The strain of the long campaign and a frenetic transition period is beginning to wear on the face of President-elect Barack Obama, who has developed a facial tic under his right eye.
The tic on the lower part of his right orbital bone is clearly visible in his recent interview with ABC's Barbara Walters. Campaign insiders say it first emerged during the primary season and has now become chronic.
A facial tic is a repetitive, spasmodic movement often involving the eyes and facial muscles. The cause of tics is unknown, but stress appears to increase their severity.
"The patients I've treated with tic disorders had one thing in common: They knew that the tics worsened when they were under stress," said Dr. Robert T. London, a psychiatrist with the New York University Medical Center.
Besides the economic crisis, Obama is having to worry about his own security. The Secret Service reportedly is dealing with more threats against him than any other president-elect in history.
"There are a lot of things that keep me up at night," Obama, 47, confided in the ABC interview.
Michelle Obama, who closely monitors her husband's public appearances, is said to be distraught over the facial tic.
In all the stress of the transition, Obama told ABC he's trying to eat healthy food, work out regularly and refrain from smoking, although he has found it difficult to quit cigarettes entirely.
London says studies show that simple tics disappear during sleep, which suggests that a relaxation treatment, such as hypnotherapy, might work better than medication to calm the misfiring nerves during the day.
Politics is a stressful job, and other politicians have succumbed to the nervous twitches. For example, Rep. Christopher Shays, R-Conn., developed a severe facial tic that became so chronic he began doing TV interviews with the afflicted side of his face angled away from the camera. Shays, who's served more than 20 years in Congress, was defeated in the November election.