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Botox as a Treatment for Depression? It's Not as Crazy as It Sounds. There's still real wisdom to be gleaned from the phrase 'fake it until you make it.'

By Laura Entis

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Opinions expressed by Entrepreneur contributors are their own.

Clichéd as it may have become, there's still real wisdom to be gleaned from the phrase "fake it until you make it." Acting the part is often the first step to legitimately owning it. Wear the persona of a competent, confident manager and you may find you're on the way to becoming one.

The same philosophy, recent research suggests, can also be applied to our emotional lives. A new study to be published in the May issue of The Journal of Psychiatric Research finds that it may be possible to treat depression with Botox injections, which prevent patients from frowning.

Related: Fake It Until You Make It: How to Believe in Yourself When You Don't Feel Worthy

Seventy-four patients with major depression were randomly assigned to receive either a Botox or placebo saline injection in a double-blind trial. (While there is evidence that the blind was at least partially breached, surprisingly only about half of the patients who received Botox injections guessed correctly. Furthermore, a patient's ability to discern which injection he or she received had no significant effect on treatment response.) Six weeks after the injection, 52 percent of the subjects who received Botox exhibited relief from depression, compared with only 15 percent of those who got the saline injection.

The idea that our facial expressions can enhance, perhaps even create, emotional responses isn't new (Charles Darwin proposed the theory of "facial feedback hypothesis" way back in 1872: "The free expression by outward signs of an emotion intensi­fies it," he wrote). Neither is the theory that, by inhibiting one's ability to frown, Botox can improve one's mood. Back in 2008, psychologists at the University of Cardiff in Wales provided an anxiety and depression questionnaire to 25 women, half of whom had received Botox injections. While those who received the Botox didn't say they felt any more attractive than they had before the injection, they did report feeling less anxious and happier (suggesting that Botox's ability to boost one's mood can't simply be attributed to its ability to boost one's appearance).

Related: 4 Tips for Dealing with Founder Depression

There are many reasons, the authors of the study to be published in The Journal of Psychiatric Research speculate, why Botox may help alleviate the symptoms of depression. "First, frowning may affect the way people feel about themselves when they look in the mirror and the way others respond to them," they write; Eliminating a person's ability to grimace will logically cause them to interact more positively with those around them, boosting their mood. Finally, and most dramatically, the authors hypothesize that the act of frowning in itself may be a depressant. In other words, our brain monitors "the extent of our facial muscle contraction and muscle tension" (i.e.our facial expressions) and adjusts our mood accordingly; Muscles tensed up into a grimace will cause the brain to generate the corresponding emotional experience. Botox treatment, the authors predict, "would interrupt the normal circuitry, reduce distress signals to the brain and thereby influence mood in a favorable way."

Botox or no Botox, the study illustrates that our facial expressions are important. Choosing to give into our dismal mood and frown – instead of smiling through any internal unpleasantness – may impact our ability to adopt a sunnier outlook.

Not only that, but our emotions are highly contagious. Because we tend to mimic the behavior of those around us, we are highly susceptible to "catching" each other's' moods. Both negative and positive emotion can spread through an office much like a cold does.

Maybe the solution is Botox for everyone. Or perhaps it's simply to heed the advice we all got (and rolled our eyes at) as children. The next time you face a rainy Monday commute, go ahead and try it: Turn that frown upside down and see what happens.

Related: How Positive Thinking Can Make You a Better Problem Solver

Laura Entis is a reporter for Fortune.com's Venture section.

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