Is It True That Botox Can Help with Depression and Bipolar Disorder?

There is some evidence that Botulinum (Botox) injections may improve mood and feelings of stress. The theory is that part of the emotional experience of stress is expressing it through facial muscles, especially the ones that cause the furrows between the eyebrows (which is where Botox is placed.) By relaxing those muscles with Botox, the feedback loop is interrupted and mood improves. However, treatment of depression and bipolar disorder is an entirely different matter.

There is clinical evidence that botox can make people feel better but the effect is very subtle.  There is no evidence that this effect can be used to treatment clinical depression or bipolar disorder.  It would be a mistake to interpret these very interesting studies as showing botox is a treatment for clinical depression.  

I do not recommend Botox for depression.  If you also have cosmetic areas to treat, then go ahead, but don't expect an anti-depressant effect.

Why not try a nutritional psychiatrist (you can find names online) who can help you nutritional and via supplements with the depression you are experiencing.  You may be experiencing side effects of the medication itself.

I wrote an article published in Drugs in Dermatology comparing the costs and benefits of Botox for Depression.

Although the data is limited, what is available suggests that Botox helps people with moderate depression.

More research is indicated to try to determine who the treatments would benefit and how/ if they work or whether the initial observations are accurate.

For some people, any cosmetic intervention helps them look and feel better and treatment with Botox may help these people feel better

attached is the abstract from the article

J Drugs Dermatol. 2010 Jan;9(1):27-30.
Cost effectiveness of botulinum toxins for the treatment of depression: preliminary observations.
Beer K.
SourceEsthetic, Surgical and General Dermatology Center, West Palm Beach, FL, USA.

Abstract
The standard of care for the treatment of depression involves pharmacologic therapy with selective serotonin reuptake inhibitors (SSRIs). Cognitive therapy is typically utilized in addition to a pharmacologic intervention. However, the benefits of the drugs used may be marginal compared with placebo yet the costs associated with their use continue to increase. One potential treatment for depression utilizes botulinum toxins. At the present time there is a small body of evidence supporting their use for depression, the potential efficacy and cost effectiveness of this treatment warrants further consideration including head to head clinical trials.

PMID:20120422[PubMed - indexed for MEDLINE] 

This is a fascinating question and I think the answer is we just don't know right now. That having been said I have heard from a psychiatrist friend that there is at least one clinical study underway looking at botox as add-on therapy for depression that is resistant to conventional therapy. The important things to focus on here are that 1) this study is ongoing, and is not proof that botox helps depression or bipolar disorder and 2) even if botox does turn out to be useful in this regard, it will only be used in addition to conventional FDA approved medications. Nobody is even suggesting that botox could be used by itself to treat these conditions. However, if a person who is on conventional FDA approved medications for depression or bipolar were to purchase botox injections it is possible that they might be helpful. That is a lot of maybes. Still, it is a fascinating question as to whether stopping negative facial expressions with botox can reduce negative feelings in the brain. Stay tuned!