Monday, 25 June 2012

Day 1285 - It's All In Your Head

"Many people know about other contributing factors such as heredity, food triggers, lack of sleep, poor posture, etc., but are not aware of any psychological connection.

Headache specialists report that many of their patients resist any discussion of emotional or psychological contributors to their recurrent headaches. Some people fear that pursuing this avenue could uncover evidence of "mental illness." Others feel that the existence of these factors would make their pain less real because it would then be "all in their heads". In just about all cases, neither of these 2 things is true!

Headache is definitely a biological disorder. However, since the body and the mind are interconnected, your emotional and psychological states can have an effect on your overall health, including your headaches. Here's why:

- When your emotional and psychological systems are in good working order, they help to create a positive environment that contributes to the health of your body.

- When these systems aren't working so well...for example, if you feel anxious, depressed or angry on a frequent basis — and especially if you find it difficult to shake these feelings — a negative environment can be created in your body that may contribute to a specific headache episode or create a fertile breeding ground for headaches to occur.

The relationship between anxiety, depression and headache is not fully understood. However, it is known that the brain chemical serotonin plays a role in all of them. Some headache specialists have theorized that these disorders may share a common mechanism in the brain.

Research has shown that some chronic headache sufferers also suffer from depression and/or anxiety. It is important to note that these sufferers' psychological conditions may not be caused by their headaches. Rather, tendencies towards depression or anxiety may be inherent in their personalities or ways of thinking. Or, they may be the result of an intense and prolonged level of stress which may lead to psychological conditions such as anxiety or depression. Regardless of the cause, having frequent headaches and feeling a lack of control over them may cause an existing condition of depression or anxiety to worsen. This situation can easily snowball, creating a vicious cycle of headache and emotional distress.

Unfortunately, emotional and psychological factors are often not considered in the treatment of headache. Doctors (especially those who are not headache specialists) tend to emphasize medical treatment — and rightly so. This is the traditional "first line of defense" and is effective for most headache patients. So is appropriate to start — and, for most, to stop — there. Also, some doctors today are cautious not to focus on psychological factors during the earlier stages of headache treatment — possibly overcompensating for the days when many doctors treated patients as if the pain was "all in their heads."
Doctors who do bring up psychological contributors as a possibility often find that their patients want to avoid psychological treatment, fearing a "mentally ill" diagnosis or having a concern that the presence of these factors would mean that their headaches are not a serious medical problem. This is very unfortunate because nothing could be farther from the truth!"*

It has taken me over three years to write this post.

When the headache started - which now seems all those years ago - I went to see a psychologist about it. The headache had exacerbated to such a degree that I was unable to work and felt completely depressed about my situation. After telling her about the distress that the headache had caused, she looked at me, arms gently folded over her lap, and stated “It must be such a headache having this pain!” and gave a little chuckle. I brushed aside this silly joke, ignoring it and thinking that maybe she had unintentionally let it out. However, when the very same joke repeated itself over the course of the next sessions, I felt hurt, frustrated and angry that a person contending to be there to help could actually end up aggravating a situation. I could bear it no longer and after a few sessions I left. That was the last of any psychological treatment I have undergone.

The possibility of the headache being related to a close friend’s death which took place a few months before the onset of my headache, has crossed my mind more than once. But nearly four years down the line I do not think the headache is related to this, or at least entirely to this. It is possible that I have not yet recovered from the shock of losing such a close friend. I truly believe there is a strong link between body and mind and that a traumatic event can undoubtedly have consequences on one’s body. The passage above taken from a Headache Centre webpage discusses this in further detail. Just today I also came across an article on the BBC website on a similar topic.

The reason it has taken me so long to write anything on this is that I am unable to draw the line between the “it could be a psychologically caused headache ” to a “it’s all in your head” (i.e. fictional). I am certain, from the manner in which this question is usually addressed to me, that by ‘psychological’ the word ‘fictional’ is intended. Does anyone feel the same?