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Why Does Botox Make People Feel Better?

August 22, 2013

The observation has been made that patients who receive Botox treatments feel better about themselves. The question has always been why does Botox make people feel better? People who look happy feel happy. Amazingly, not only can you look better after having Botox treatments, but we now have proof that you can also feel better! 

Below is the article "Can Botox wash away your blues?" from the American Society for Aesthetic Plastic Surgery

 

You've probably heard Botox can treat frown lines – those pesky facial wrinkles that appear around the corners of the mouth. But could the injectable medicine also help ward off depression? That's what researchers at the Chevy Chase Cosmetic Center in Maryland suggested at the recent annual meeting of the American College of Neuropsychopharmacology, reports Time magazine.

The medical director of the center and his colleagues presented a study that suggested treating frown lines and reducing the signs of aging could help those suffering from depression feel happier. The background of the research has its roots in history – Charles Darwin coined the term "grief muscles" to describe the muscles we use to frown, and he suggested making an unhappy face was intensely connected to true feelings of sadness.

"We feel sorry because we cry. We feel angry because we strike [out], and not vice versa," explained the lead researcher during the meeting. According to Time, he hypothesized that freezing the "grief muscles" with Botox could prevent individuals from frowning, thus breaking or weakening the connection the facial expression has with the emotion of sadness.

Researchers looked at 84 individuals who had severe depression lasting for an average of two years, none of whom had responded to antidepressants. Some of the participants were given Botox injections while others were injected with a placebo. They were then assessed three to six weeks later. According to the news source, at that time just over a quarter of those receiving Botox had a "nearly complete remission of their depression," while only 7 percent of those who had received the placebo reported the same turnaround.

Until this study undergoes further vetting, Botox shouldn't be considered an official treatment of depression. However, the medicine does carry other benefits, according to the American Society of Aesthetic Plastic Surgery (ASAPS). The injectable cosmetic can reduce the appearance of wrinkling around the mouth, forehead and eyes, giving patients an overall younger appearance.

What's more, Botox is more affordable than other rejuvenation procedures like facelifts, though the results don't last as long. Side-effects are also minimal – patients can expect mild swelling or bruising and a temporary redness. Botox is a good "first-time procedure," because patients' appearance will return to normal if they decide it's not the right look for them. 

 

Another article that was originally published with the title Smile! It Could Make You Happier:

We smile because we are happy, and we frown because we are sad. But does the causal arrow point in the other direction, too? A spate of recent studies of botox recipients and others suggests that our emotions are reinforced—perhaps even driven—by their corresponding facial expressions.

Charles Darwin first posed the idea that emotional responses influence our feelings in 1872. “The free expression by outward signs of an emotion intensi­fies it,” he wrote. The esteemed 19th-cen­tury psychologist William James went so far as to assert that if a person does not express an emotion, he has not felt it at all. Although few scientists would agree with such a statement today, there is evidence that emotions in­volve more than just the brain. The face, in particular, appears to play a big role.

This February psychologists at the University of Cardiff in Wales found that people whose ability to frown is comp­romised by cosmetic botox inject­ions are happier, on average, than people who can frown. The researchers administered an anxiety and depression questionnaire to 25 females, half of whom had received frown-inhibiting botox injections. The botox recipients reported feeling happier and less anxious in general; more important, they did not report feeling any more attractive, which suggests that the emotional effects were not driven by a psychological boost that could come from the treatment’s cosmetic nature.

“It would appear that the way we feel emotions isn’t just restricted to our brain—there are parts of our bodies that help and reinforce the feelings we’re having,” says Michael Lewis, a co-author of the study. “It’s like a feedback loop.” In a related study from March, scientists at the Technical University of Munich in Germany scanned botox recipients with fMRI machines while asking them to mimic angry faces. They found that the botox subjects had much lower activity in the brain circuits involved in emotional processing and responses—in the amygdala, hypothal­amus and parts of the brain stem—as compared with con­trols who had not received treatment.

The concept works the opposite way, too—enhancing emotions rather than suppressing them. People who frown during an unpleasant procedure report feeling more pain than those who do not, according to a study published in May 2008 in the Journal of Pain. Researchers applied heat to the forearms of 29 participants, who were asked to either make unhappy, neutral or relaxed faces during the procedure. Those who exhibited negative expressions reported being in more pain than the other two groups. Lewis, who was not involved in that study, says he plans to study the effect that botox injections have on pain perception. “It’s possible that people may feel less pain if they’re unable to express it,” he says.

But we have all heard that it is bad to repress our feelings—so what happens if a person intentionally suppresses his or her negative emotions on an ongoing basis? Work by psychologist Judith Grob of the University of Groningen in the Netherlands suggests that this suppressed negativity may “leak” into other realms of a person’s life. In a series of studies she performed for her Ph.D. thesis and has submit­ted for publication, she asked sub­jects to look at disgusting images while hiding their emotions or while holding pens in their mouths in such a way that prevented them from frowning. A third group could react as they pleased.

As expected, the subjects in both groups that did not express their emotions reported feeling less disgusted afterward than control subjects. Then she gave the subjects a series of cognitive tasks that included fill-in-the-blank exercises. She found that subjects who had repressed their emotions performed poorly on memory tasks and completed the word tasks to produce more negative words—they completed “gr_ss” as “gross” rather than “grass,” for instance—as compared with controls. “People who tend to do this regularly might start to see the world in a more negative light,” Grob says. “When the face doesn’t aid in expressing the emotion, the emotion seeks other channels to express itself through.”

No one yet knows why our facial expressions influence our emotions as they seem to. The associations in our mind between how we feel and how we react may be so strong that our expressions simply end up rein­forc­ing our emotions—there may be no evolutionary reason for the con­nec­tion. Even so, our faces do seem to communicate our states of mind not only to others but also to our­selves. “I smile, so I must be happy,” Grob says.

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Doctor Olson is board certified and is fellowship trained as an oculofacial plastic surgeon.
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