If you look good, you feel good. That's the slightly spurious basis on which the UK spends an estimated £2.75bn ($3.68bn) annually on cosmetic procedures like Botox and dermal fillers.
Collectively, we have around 900,000 aesthetic treatments every year, each one described as “non-invasive” but nevertheless designed to rearrange our faces and disguise the ravages of time.
What’s surprising is that some of the reported benefits aren’t about how young a person looks or how much better they feel in their newly-taut skin. They’re about improvements in mental health.
Users speak about how Botox injections have lowered their symptoms of depression or anxiety. Others make jokes about not needing another reason to go for their touch-ups.
The commentary picks up on a steady drip of eyebrow-raising research from the last 15 years, which suggests that Botox can indeed help people with depression.
Researchers have shown that Botox injections can significantly lower depressive symptoms within 12 weeks.
According to a 2025 review of the evidence, some studies noted an effect that’s comparable to selective serotonin reuptake inhibitor (SSRI) medication and faster acting, too.
Other studies have shown similar effects with anxiety disorders. A paper in 2024 even found that among non-depressed people, Botox increased life satisfaction and happiness scores.
“The antidepressant effect is real, it’s in the data, and it persists for various indications and goes beyond the control [in clinical trials],” says Dr Ruben Abagyan, professor of pharmaceutical sciences at the University of California.
“Properly administered, it can be used for the purpose of managing suicidal depression.”
How does Botox influence our mood?
Botox works by relaxing or weakening muscles. Injections deliver a purified dose of botulinum toxin, which temporarily disrupts the communication between nerves and muscles.
In cosmetic use, the muscles that cause frown lines or crow’s feet become less active, so the wrinkles disappear. (Botox is also used as a treatment for conditions like chronic migraines or excessive sweating.)
One theory about how Botox makes people less depressed centres on a mind-muscle feedback loop. When we frown or otherwise express sadness, the brain interprets those muscle contractions as sadness and enhances the emotion.
After Botox injections, those muscles are effectively paralysed – the feedback loop is blocked and symptoms flatten, just like the wrinkles.
There’s more going on than that, however. Abagyan’s research has shown that you don’t have to be injected in the face to see an antidepressant effect. Botox injected into the arms, legs, neck and – ahem – other places can also lead to improvements in symptoms.
“The main question is whether you can inject something peripherally [not directly into the central nervous system (CNS)], but still have a [positive] CNS effect or a psychiatric effect,” Abagyan says.
It may be that there’s a form of signalling happening in the nerves, but whatever the mechanism, there does seem to be a neurological effect.
A study back in 2014 using magnetic resonance imaging (MRI) showed that after a Botox treatment, participants exhibited less activity in the amygdala.
Often described as the brain’s emotion processing centre, the amygdala regulates ‘negative’ emotions like fear and anxiety.
Reasons to be cautious about Botox
There are, of course, a few caveats – wrinkles, if you will – in the research around Botox as a treatment for mental health. One is that there aren’t many studies out there.
Among those that do exist, doses and other measures and methods are inconsistent, making it hard to draw clear conclusions, especially when the number of participants is small.
“Most likely it’s not the best treatment for severe depression,” says Abagyan. “It may have some antidepressant effect, but not every person gets less depressed. It can be a very uneven distribution, like drugs.”
Another reason to be cautious is to avoid becoming another Botox scare story.
Save Face, an organisation that campaigns for better regulation of the cosmetic industry, has warned of a growing number of black market practitioners in the UK and counterfeit Botox products, which can lead to severe complications and side effects.
With all this said, please remember that Botox is not yet an approved treatment for depression.
Abagyan describes it as a positive side effect of other treatment, so if you’re struggling with depression, a doctor should be your first port of call, not an aesthetician.
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