in how much their treatment made them feel attractive from those who had other treatments, suggesting that [the mood boost] wasn’t just down to a boost in self-confidence.”

Face and Brain Link

At the time, Finzi explained the results of his 2006 study using the facial-feedback hypothesis — a feedback loop in which people frown back at a depressed person, further deepening that person’s sense of isolation. He suggested that if a depressed person can’t frown because of Botox treatment, then others won’t frown back at them, thereby breaking the loop.

Others have suggested facial muscles may alter the temperature of blood flowing in the brain. Relaxation techniques such as yoga and tai chi may help cool the brain and result in a more positive mood.

Whatever the mechanism, moods can clearly be influenced by expressions, not just the other way around, said Paul Ekman, emeritus professor of psychology at the University of California at San Francisco, who has spent decades exploring the connection between emotions and expressions.

“If you make a facial expression voluntarily, you can change the autonomic and central nervous system to generate that emotion,” he said.

Meeting People Easier

But Ekman said the relationship between emotions and expressions is probably too complex to explain Finzi’s finding. It is unlikely, he said, that simply altering one’s expressions can relieve depression.

More plausible, Ekman said, is that changing expressions can help heighten or decrease emotional states. Or it is possible that by frowning less, patients in Finzi’s study seemed less forbidding to others, which helped to strengthen their social connections. In turn, that may have helped ease the depression, Ekman said.

But Lewis says he favors the theory that facial muscles influence brain activity directly and points to earlier research that suggests such a neurological link.

Fake It Till You Make It

For example, studies have shown that subjects find comedy routines significantly funnier when they hold a pen between their teeth the way a dog holds a bone, a pose that stimulates the muscles used for smiling. Similarly, subjects laugh less when holding a pen between their lips, a pose that mimics frowning.

Such studies are part of a growing trend in counseling and therapy that focuses on behavioral change — a new approach summed up by the Alcoholics Anonymous slogan “Fake it till you make it” — rather than the stern “talk therapy” of the Freudian era.

Cognitive behavioral therapy, for instance, teaches patients to alter the physiological feedback cycles of certain conditions by slowing their breathing during panic attacks or cutting the hangdog look during periods of depression.

But Lewis warns that his and Finzi’s studies both examined small sample groups, so it would be premature, he says, to consider Botox injections — at around $400 each — purely on the basis of their potential for mood enhancement.

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