Chronic Headaches and Migraines

January 26, 2015

Could a headache be a symptom of an underlying psychological problem?

Headache is one of the most common complaints in general population. Causes of headache range from muscle spasm to vascular contractions and so do myths surrounding this issue. Globally, it has been estimated that prevalence among adults of current headache disorder (symptomatic at least once within the last year) is 47%. Headache on 15 or more days every month affects 1.7–4% of the world’s adult population. Clinicians observe that while headache is common and many a times functionally disabling, its most often not associated with significant organic disease. Most work ups for common headaches have negative findings. Many people are susceptible to headaches at times of emotional stress and psychological stress usually exacerbates headaches, whether their primary cause is physical or psychological.

Tension type headaches are most common type of headache presenting in general population and its mechanism may be stress related or associated with musculoskeletal problems in neck. Chronic headaches are commonly found together with depression, anxiety, panic disorder and other chronic stress related conditions. The holistic management of headache thus lies in identifying psychological factors associated with it. Stress management thus becomes an important aspect of headache management. Following measures are useful in dealing with chronic headaches:

• Keep a headache diary, include precipitating factors, duration and intensity of attack and relieving factors.
• Identify modifiable factors like certain foods or situations that trigger headache attacks.
• Develop positive stress coping and stress relieving mechanisms.
• If headaches are chronic and debilitating, seek medical advice.