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Headaches - A Side Effect of Stress

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Most of us have experienced a headache in our lives. The stresses of college can contribute greatly. Seven in ten people have at least one headache a year. The majority of these headaches only last a few hours, but some headaches can persist for weeks.

There are two types of headaches: primary headaches and secondary headaches. Primary headaches are not caused by other diseases. Examples of primary headaches are migraine headaches, tension headaches, and cluster headaches. Secondary headaches are caused by other diseases. The other diseases may be minor or life threatening.

With a headache, pain may occur in only one part of the head or it may involve the entire head. The type of pain experienced varies – constant, dull, sudden, or sharp. Sometimes other symptoms, such as nausea, occur depending on the type of headache.

There are three main types of primary headaches:

  • TENSION HEADACHES

Tension headaches are the most common type of headache. As many as 90% of adults have had or will have tension headaches. Tension headaches are more common among women than men. Tension headaches are often described as a band of pressure encircling the head with the most intense pain over the eyebrows. They can last for minutes or days, and can happen frequently or sporadically. Tension headaches are often the result of stress or bad posture. The pain of a tension headache is not usually disabling. Tension headaches often worsen with noise and hot, stuffy environments.

Tension headaches are not associated with an aura and are seldom associated with nausea, vomiting, or sensitivity to light and sound. These neurological symptoms differentiate tension headaches from migraines. Common tension headache symptoms include:

  • Anxiety
  • Head, face, neck, and/or shoulder pain and “tightness”
  • Fatigue
  • Insomnia
  • Irritability
  • Impaired concentration
  • Depression
  • MIGRAINE HEADACHES

Migraine headaches are intense and throbbing. They often involve one side of the head and can make you sensitive to light or noise. A migraine can last from hours up to days. Migraines recur at intervals of varying length. Some people find that attacks occur less frequently and become less severe as they get older.

An estimated 28 million people in the United States (about 12% of the population) will experience migraine headaches. Migraine sufferers usually have their first attack before age 30, but they can also occur in children as young as age three. Before puberty, boys and girls are affected equally by migraine headaches, but after puberty, more women than men are affected. An estimated 6% of men and up to 18% of women will experience a migraine headache. In the United States, migraine headaches often go undiagnosed or are misdiagnosed as tension or sinus headaches. As a result, many migraine sufferers do not receive effective treatment.

There are two types of migraine: migraine with an aura and migraine without an aura. An aura is a group of symptoms that develop before the onset of the main headache. An estimated 20% of migraines are associated with an aura. Usually, the aura precedes the headache, but occasionally it occurs simultaneously with the headache. The most common auras are flashing, brightly colored lights in a zigzag pattern and a hole in the visual field, also known as a blind spot. A less common aura consists of pins-and-needles sensations in the hand and the arm on one side or around the mouth and the nose on the same side. Other auras include auditory hallucinations and abnormal tastes and smells.

Nausea, vomiting, diarrhea, facial pallor, cold hands, cold feet, and sensitivity to light and sound commonly accompany migraine headaches. As a result of this sensitivity to light and sound, migraine sufferers usually prefer to lie in a quiet, dark room during an attack. For about a day after a migraine attack, the migraine sufferer may feel drained of energy and may experience a low-grade headache along with sensitivity to light and sound. Unfortunately, some sufferers may have recurrences of the headache during this period.

A small proportion of migraine sufferers can identify triggers for their migraines. Examples of triggers include:

  • Sleep disturbances – deprivation, too much sleep, poor quality of sleep
  • Bright lights – sunlight, television and flashing lights especially
  • Food and drink – some possibilities include chocolate, red wine, aged cheese, beer, dry sausage, sauerkraut, MSG, hot dogs, ham, bacon, sausage, and aspartame

The interval between exposure to a trigger and the onset of a headache varies from hours to days. Exposure to a trigger does not always lead to a headache. Avoiding triggers cannot completely prevent headaches.

  • CLUSTER HEADACHES

Cluster headaches are a rare non-throbbing headache. It is usually felt on one side of the head behind an eye. Cluster headaches affect about 1 million people in the United States. An estimated 85% of cluster headache sufferers are men. The average age of cluster headache sufferers is 28-30 years, although headaches may begin in childhood.

These groups of headaches can last weeks or months, separated by pain-free periods of months or years. During the period in which the cluster headaches occur, pain typically occurs once or twice daily, but some patients may experience pain more than that. Each episode of pain lasts from 30 minutes to 90 minutes. Often, attacks occur at about the same time every day and can awaken someone from a sound sleep. The pain typically is excruciating. Some describe the pain as feeling like a hot poker in the eye. The affected eye may become red, inflamed, and watery. The nose on the affected side may become congested and runny. Patients with cluster headaches tend to be restless.

Forty-five million Americans suffer from chronic headaches. These headaches cost billions of dollars in lost productivity every year. Individuals with occasional tension headaches or mild migraine headaches that do not interfere with daily activities usually medicate themselves with over-the-counter pain relievers. A doctor should be consulted if the headache is:

  • Severe (“the worst ever”)
  • Different than the usual headaches
  • Starts suddenly during exertion
  • Aggravated by exertion, coughing, bending, or sexual activity
  • Associated with persistent nausea and vomiting
  • Associated with stiff neck, fever, dizziness, blurred * vision, slurred speech, unsteady gait, weakness or unusual sensations of the arm or leg, excessive drowsiness or confusion
  • Associated with seizures
  • Associated with recent head trauma or a fall
  • Not responding to treatment and is getting worse
  • Disabling, and interfering with work and the quality of life
  • Requires more than the recommended dose of over-the-counter analgesics for relief

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