We have a couple more studies that suggest that paralyzing key facial muscles with Botox can reduce the symptoms of depression.
In a recent 24-week randomized double-blind placebo-controlled study, done by Michelle Magid, MD, clinical associate professor of psychiatry at the University of Texas, 30 participants with depressive symptoms were randomized and give injections of Botox or a placebo between the eyebrows (which happens to be exactly where I need it.)
The men were injected with 39 units of botulinum and the women were injected with 29 units. At week 12, the placebo group crossed over to treatment, and the treatment group crossed over to placebo.Participants were evaluated at weeks 0, 3, 6, 12, 15, 18, and 24. The primary outcome was a reduction from baseline of at least 50% in the 21-item Hamilton Depression Rating Scale score.
In a yet-to-be-published study in the in the Journal of Psychiatric Research, Eric Finzi, a cosmetic dermatologist, and Norman Rosenthal, a professor of psychiatry at Georgetown Medical School, randomly assigned a group of 74 patients with major depression to receive either Botox or saline injections in the forehead muscles that enable us to frown.
For those of you with depression who live in areas that are expecting life-threatening cold weather this week, I am not going to say “I feel your pain.” I don’t and I won’t insult you by saying it.
Although I have felt your pain in my lifetime, I do not feel your pain now because I live in Florida. I also won’t insult you by telling you what the weather is like in West Palm Beach right now.
I was born and raised in northwest Wisconsin and southwest Michigan. Phrases like “wind chill,” “lake effect,” “black ice” and “sub-zero” were part of my daily vocabulary for about five months of the year.
The only thing worse than the temperature was the sky – so uniformally gray that it looked like someone had painted it one solid color. There were no clouds per se – just one massive, flat gray cloud that covered the entire sky for as far as you could see. Nine hours separated sunrise and sunset but it would be months before you would ever see the sun again so it didn’t really matter if it was day or night.
Every Saturday morning I refill my pink pill box: S-M-T-W-T-F-S. I have been doing this for years. Three different medications. One of this pill. One of that pill. One-and-a-half of those pills. Every morning and every night, I take my meds. It’s like brushing my teeth – just something I do when I wake up and before I go to bed.
My meds. I go weeks without giving a thought to my meds. I just take them. My life is good. No more hopeless black holes or vibrating with energy like a wide-eyed racehorse pawing at the dirt in the starting gate. Nice and steady. I have grown used to it and I really, really like it.
So, when something comes along that has the potential to seriously disrupt my balance, I tend to freak out. Anxiety is the enemy. Drama is the enemy. I have made enough enemies in my life. I don’t need to make anymore.
There are three things that scare the hell out of me: Sharks. Being trapped in a car after an accident and cut out with the jaws of life; unemployment. As long as I stay out of the ocean and drive safely, I’m in good shape. Right now, unemployment is beyond my control.
And I like to be in control.
I am a newspaper reporter. In the 30 years I’ve been doing it, I’ve seen some horrific stuff – crimes and atrocities that grab headlines and break hearts. Last week I covered a case that knocked the emotional wind out of me.
I am hoping that my editors don’t read this. If they do, I’m afraid they will say I’m too weak to cover these kinds of stories – which I am not. Just the opposite.
Anyone who is regularly exposed to grisly violence and depravity and tells you it doesn’t affect them is either a liar or a sociopath. Yes, you can train yourself to disregard emotions and focus on your responsibilities – your job. You can wear emotional oven mitts when you have to reach in and touch the searing reality of what has happened.
But you cannot stuff your feelings or bury them forever. They are there, waiting to be acknowledged. If you ignore and deny them long enough, they will haunt you and stalk you until you either give in or become a mean, nasty, sarcastic and heartless son-of-a bitch.
It’s your choice – and it is a choice. I learned that lesson the hard way. Some people will drink or take drugs to take the edge off what they have seen or heard or smelled or touched. Some will become violent themselves. Many will become depressed.
I covered criminal courts for 12 years, which meant I hunted down the by-product of rage, terror and inexplicable tragedy every day. I trolled the hallways of the courthouse every morning in search of the saddest, most horrific, bizarre and violent stories on display that day.
In south Florida, where I have worked for most of my career, that’s saying something.
My mother, who lived her life in the midwest, would read my stories and say, “Things like this just don’t happen in Grand Rapids.” In my head I responded, “No shit.”
I can’t help but watch Wayne LaPierre, executive vice president of the National Rifle Association, talk about mental illness after a mass shooting. He’s like a zamboni clearing the ice of any blame that should go to our lack of gun regulations and leaving behind a nice smooth surface for him to rant on and on about us “maniacs” getting our hands on guns.
I can’t help myself. I have to watch him. Last Sunday on Meet the Press he claimed there just weren’t enough “good guys with guns” to stop the “bad guy” with a gun at the Navy shipyard in Washington, DC. I think Wayne watched too many westerns as a kid. Wayne, you just can’t divide the world into “good guys” and “bad guys.” You ever see the movie Taxi Driver with Robert De Niro?
We have got to stop letting guys like LaPierre stoke the fear of people with mental illnesses. The overwhelming majority of us are not a threat. Putting my name in a database because I tried to kill myself 30-some years ago is not going to make you safer, Wayne. And, it’s going to piss me off and clear the ice for a nasty, expensive legal showdown between the ACLU and government – which will again distract us from any meaningful gun regulation and care for people with mental illnesses.
The first step of any 12-step program is to admit you are powerless over something and that your life has become unmanageable.
For many addicts and alcoholics, this is an extraordinarily difficult task even though their addiction has cost them their job, their marriage, a few teeth or most of their body fat. If you are not an addict, you look at these poor souls and wonder, “How can you possibly not see what you addiction has done to you?” “Why haven’t you you made that connection?”
A lot of it has to do with denial. They blame their predicament on anything and everything BUT their addiction: It’s the ultimate dog-ate-my-homework excuse on a massive scale. Taking that first step means admitting two things: 1. That you have no control over something. 2. That your life has become unmanageable.
There are some addicts and alcoholics who readily admit that their lives have become unmanageable, but they refuse to see that the cause of the un-manageability is drugs and/or alcohol.
For others, they readily admit that they cannot stop drugging or drinking but they cannot see that their lives have become unmanageable. I am one of these folks.
I was what is known as a high-functioning alcoholic. I knew I could not stop drinking. I even admitted I was an alcoholic. But I refused to admit that my life had become unmanageable. We are the ones who often drink at home, so no one can see our unmanageability. Those around us high-functioning addicts/alcoholics don’t see it either. In fact, they praise us for how well we manage our busy, successful lives.
Although we’re very often the biggest pricks you will ever meet, deep down we are very, very concerned about what other people think of us when it comes to our drinking and drug use. We can be ruthless in our drive to prove that we have control and that our lives are manageable.
You live like this long enough and you can become exceedingly good at what you do. Which is why a lot of high-functioning addicts and alcoholics are so successful. We work our asses off – will sacrifice our families, marriages and children – to prove to ourselves that our lives are manageable. The more unmanageable our drug use or drinking becomes, the harder we work at proving to ourselves and others that we have our shit together.
God help the person who threatens our relentless drive to prove that our lives are manageable. We will eat you alive. We can become ruthless, sarcastic, self-righteous bastards in our effort to prove the manageability of our lives. We will intimidate you so you will shut up. If you happen to have depression or bipolar along with your addiction, you are a living hell.
Here’s what it looked like for me:
Being a recovered alcoholic and boozeless for nearly 14 years, you can imagine how wide my eyes opened when I read recent headlines about research on lomazenil.
The commotion began when some zealous journalists got loosey-goosey with the facts – claiming that researchers at Yale University had released results of a preliminary study showing that the drug lomazenil, when taken before drinking, weakens the effect of alcohol.
Well, turns out that is not exactly true. According to folks at Yale, there has been no study at Yale about lomazenil’s ability to thwart the effects of alcohol. Yale is NOT developing a “sober pill.”
Certain places intimidate the heck out of me, like the supplement aisle at any health food store. Whoa.
I just wish I had some Harvard expert telling me whether Omega-3s, St. John’s Word, SAM3 and folate would help my depression.
Voila! Next thing I know I’m at a fundraiser for psychiatric research at Harvard and Massachusetts General Hospital in this oceanfront mansion in Palm Beach, (also very intimidating) listening to Dr. Marlene P. Freeman, an associate professor at Harvard Medical School and expert in Complementary and Alternative Medicine.
Lord knows I wasn’t there as a philanthropist. I’m a journalist – I used my last buck to tip the valet. But every year Michelle and Howard Kessler, who own the intimating, oceanfront mansion, invite me to their fundraiser because they believe – regardless of how much money you have or do not have – “no family goes untouched.”
Since these are the heavy hitters in the world of philanthropy, Mass General brings in its best researchers – like Dr. Freeman. Among all of Dr. Freeman’s titles, positions and research, she chaired the American Psychiatric Association’s Task Force on Complementary and Alternative Medicine (CAM) – which focused on the potential benefits of Omega-3 fatty acids, St. John’s Wort, SAMe, folate, light therapy, acupuncture, exercise and mindfulness based psychotherapies in treating psychiatric disorders.
First of all, it’s pretty cool that the APA is taking CAM so seriously. Second, this whole event could not have happened at a better time because I am about to run out of my Omega-3 supplement and was wondering whether it was worth investing in some more.
And the answer is…yes.
The great thing about being a journalist in south Florida is you get some really weird assignments. Couple of years ago I went alligator hunting with some wounded vets courtesy of the Wounded Warrior Project. I’ve been assigned to go scuba diving to cover damage to coral reefs. Chased oil in the bayous of Louisiana after the BP disaster. Been to more crime scenes than I can remember and lived to write about three hurricanes. I walked on death row a few times. Watched a man die in the electric chair. Even sat in the electric chair during one visit.
So, last Saturday night when I walked into the newsroom for my occasional, obligatory weekend shift and my editor said, “I’m going to rock your world, I knew it was going to be an interesting evening: “You’re going to Mar-a-Lago to interview the governor and his wife,” she said.
Mar-a-Lago is the palatial, oceanfront estate and swank club owned by Donald Trump on Palm Beach. I’ve been there a few times. Once I rode my bike to a fundraiser luncheon and waited in the valet line with the Bentley’s and Roll’s. Amused the hell out of the valets.
Anyway, I went home, put on the LBD (Little Black Dress), lipstick and my red, patent leather, pointy-toed stilettos and headed over to The Donald’s. The thing about these $500/plate galas is you realize, immediately, that rich people – the top one percent of the ten percent – really aren’t that different from you and me. They have money. Lots of money. But that’s it. They are still people – human beings. We may think they are insensitive, arrogant, self-righteous, clueless bigots but I am no longer willing to write them all off as insensitive, arrogant, self-righteous, clueless bigots. They’re people who just happen to have a lot of money. A whole lot of money.
My meds FINALLY came in the mail. Amen. I take three meds, but I ran out of one before the refills came in the mail. Three days without one of the meds. Three days. My brain was starting to feel squishy. I had a horrible nightmare and I could feel a tsunami size headache building behind my eyes. Just a day after resuming the med I felt like my delightful self again.
Am I an idiot or what? I went to my nurse practitioner today and told her about my little refill snafu. She writes me scripts for three months worth of each of my meds. I send them to my insurance company’s pharmacy and, voila, three months worth of meds arrive in the mail. She explained that I don’t have to wait until I am almost out of my meds to send in the refill prescriptions. I told her I knew that. She shook her head. I know. There is no excuse.
I like Pat, my nurse practitioner. I see her every three months and have been doing that for about five years, unless she changes the dosage. Then I have to call her and visit her every week for awhile. Kind of a pain in the butt but I trust Pat with my life. She saved me, along with my therapist. You gotta trust the person writing your scripts. This is very, very important. It’s not like the kind of trust you put in the doctor who writes you a script for a Z-Pak and a couple days later that infection is gone.
I am talking about the kind of trust you put in someone to whom you have given your brain. Literally. You have to really, really trust this person because you have only one brain. We’re not talking about kidneys or eyes and ears. You lose one of those and you can still live. But you have one brain. That’s it.