Depression is a tough beast,
it affects millions of people.
We've developed lots of medication treatments,
and even therapy treatment.
But despite this,
about a third of people (keyboard keys clacking)
don't respond to these treatments and remain depressed.
Today, I'm going to tell you
about a relatively new development
that's gaining some traction,
(metal dinging) and that is Botox injections.
(graphic whooshing) I'm Dr. Tracey Marks,
a psychiatrist, (rhythmic music)
and I make mental health education videos.
Botox, or botulinum toxin,
is a neurotoxin produced by the bacterium
clostridium botulinum.
A neurotoxin is a substance
that interferes with the functions of the nerve cells.
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One of the ways it does this
is by disrupting or blocking the communication
between neurons.
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If neurons can't communicate with each other,
(keyboard keys clacking)
they don't function properly.
Botulinum toxin blocks the nerve cells
from releasing acetylcholine,
and this action paralyzes the muscles so that it can't move.
You're probably familiar (keyboard keys clacking)
with Botox being used for cosmetic procedures
to reduce facial wrinkles in the forehead
and around the eyes and mouth.
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It's also used to treat migraine headaches.
(keyboard keys clacking)
When it's used for migraines,
you get injections in the forehead, scalp,
neck, and shoulders. (syringes fwipping)
These treatments aren't new. (clouds whooshing)
Botox has been used for facial wrinkles since 2002
and for migraines since 2010.
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The paralyzing effects of these medications are temporary,
lasting on average about three months.
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As time has progressed,
there have been other conditions that Botox has helped,
like overactive bladder (graphic fwipping)
and extreme sweating (graphic fwipping)
under your arms and the palms of your hands.
As more people have used it, (clouds whooshing)
we've seen that many people also have had improvement
in their depression symptoms. (keyboard keys clacking)
The theory behind this potential treatment
is based on the facial feedback hypothesis.
(panel whooshing)
I talked about this in a video I did
using the half smile technique to manage difficult emotions.
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Essentially, the idea is that facial expressions
can affect your mood.
When your facial muscles
send positive sensory feedback to your brain,
that changes your emotional experience.
So in this case, with Botox,
relaxing your facial muscles with the toxin
sends positive feedback
in a way that improves your depression symptoms.
That's one theory, but it's not the entire explanation.
(wave whooshing)
Some researchers have seen
that the toxin increases serotonin
and brain-derived neurotropic factor,
which is a chemical that increases nerve regeneration.
(wave whooshing)
I have some article references in the description
if you want to read more about it,
but suffice it to say that there is strong enough evidence
to show that injecting botulinum toxin
into the muscles of the forehead and around the eyes
has antidepressant effects.
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So how does this work in the real world,
outside of academic medicine and research?
Although botulinum toxin is FDA approved
for certain medical conditions,
it's not approved for depression treatment yet.
(wave whooshing)
That means you'll have to see a specialist
who keeps up with the research to do it,
and your insurance may not pay for it.
The doctors who typically give these kinds of injections
are neurologists, dermatologists, and plastic surgeons.
So far, it looks like it takes several weeks
to see results, similar to the antidepressants,
and it's not clear how long the improvement lasts.
(wave whooshing)
So we don't have an established protocol
on how many injections you should get,
it will be trial and error,
probably dictated by how you feel.
There are a few adverse effects from it,
things like sensitivity at the injection site,
(graphic fwipping) headache,
(graphic fwipping) flu-like symptoms,
and probably the most distressing
would be a mild eyelid drooping,
which would be temporary.
(waves whooshing)
In rare instances though,
the FDA has noted that Botox
might spread to other areas of your body.
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If that happened, you could get botulism poisoning,
which is life-threatening. (tense music)
The symptoms of botulism poisoning
include trouble swallowing, (graphic fwipping)
muscle weakness, (graphic fwipping)
where your muscles become easily tired,
(graphic fwipping) drooping of both eyelids,
(graphic fwipping) blurred vision,
or double vision,
(graphic fwipping) trouble breathing or speaking.
(clouds whooshing)
You can see these signs within hours or weeks.
If you notice any of these symptoms,
it's crucial to reach out to your doctor right away,
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or dial 911.
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By the way, botulism poisoning is what you can get
from contaminated canned foods.
(image fwipping) (tense music)
You should be suspicious of this
(graphic fwipping)
if you see a can that's leaking, dented, or bulging,
or if you see foamy bubbles when you open the top.
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In any of these cases,
it's best to throw the can away and not even taste the food.
(image fwipping)
You only have to consume a small amount of botulinum toxin
to experience the poisoning symptoms.
What you get with the Botox injection
is a purified form of the botulinum toxin.
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Maybe sometime in the future,
this treatment will move from experimental
to standard of care,
or will be easier to get,
have it covered by your insurance,
and we'll be able to know what to expect
as far as how many injections you'll need.
(clouds whooshing)
But despite these limitations, it's still promising,
and if you or someone who has tried almost everything
(keyboard keys clacking)
without good results,
or have trouble tolerating (keyboard keys clacking)
the standard antidepressant treatments,
you should consider consulting a doctor
about Botox injections to treat your depression symptoms.
(clouds whooshing)
Thanks for watching.
See you next time.