| Headache is the most common pain known to humans, and it is the most frequently reported symptom in any clinical practice. Interestingly, it is headache that often makes the person seek medical help, both in somatic diseases such as hypertension, cerebrovascular disorders, infections of the central nervous system, eyes and nose, as well in psychological conditions such as stress, anxiety and depression. However in most cases, headache is a symptom and not a disease, and involves intricate mind-body links.
Personality and Emotional Factors: Search for personality correlates in headache patients reveal that though no one specific personality pattern describe all headache patients, Passive-aggressive (those who take out their hostility through negative behaviours), obsessive-compulsive (those who are rigid, conscientious, ritualistic, perfectionist) and hysterical (histrionic, attention seeking) are some of the frequently observed personality patterns in them. Suppressed rage and repressed anger can reach their levels of tolerance and then literally ‘burst’ upon as a headache. It also serves as a dependency need when a person unconsciously strives to gain attention or affection of another family member or friend. Thus a psychological or emotional conflict can be ‘converted’ into a physical symptom i.e. headache.
Migraine: Also known as ‘sick headache’, it is intense, recurrent, usually one-sided, throbbing in nature, which is accompanied by disturbances in vision, tendency to avoid bright lights (photophobia) and nausea or even vomiting. The headache usually lasts anywhere from two hours to a couple of days. Some people experience visual disturbances before an attack. Others have some kind of premonition of an attack coming on which can be as sudden lethargy or in others a great surge of energy. Known also as vascular headache it is caused by first a narrowing of the blood vessels to the brain followed by their sudden expansion or dilation that sees a rush of blood to the head, causing pain and throbbing.
Most migraine sufferers are women, majority of whom report that their attacks are connected to their menstrual cycles. Migraines are known to be precipitated by events or situations, fasting or missing meals, dietary intake of foods like chocolate, cheese, alcohol, sudden changes in temperature or pressure and even oral contraceptives.
Tension Headache: Variously known as muscle contraction or psychogenic headache, it is due to a sustained contraction of the muscles of the head and neck caused by excess stress. It usually occurs in those suffering from anxiety, environmental or situational tension, as well as in depressed states. It is described as a dull ache that stretches like a tight band, around the head, all over. It may be experienced as something swelling that wants to ‘explode’. The neck and shoulders are often also stiff and tight, and occasionally neck movements is restricted. These headaches are also accompanied by complaints of extreme tiredness, lack of concentration and sleep disturbances. Ninety percent of all headaches are usually due to muscle contraction.
Coping with headaches: Most people with tension or migraine headache worry that it may be due to some terrible illness, or something inside their brain. They first need to be educated about their headache, why they occur and the relationship with stress factors such as pressure of work, worry, discord at home, etc. Once they are able to identify the sources they can be helped to bring about changes in their functioning through stress management techniques that includes relaxation training, yoga, meditation and leisure activities that can distract from the pain and relives stress. Emotional conflicts need to be resolved with help of a psychotherapist. Changes in one’s lifestyle such as regular eating and sleeping patterns, avoiding foods that are known to trigger migraine attacks, limiting the intake of alcohol or caffeinated drinks are strongly recommended.
Specific medication for migraine is available but only after consulting the doctor. All forms of self-medication with analgesics are only temporary and are potentially harmful in the long run as they lead to dependence. Ultimately what the patient needs to realise is that most headaches are preventable and it is not necessary to live them anymore.
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