Mahendru Psychiatric Centre

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Knowing Your Headache

Mrs. S.L aged 32 yrs. house wife presented with moderately severe and continuous headache for about six weeks when she has not able to decide which brand color television she should go in for Mrs. R.S., aged about 50 yrs started having persistent headache following in several months of menstrual irregularity. Routine physical examination, investigations and even CT Scan head did not reveal any abnormality. Psychiatric assessment revealed that she doesno feel as cheerful as she used to be some months ago. She was not enjoy life and had disturb sleep. She was diagnosed to be suffering from depressive illness. After about 6 weeks of antidepressant therapy her headache disappeared and she become cheerful and regained interest in life.

Headache probabily is the most annoying affliction of humans- more than even the common cold. Many of us worry about headache neediessly; others are not concerned about their importance. It's very difficult to measure the prevalence of headache precisely. One estimate is that at least half the people who see a doctor have headache as one of their complaints. "Chronic Headache" affects possibly 10% of our population. The average Indian probably has no less than six headachas a year, painful enough to drive him to yhe medicine cabinet.

It is some times said that we now have a "headache culture". Indeed, either there is something wrong about our way of living that results in more headaches in the total population - or else we are quite conscious of our health and more aware of the headaches. Such a simple thing as poor ventilation in a room, which results in an imbalance in the air you breath, may cause a headache. If you skip a meal, you may have a headache. If you concentrate on one task for too long- whether it's reading or TV or driving a car your muscles become strained, they overcontract and they cannot get enough blood. The result is headache.

Nearly 70% headachea are tension headaches. The patient complains of periodic or recurrent headache which very in frequency and severity and usually persist for hours or even days or months. The onset of headache is often directly related to specific stressful situations. The pain is usually bilateral over back of the head and may also be reffered to the frontal region and face and may be felt as a band around the face and head. The tension headaches are often felt as dull aching or pressing type. The nausea and vomiting with this type of headache are rare. On examination one may find tenderness on the scaip and neck. It is presumed that tension and emotional stress cause the tightening of neck and scalp muscle and cause muscle contraction. Persons of every personality type have been found to be suffering from tension headaches. These patients are usually in a state of chronic anxiety. They are usually tense, apprehensive, irritable and are worried and overconcerned abot the opinions of other people.

The second common variety of functional headache is found as one of thesymptoms of hysterical neurosis. Hysterical headache is as common in males as in females.Th special significance of head in the body as well as in society enables patient to choose the head as the site of pain. This kind of headache occurs in the entire head and if you inquire about pain elsewhere, perhaps the patient will be having pain the whole body. The pain is acute, severe and bursting and may be associated with unconsciousness and hysterical fits.

Another common variety of headache is migraine headache. Migraine headaches are usually unilateral, throbbing & may be associated with nausea and vomiting and can be triggered by stress exercise and lack of sleep. There are quite a number of effective antimigraine treatments are available. Consult your doctor for the specific therapy you require.



The tension headache generally is the simplest of deal with, if a patient can or willdo as advised. If you change positions a while, relax and take an aspirin, the ache should go away. A bath and massage of the back, of the shoulders and neck should be of help as well, in case of chronic tension headaches, attempt should be made to find out the personality traits and relationship of headache to emotional stresses. Since most of the headaches are psychogenic in nature they should not be underestimated and ignored rather the symptoms should be given due weightage and respect. The physician should assume a joined venture approach. The doctor and patient should work together to understand the nature of headache. This attitude reassures the patient and insures cooperation. Attempts are also made towards finding underling psychological conflict and helping the patient in finding better ways of solving their problems. Antianxiety and antidepressant drugs along with realxation techniques are also of great help in alleviating anxiety and depression so commonly associated with tension headaches.


  • Avoid useless worry. Worry seldom solves anything only makes you tired and tense. Do something about what is worrying you, get the problem off your mind.

  • Develop tolerance. Friends, husbands, wives and associates may no fit the ideal, but they all have some good qualities. Try to understand people better, leran to see their point view.

  • Reduce your day's work. Over concentration on the job leads to headache. Dont try to do all the work yourself. Use assistants.



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