Saturday, February 28, 2015

Don't Fear, Botox is Here

It’s time to turn that frown upside down, literally (and scientifically).

We all have our bad days now and then, but for some, those bad days seem to never end. There may be no definitive “cure” for depression, but fortunately, a new scientific finding has potentially found an alternate, less conventional solution for our bad days—Botox, a widely popularized cosmetic surgery procedure in America. In fact, Botox was ranked as the top minimally invasive procedure in 2013. Shocker. Most Americans want at least a sip (or in this case, an injection) from the fountain of youth. And Botox, in many ways, has become synonymous with American culture—or at least, in the superficial, skin-deep sense. But perhaps Botox penetrates the skin deeper than we think. Perhaps it is more than an artificial tool for external beauty. Perhaps it is more about enhancing who we are internally.

Before we examine the ways in which Botox can psychologically alter our lives, let us first take a look at how this magical Botox scientifically operates in our bodies.    

Botulinum toxin is administered by diluting the powder in saline and injecting it directly into neuromuscular tissue. Once injected, the toxin works to inhibit the signal pathway from the nerve cells to the muscles, essentially leaving the muscles without instructions from the brain to contract and thus, total paralysis. In order for muscles to contract normally, nerves release the neurotransmitter and chemical messenger, acetylcholine, at the neuromuscular junction, where nerve endings meet muscle cells. The acetylcholine binds to receptors on the muscle cells, generating a post-synaptic potential that will cause the muscle cells to contract or shorten. However, with Botox, the release of acetylcholine is inhibited, preventing the contraction of the muscle cells. Because there is a reduction in muscle contraction, the muscles become more flexible and—voilá—bye, bye wrinkles!

While the success of Botox is due to its neuroscientific ability to eliminate wrinkles, contemporary scientific research suggests that its capabilities extend far deeper. In a forthcoming study in the Journal of Psychiatric Research conducted by Eric Finzi, a cosmetic dermatologist, and Norman Rosenthal, a professor of psychiatry at Georgetown Medical School, it has been suggested that Botox can treat depression by paralyzing key facial muscles and thus preventing patients from frowning. Finzi and Rosenthal randomly assigned 74 patients with major depression to receive either Botox or saline injections in their forehead muscles (because the contraction of these muscles completely prevents frowning). After six weeks, 52% of patients who received Botox showed relief from depression, compared to the 15% who received the saline placebo. Other studies have also corroborated this evidence, and as a result, our preexisting ideas about not only Botox, but also the nature of emotion have turned inside out. This “facial feedback” seems unnatural, yet the Botox studies suggest “a circuit between the brain and the muscles of facial expression in which the brain monitors the emotional valence of the face and responds by generating the appropriate feeling.” In other words, by changing our expression we change our mood—an “‘outside-in’ somatic therapy” as Friedman calls it. Because of this new understanding of Botox, we have the potential to entirely alter the way we approach and treat depression. And while it remains unclear whether Botox could serve as a beneficial antidepressant, the possibility for this use raises the question of whether cosmetic surgery should be administered as a widespread prescription for depression and other medical diagnoses in the future.

The origins of the facial feedback system proposed by Finzi and Rosenthal can be traced back to the 19th century hypothesis of scholars James and Lange, who argued that by producing a response that is characteristic of a particular emotion, you experience that emotion. Since then, many alternate theories about emotion have been proposed, but substantial research still exists corroborating James and Lange’s original ideas. Other cosmetic studies have also been conducted to determine the psychological and emotional implications of Botox.

For many, Botox will not be the answer to their problems, mainly because there is still not enough evidence to legitimize its use as a “medication.” And after all, it is cosmetic surgery, a topic of ongoing ethical debates. But if there is anything we should gain from this, it is that turning your frown upside down (naturally, not surgically) can scientifically transform your bad days into good days—at least for a little while.

-Isabella Cuan


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