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The Stress Headache

Posted on 12/17/2012 by Dr. Martha E. Rich
A young man sitting at a desk in front of his laptop pinching the bridge of his nose Long-term stress is perhaps one of the most damaging states a body can experience. Existing conditions are almost always worsened by the addition of stress, and a healthy person can experience previously unknown levels of pain or discomfort because of stress alone. There are certainly chemical processes in the body triggered by stress that contribute to these effects, but the choices we make when we are stressed are often equally or perhaps even more detrimental to our health than the stress itself.

Chronically stressed individuals tend to self-medicate with food, alcohol, caffeine, drugs, or other stimulants. Physical exercise is often ignored, sleep can be fragmented, and relaxation of any kind can feel impossible when life stressors dominate our thoughts. Add physical pain to the mix in the form of a chronic headache, neck ache, stomachache, or backache, and stress can become truly debilitating.

A young patient of mine at the very end of his senior year in college recently experienced first-hand how stress can create physically debilitating symptoms that can present in frightening and painful ways. Graduation was approaching, finals were looming, and a very large presentation was due before the end of the semester. It was a lot of work to do in a short period of time, but the real stress for this young man did not come from the work itself, but from the worry and anxiety about all the unknowns facing him at the time. Would he be able to finish his presentation? Would he pass his finals? Would he graduate? And the biggest unknowns of them all: What would he do after graduation? Would he be able to get a job? Where would he live? How would he support himself?

He was facing a period of uncertainty for the very first time in his life. And what happened? He got a splitting headache. A headache so painful and unusual for him that even his primary care physician was concerned. The doctor ordered MRI's and CT scans, prescribed prescription pain medication, and watched him for a couple of weeks. All the scans were normal, but still the headache did not improve.

When he came to me, I listened at length to the obvious amount of stress this young man was not only experiencing from the outside in the form of deadlines and assignments, but also from the pressure he was creating on the inside to figure out his life after graduation. I noticed how tightly he held his shoulders as he spoke and the tension in his jaw. I asked him about his sleeping patterns, his eating, his exercise, how much water he was drinking, and how many cups of coffee and energy drinks he was having each day in order to keep up. The answers created a picture of a complete absence of self-care that so many of us experience at any age when we are faced with extreme stress, uncertainty, and fear.

A short series of neuromuscular massages to ease the tension of the muscles in the head and neck, combined with an effort at better dietary choices and a frank conversation with his parents about the kind of support he could expect after graduation, and the headache went away in less than a week.

Sudden and severe head pain should always be taken seriously, and scans to rule out serious injuries or pathological conditions in the brain are important. But scans and pain medication do not address stress. And even if an injury or pathological state is ultimately causing the headache, stress can turn up the volume of pain associated with almost any condition. This month in our newest addition to The Headache Series, we are exploring how exercise, rest and other self-care habits work together to counteract the effects of stress on our bodies and our brains.

I hope that you will take a look and learn a little bit more about how a few simple stress-reduction techniques and healthy lifestyle choices can reduce or even eliminate the head and body pain most commonly associated with increased stress and anxiety.

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