Imagine the stereotypical Botox patient.  Go ahead.  Are you seeing someone from “Real Housewives of Orange County,” a woman whose face is immobile after countless invasive plastic surgeries and who is so obsessed with defying the aging process that she’ll mutilate herself and inject her body with dangerous toxins to avoid a furrowed brow?

That’s the stereotype all right.  But it’s false.  It’s a phantasm born of a dozen bad reality TV shows.  Sure, there might be some women for whom Botox is one part of a shallow, self-absorbed trek into deep denial, but the huge majority of women who get the procedure are normal, healthy people who just want to look better and feel better.  Yes, we said feel better.  In The Beauty Prescription, we talked a little about research that showed that having Botox treatments actually made women feel more positive.  Now there’s more evidence that the phenomenon is real .

Research results published in the March issue of the Journal of Cosmetic Dermatology suggested that based on a controlled study, people who received injections of Botulinum Toxin A (Botox is the brand name) to paralyze the muscles in their brows and make them incapable of frowning actually showed fewer negative emotions and experienced lower levels of depression and anxiety.  Twenty-five volunteers participated, and while 12 recieved Botox, the control group got facial peels and other therapies for “frown lines.”  After two weeks, all the patients filled out surveys on their emotional states.  The patients who got Botox scored much lower for depression, irritability and anxiety.

What we find very interesting is that the Botox patients said their improved mood didn’t stem from feeling more attractive after the treatments.  We agree with the researchers who surmised that the effect probably came from a kind of “feedback loop” (our Beauty-Brain Loop in action) in which facial expressions that reinforce positive emotions stimulate more of the same in a person, while expressions such as frowning stimulate anger, fear, irritation and stress.  Essentially, when you frown, you might be cueing yourself to feel like there’s something to frown about, which makes you frown more.  As goes thy face, so goes thy mood.

This is a small sample size and there’s more work to be done, but we find this research incredibly promising for promoting the idea of holistic beauty.  In a holistic system controlled by the Beauty-Brain Loop, how you react to your environment stimulates your inner beauty, which affects how you look physically.  Your appearance sparks a reaction from the people around you, who are also part of your environment, and that reaction feeds back to you.  Simply put, think beautiful and smile, and you become beautiful.  The evidence is piling up that this is so, and it offers wonderful possibilities for women and men to take control of their own internal and external beauty simply by making new, conscious choices for how to view life, people, and the events of the day.  Imagine if you could be more beautiful on your own, without injections, by choosing to smile instead of frown.

Either way, Botox or no, it’s exciting. We’ll keep you posted on more research of this kind as it comes along.

Stay beautiful,

Debi & Eva

It’s a myth that women worry more than men, but being more communicative than men, women do tend to talk about their worries more.  And while talking about our worries can ease them, it can also reinforce them as we hear about the troubles and concerns of others.  So how can women break the cycle of worry—or from a mental and physical health perspective, stem the damage that can occur due to unrelenting anxiety, especially in a time of such dire economic difficulty?  Since worry seems to be rampant right now, we thought we’d answer some of the most common worry-related questions that we hear:
Q: How can women stop worrying so much?
A: It takes a great deal of self-awareness to realize that you are a chronic worrier.  The trouble with worry is that our culture tells us that responsible people are supposed to worry, so if we’re not worried, we feel as though we’re ignoring problems.  However, worry accomplishes nothing.  It is a useless emotion.  One way to stem the tide of worry is to be aware of the uselessness of worry, but one of the best ways is to find ways to relax what Buddhists call the “monkey mind,” the racing thoughts that lock us in a maze of anxiety like rats.  Meditation is wonderful for this.

Q: Is worrying “contagious”? Is there any way to avoid catching it?
A: It can be, if you let the worries of others start you worrying about the same issues.  This can be a sign of a generalized anxiety disorder, in which people worry about extremely unlikely events.  One of the best ways to avoid the worry “contagion” is just to avoid spending time with people who are chronic worriers.

Q: Are people born worriers, or made?
A: A little of both.  People who worry constantly about even the most remote possibilities may suffer from generalized anxiety disorder, a medical condition that we think can be inherited.  But worry is also a habit, and women who grow up in an environment where one or both parents worry about everything and instill fear of the unknown in their children may see that as a normal way of thinking and regarding the world.  So worry appears to be part nature, part nurture.

Q: What do people do when they worry—eat more, drink more, etc.?
A: There’s no single pattern of behavior.  Look at your own friends: some are probably “stress eaters,” who eat more when they’re worried, while others lose weight during stressful times because they can’t eat a thing.  Where we become concerned as physicians is when someone begins doing something potentially self-destructive because of worry, like self-medicating with drugs or alcohol.

Q: Have any studies or polls been done on worry?
A: Yes.  One of the more recent ones was a study of global poll results done by the University of Kansas working with the Gallup Organization.  It found that the link between positive emotions and good health is very strong.  You can find more about the study at www.news-medical.net/?id=46535 or at the University of Kansas website, www.ku.edu.

Q: Do people worry more today than in the past? Did people worry a ton during the Great Depression?
A: There isn’t much hard data about worry rates from today versus 60 years ago.  But the consensus is that people today tend to worry more than their parents and grandparents did because of global media and the Internet.  For example, during the Depression there was no TV or Internet.  Most people’s worlds were confined to their neighborhoods or cities.  So while they may have worried about their own economic situation, there was probably less of that “the sky is falling” anxiety that we find today when every news report talks about rising unemployment and the moment a financial collapse occurs, it’s all over the Internet in minutes.  With more knowledge and more awareness of the world come more reasons to worry, if you’re looking for them and if your emotions overcome your rationality.

Q: Can worry impact your looks? If you’re constantly furrowing your brow, can it cause wrinkles?  I’ve heard that if you force yourself to smile, you activate areas of the brain that make you happier, plus you avoid those worry wrinkles to boot. Is this true?
A: Worry can indeed impact your looks, but not as directly as you might think.  Frowning and furrowing your brow can certainly imprint lines in your face over time, but wrinkles are really caused by the natural effects of aging as our skin becomes less elastic over time.  You can’t avoid them.  The more direct impact of worry comes when worry causes you to neglect your self-care: to eat poorly, not cleanse and moisturize your skin, abuse alcohol, take up smoking or fail to protect your skin from the sun.  Also, keep in mind that frowning and worry affect your Inner Beauty, too, as people perceive you as someone negative who is not enjoyable to be around, regardless of your looks.  As for smiling, it’s always a good idea, because smiling tells your brain to release serotonin and dopamine, the feel-good neurochemicals that improve mood.

Q: What worries have you struggled with in the past and how did you cope?
A: We all struggle with the worries that come with aging: parents becoming ill, our own bodies starting to show signs of age and the loss of some of our youthful beauty, and certainly right now, economic worries.  In general, we find that no matter what the worry is, the “Three Ps Rule” really helps us handle whatever comes along: 1) Perspective.  Step back and get some perspective on the situation.  Is it really as bad as you fear?  What are the facts?  2) Plan.  What scenarios could play out and what will you need to do to be prepared for them?  3) People.  Don’t try to deal with things alone.  Share your fears and talk to the people who care about you.  It’s amazing what a difference support makes.