I am ageing in dog years and this worries me more than the fact that my GP and therapist have doubled my dosage of antidepressants in the past six months. I exude misery from every pore. It’s written all over my face, literally.
“I’m concerned about this dramatic increase in negative thoughts,” my therapist said last week.
“I’m concerned about my glabellar frown lines,” I replied.
[Read the original Times article here]
I think it’s unfair that I’m ageing faster than happy people, who by virtue of being happy probably don’t care as much about wrinkles anyway. I’ve been certifiably depressed for more than 15 years, but I never used to look depressed, even at my lowest. I have Botox to thank for that. I’ve been a user since my mid-twenties, upping the frequency when things were really bad. So, the worse I was feeling inside, the better I looked on the outside.
When it works, that is. This time, it hasn’t “taken”, and I’ve just been told that in cases of overuse, it’s sometimes possible to develop an immunity to Botox. Either that, or I’ve gone to a dodgy “pop-up” with posters saying “half-price Botox with every blow-dry” and then had my face injected with tap water. I’m guilty of overuse and being a cheapskate, so who can say.
I use Botox only partly for its beauty benefits. For me, it is as much an antidepressant as anything else. If I look better, I feel better, even if by freezing my facial muscles, I’m actually inhibiting the feedback loop between displaying emotions and actually feeling them. It’s a long-suspected belief that facial expressions, while not an essential element, do in fact contribute to real emotions. Scientists have known for a long time that emotions are accompanied by numerous changes in the body, from elevation in the heart rate to flexion of the zygomaticus major muscle (or smiling, as the action is most commonly referred to). Past studies have found that smiling makes things funnier, wrinkling your nose makes you more disgusted and frowning makes you dislike the world more. That’s why phrases such as “fake it to make it” and “smile even though your heart is breaking” were invented. They’re annoying, but accurate.
If Botox can inhibit happiness, could it affect my misery, too? “Most people will undergo Botox injections to paralyse facial muscles in order to decrease the appearance of wrinkles, but our research suggests that by limiting facial expressions, they may also be limiting their ability to feel emotions, too,” says Professor Ann Senghas of Barnard College, New York, who has studied in depth the emotional consequences of Botox injections.
“With Botox, a person can respond otherwise normally to an emotional event, but will have less movement in the facial muscles that have been injected, and therefore less feedback to the brain about such facial expressivity,” she says. “Our research proves emotions and expressions are inextricably linked. Your brain pays attention to what your body is doing, and so your expressions do influence your emotions. It’s hard to control emotions, but it’s easier to control our muscles.”
When it was working, Botox did help me control how I presented myself to those around me, and we all know that how the world sees and responds to you matters. The biggest difference between my Instagram feed today and 2017/8 is there are fewer selfies — 2019 is nearly exclusively dogs for a very good reason. But while 2018 looked like it was a good year, it wasn’t. In the space of six months, I lost my job, broke up with my boyfriend, gained a stone and fostered a traumatised, three-legged greyhound who hated the world and wanted to bite it. My stress levels were through the roof. On some days I wanted not to exist, but to the outside world I looked positively serene.
Marie Duckett has a clinic in Harley Street (Marie Duckett Aesthetics) and, by virtue of being good at what she does, turns down as many clients as she takes on. Many come to her because they’re uncomfortable with how they’re perceived, as much as how they themselves feel. “Furrows, lines, dips and grooves tell a story,” she says. “Sometimes that story is fact, sometimes it’s fiction, either way you don’t necessarily want that story broadcast to the outside world. The fact is, people look at your face and make assumptions based on your expression, which isn’t always true or helpful,” she says.
A few of my nearest and dearest don’t like the Botoxed me. A close friend felt I wasn’t taking her grief seriously when her cat died last year. I was, but probably didn’t look particularly concerned, because I couldn’t. My ex didn’t like it because it made him insecure in bed. “I never know if I’m doing the right thing or the wrong thing because your face is the same the whole time,” he said. In fact, last year, research from Cardiff University suggested that the inability to make an expressive face leads to a less enjoyable orgasm. More fool me.
Dr Ros Jabar runs a beautiful and exclusive clinic in south Wales, where I live. I’m hoping she can help me work out if my dermal issues are real or all in my head. “I work closely with a psychologist and sometimes refer new clients to him before I work with them. In these cases, what they’ve wanted to ‘fix’ isn’t physically possible, or not an issue to begin with, or something that’s more in his area of expertise than mine,” she says.
I know I can’t inject my depression away — if only it were that straightforward. But I always felt there was more to it than simply a smooth dermis. “If you have Botox done properly by someone who understands skin and the person beneath it, you won’t look like you’ve had anything done at all — you’ll just look like you, but on a good day several years ago,” Jabar says.
I already loved Botox before I considered how it could be impacting my mood. I don’t think it’s a substitute for good drugs and therapy, but for me, it’s a definite bonus. And when you’re depressed, it’s the unexpected bonuses that keep you from cracking up, inside and out.
