Nothing helped with her debilitating depression. Not massage therapy, not physical therapy and not aqua therapy. And then, Vivian Cooke found Botox.
Several times a year, Cooke receives an injection of the drug — best known for smoothing out facial wrinkles by paralyzing muscles or blocking nerves — between her eyebrows to help with depression.
“This is an alternative for me that has proven to be, almost immediately, giving the result that I want, and that is to feel happier and not be depressed,” Cooke told TODAY.
She is being treated by Dr. Eric Finzi, a Maryland dermatologist who pioneered the use of Botox to treat depression. His research found that more than half of people suffering from moderate to severe depression who received Botox showed “substantial improvement” in their symptoms.
While the conventional wisdom is that the brain tells the face how to act, not the other way around, Finzi says his findings support the “facial feedback theory” of Charles Darwin and William James, which suggests that the expression on your face can influence your mood.
"Your emotions are actually created, in part, by your face," Finzi told TODAY’s Tom Costello, adding that people can control their emotions “to some extent.”
How does it work? Finzi explains: “Botox is an inhibitor of nerve transmission, so the muscle can't fire.”
"The same muscle here,” he says, pointing to his forehead, “is involved not just with sadness, but anger and fear."
Two additional studies support Finzi’s research, but the treatment is not approved by the Food and Drug Administration and it is not covered by most insurance companies.
Whether Botox would ever become a standard treatment for depression is unclear.
"It clearly needs more research because the most obvious explanation of why people respond to this treatment is that they feel better about themselves,” said Dr. Thomas Wise, a psychiatrist. “They look in the mirror every day and think they look younger."
Still, some patients say it is making a difference.
Pam Oginz did not like the side effects of the antidepressant medication she was taking.
"With Botox, there is also a side effect, but to me it was a real positive side effect, because it would make my skin look smoother,” Oginz told TODAY. “What woman doesn't want that?"
Taffy Brodesser-Akner also tried Botox, and wrote about her experience for “Pacific Standard” magazine.
"It made me feel very distant from the people that I was talking to,” she said on TODAY. “It made me feel very neutral, in a way that was wonderful, because I had been a little depressed."
Lisa A. Flam is a news and lifestyles reporter in New York. Follow her on Twitter.