I’m not a cosmetic procedures kind of gal, and Botox (botulinum toxin) was never on my wish list. Power to others if that’s what works for them, but given that I can’t even be bothered putting on makeup most of the time, all things physical appearance-related don’t rank very high on my priority list.
The research on Botox
But that’s not why I’ve just gotten Botox. To keep my knowledge base up to date in the field of psychiatry I try to watch webinars on a somewhat regular basis. The other day I was watching a webinar on novel treatments for depression, and one of the things mentioned was Botox. There have been a few small research studies, listed at the end of this post, that found that injecting Botox into the frown line areas on the forehead actually led to an improvement in depressive symptoms, even in people with treatment-resistant illness. The thinking behind it is that not only does facial musculature express mood states, but it gives feedback that in turn regulates mood states. By preventing frowning, Botox may disrupt that harmful feedback loop.
Will it work? Who knows. At this point, I’m willing to try just about anything. I’m doing this with my naturopath, who does cosmetic procedures as part of her practice. I trust her, and she thinks it’s a good idea, so what the heck, might as well give it a go. Fingers crossed!
An update 5 weeks later
Around 5 weeks ago, I go my first Botox injections. I then got round two a couple of weeks later, for a total dose of 29 units, which was the amount used in the relevant research studies.
For anyone who’s curious, botulinum toxin comes from the Clostridium botulinum bacteria and acts at the neuromuscular junction to cause muscle paralysis. Besides cosmetic use, it’s used for a number of different muscular disorders, hyperhidrosis (excessive sweating), and the in the prevention of migraines. Effects are expected to last 3-4 months, although in the studies for depression the beneficial effect was found to last even longer.
Numb but not numb
It takes about 2 days to start noticing the effects of Botox injections, and 2 weeks to get the full effect. I would describe the feeling as numb but not numb. It feels numb much the same way as if your mouth was numb after going to the dentist and you couldn’t move the area. When I try to move the muscles in my forehead, I get that same sort of numb feeling.
It’s not numb to sensory input, though, so I still feel touch, pressure, temperature, and other sensations.
What I’ve really noticed is how often I was frowning before. Because I get that numb sort of feeling when I try to move my forehead, I notice when my face is trying to frown. And it happens often, far more often than I would have guessed.
In terms of outward appearance, when I try frown there are some little crinkles visible above the outer half of each eyebrow, but that’s it. When I raise my eyebrows in a surprised sort of expression, there’s limited movement, but one eyebrow raises more than the other one, a fun little quirk that my naturopathic doctors said she could fix but I actually kind of like.
Does it work?
So, is it helping with my mood? I’ll say a cautious maybe. I’m still having bad days and I have no resilience when it comes to situational stressors, but looking at my mood tracking app, there has been a bit of an improvement over the last couple of weeks. It’s always hard to know what’s causing what, and there are probably other things that are helping, like the approach of spring probably and some more positive interpersonal interactions.
I’ll probably never really know for sure what effect if any the Botox is having, but I do like the idea that it’s getting in the way all the frowning I was apparently doing before. And at this point, I’m willing to do pretty much anything, even if it’s only having a small impact.
- Finzi, E., & Wasserman, E. (2006). Treatment of depression with botulinum toxin A: a case series. Dermatologic Surgery, 32(5), 645-650.
- Magid, M., Reichenberg, J. S., Poth, P. E., Robertson, H. T., LaViolette, A. K., Kruger, T. H., & Wollmer, M. A. (2014). Treatment of major depressive disorder using botulinum toxin A: a 24-week randomized, double-blind, placebo-controlled study. Journal of Clinical Psychiatry, 75(8), 837-844.
- Wollmer, M. A., de Boer, C., Kalak, N., Beck, J., Götz, T., Schmidt, T., … & Sönmez, D. (2012). Facing depression with botulinum toxin: a randomized controlled trial. Journal of Psychiatric Research, 46(5), 574-581.