Can Botox Alleviate Depression and Reduce Anxiety?
There is evidence that the use of Botox has remarkable results in managing depression. In recent years, the application of botulinum toxin (BTX), commonly known as Botox, has been introduced in various fields of medicine, such as for the treatment of migraines, dystonias, or spasticity. New studies have highlighted an additional use of Botox related to psychiatry, showing how it may relieve depression, anxiety, and other related conditions.
Recent research examining the connection between Botox use in individuals suffering from depression or borderline personality disorder—who often experience extreme mood fluctuations—concluded that Botox (botulinum toxin, BTX) can significantly reduce depressive symptoms and decrease negative emotions in patients with borderline personality disorder. Specifically, these studies showed that injecting Botox into certain areas of the face can achieve up to a 72% reduction in these negative symptoms.
The explanation behind this previously unknown effect is as follows: our face expresses negative emotions through the lower central part of the face, particularly the glabellar region. These facial contractions work bidirectionally — emotion triggers expression, but expression also reinforces the emotion.
In simple terms, when we are angry or stressed, two muscle groups in that area contract, creating frown lines and worry lines at the “root” of the nose. These facial expressions, in turn, intensify the emotions.
With Botox injections in the glabellar region, we achieve paralysis of these muscles, preventing the face from reinforcing unpleasant emotions. According to the facial feedback theory, a relaxed face — and therefore a relaxed forehead — calms us and transmits a positive emotional state.
Reduction of Anxiety Disorder Symptoms
Regarding anxiety reduction, a study led by Professor of Pharmacology Ruben Abagyan, conducted in collaboration with the University of California, San Diego, and published on December 21, 2021, in the journal Scientific Reports, provides relevant findings.
The study, based on data from 13,000,000 individuals from the FDA’s Adverse Effect Reporting System (FAERS), of whom 40,000 reported their experiences after Botox treatment, found that patients who received Botox injections in four different areas—not just the forehead—reported anxiety far less frequently than those who underwent other treatments for the same conditions.
Abagyan and his team had previously published a similar study in July 2020 in Scientific Reports, showing that people who received Botox injections reported depression significantly less often compared to those undergoing different treatments. Both studies found reduced symptoms regardless of injection site, questioning the theory that patients simply felt happier because they had fewer wrinkles or because Botox prevented frowning. The researchers believe that the molecular mechanisms through which Botox reduces depression and anxiety — although unknown — may differ.
The reduction of anxiety disorder risk from injectable Botox, in at least four different body areas, ranges from 22% to 72%, an impressive percentage.
Treatment of Depression and Borderline Personality Disorder
Another research team, led by Professor Dr. Tillmann Krüger, Senior Physician and Head of Research at the Clinic for Psychiatry, Social Psychiatry, and Psychotherapy at Hannover Medical School (MHH), along with PD Dr. Marc Axel Wollmer from Asklepios Campus Hamburg at Semmelweis University, discovered through MRI (MRT) scans where and how Botox affects the brain.
Their study made visible the neural effects in patients with borderline behavior.
The results showed that botulinum toxin affects the amygdala — the area of the temporal lobe responsible for creating and processing fear. The findings were published in Scientific Reports. The conclusion was that botulinum toxin significantly influences emotional feedback by interrupting the feedback loop between forehead muscles and the brain.
Further Trials
The research aims to determine the biological mechanism through which Botox reduces anxiety. Clinical trials will identify the exact body points where injections should be administered to maximize effectiveness in treating anxiety, anxiety disorders, depression, and borderline personality disorder.
What is known today is that Botox significantly improves the quality of life for these patients. It must, of course, be administered by specialized physicians who understand the anatomy of the injection areas as well as the proper injection techniques.
