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“Botox Injections Helpful for Depression?”

March 2010

Sidney M. Wolfe, M.D.

This question posed above appeared as the headline in an article on

According to the article, “Eva Ritvo, M.D., author and vice-chair of the department of psychiatry and behavioral sciences at the University of Miami, shared a memory in a recent Psychology Today blog. She wrote about seeing the Michael Jackson concert film This Is It and feeling moved to tears afterward. When Ritvo tried to cry, she found that she couldn’t, due to muscle paralysis caused by a recent Botox injection.”

“When I couldn’t cry, I quickly stopped feeling sad,” said Ritvo. “I felt so odd that I couldn’t find those emotions.”

Dr. Ritvo suggested that the emotion of sadness seemed to disappear after it couldn’t be fully expressed. She said, “the emotions lingered a bit but felt ‘unreal’ and disconnected,” citing “facial feedback theory,” which is the connection between the physical expression of an emotion and the intensity of that emotion.

Ritvo asked: “Is that because looking better makes us feel better? Is it because our faces can’t provide negative feedback such as frowning, scowling and crying? ... Are we more appealing to others when we look happy and this triggers more positive events in our lives?” Dr. Ritvo discussed the need for new research that could reinforce a link between emotion and the facial effects of Botox.

As we age and encounter more circumstances such as the loss of loved ones, crying and frowning are natural, human responses that express to others, as well as to ourselves, how we feel. Asking whether we are “more appealing to others when we look happy” seems to be denying parts of our humanity.

To purveyors of Botox — the companies and some doctors — depressed people may seem to be yet another market for this neurotoxin. But it seems, even if it works, nothing but ghoulish to try to chemically suppress crying and the emotions connected with it.

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