Term Paper on "Stress and Migraines"

Term Paper 5 pages (1725 words) Sources: 1+

[EXCERPT] . . . .

journal articles regarding migraines caused by stress. Migraines are one of the most pervasive forms of headache pain, and many researchers have looked extensively into their causes. However, much about migraines is still elusive to the health care profession, and some still do not take migraine pain as seriously as they see other forms of pain. Many studies have been conducted that indicate stress can be a major factor in causing at least some forms of migraines, and treating the stress in a patient's life can often lead to a reduction in migraine pain and reoccurrence.

Migraine headaches are quite painful for their sufferers, and often difficult to control or eliminate. Patients report feeling a severe throbbing or aching, normally in one side of the head, which often does not respond to normal painkillers. There can be sensitivity to light or noise, nausea, vomiting, and intense pain in the area of the headache. Often, a migraine attack is predicted by an aura of light the patient sees before the pain begins. More women suffer migraines than men, and they tend to hit the 35- to 45-year-old age group the hardest (Block, Kremer, and Fernandez 9). It is believed migraines are caused by a restriction of the blood vessels in the area of the brain where the pain is centered, and in the 1990s, the drug Imitrex came on the market to specifically treat these restricted blood vessels. It quickly opens up the vessels to their normal size and relieves the pain. Other therapies include a new set of drugs developed specifically for migraines, plus removing certain foods from the diet that may be triggers, and even biofeedback to reduce stress and manage the pain in patients. Mild migraines may respond to over-the-counter aspirin or pain-relief therapies.

It is estimated migraines cause "an annual loss in employee productivity of $17 billion a year, they are often treated as less than legitimate illnesses by employers, family members, and friends as well as health care providers who often view headaches as having a psychosomatic etiology" (Degges-White et al.). Some physicians may not fully understand the debilitating pain of migraines, and so may not treat them accordingly. Clearly, migraines cause lost work time, increased health care costs, and additional stress in a life that may already be overstressed to begin with.

Many studies indicate migraines are caused by a variety of other physiological triggers, including bright light, certain foods (most notably red wines and aged cheeses), certain smells, unbalanced sleep patterns, and hormonal changes or imbalances in women (Degges-White et al.). Some of these triggers can be treated by avoidance, and some, such as hormonal imbalances, are treated with a variety of drugs, from birth control pills to certain types of low-dose antidepressants. Some physicians also believe there are certain personality traits that lead themselves to migraines. One German doctor reports, "In reports based on clinical observations, typical migraineurs are generally described as ambitious, perfectionistic, rigid, obsessional, and very achievement-oriented people who, because of their characteristic anxiety and lack of self-confidence have great difficulty in expressing their feelings adequately" (Henrich). Thus, migraine sufferers may have several physiological causes of migraine affecting their pain and pain management. However, most of these causes can also be linked to stress, and stressors in daily life.

The "American Heritage Dictionary" defines stress as, "A mentally or emotionally disruptive or upsetting condition occurring in response to adverse external influences and capable of affecting physical health." Stress affects nearly every person at one time or another and some people are more prone to the condition than others. There are some occurrences in life that are more stressful and difficult to deal with, such as death, divorce, marriage, the birth of a child, and relocating to a new home or area. Stress is also a major cause of migraines, and numerous studies have been done linking stress to migraine pain. These professionals state,

For instance, the mechanisms of migraine headache are relatively well understood to be triggered at least in part by vasoconstriction resulting from chronic stress. This is contrasted with the studies investigating the surface electromyographic (EMG) studies of chronic low back pain (CLBP), which have shown virtually every conceivable relationship between muscle tension and pain (Block, Kremer, and Fernandez 33).

Thus, there are many different types of pain, and many different causes of pain, but stress is recognized as a direct cause in many patients with migraines. Studies also indicate that many migraine sufferers have poor coping mechanisms for both stress and their conditions, and so stress affects them more strongly, thus leading to migraine pain as a result of stress (Degges-White et al.). As already noted, migraines cause lost work, increased health care costs, and many co-workers, friends, and loved ones may not understand the severity of the condition, or the extreme pain involved, and so may downplay the actual condition. This could add to the stress that might already be aiding the condition, creating a never-ending circle of stress, pain, stress, pain, to infinity. Many migraine sufferers feel there is no way out of this circle of pain and stress, and some have even considered suicide as a way to end the pain.

Many studies seem to indicate that it is not major stress points in life, such as death, marriage, birth of a child, etc., that are the biggest causes of migraine, it is the small, "daily hassles" that all add up to headache pain. Doctor Henrich continues, "The association between external stress and migraine has been demonstrated repeatedly. Minor hassles and not major life events are associated with an increase in the frequency of migraine attacks" (Henrich). Headaches are also geared in some ways to how patients handle these day-to-day stressors. Many physicians urge their patients to practice some kind of stress management to reduce the number and severity of their headaches. Doctor Henrich maintains, "In particular, migraine patients seem to deal with stress more frequently by problem avoidance, self-criticism, wishful thinking, catastrophizing, and social withdrawal -- by using coping strategies that, in the end, serve to maintain stress rather than reduce it" (Henrich). If migraine patients can learn to change some of these behaviors, then they may be able to more effectively control their headache pain, along with many of the stressors in their lives.

There are a number of drug and preventative treatments on the market today geared specifically to reducing or removing migraine pain. Another treatment that has had success in many patients is biofeedback. These researchers note,

Finally, Holroyd and Penzien used meta-analysis to compare the relative efficacy of behavioral interventions to propranolol in treatment of recurrent migraine headache. In the literature reviewed, 73 studies provided usable date with 60 treatment groups and 37 control groups. Behavioral treatment was defined as relaxation training of some form (e.g., progressive muscular relaxation, autogenic training, etc.) and thermal biofeedback. The meta-analysis indicated that average group percent improvement for both groups was 55.1% as compared to 12.2% for placebo and 1.1% for untreated patients (Block, Kremer, and Fernandez 294).

Biofeedback teaches the patient to relax, manage the pain, and use these new skills to reduce or remove the pain when a migraine attack occurs. As the previous study indicates biofeedback can be very successful in many migraine situations, especially where the migraines are induced by stress. Teaching the patient to manage their stress and their pain is a valuable tool in these cases.

How does biofeedback work? One case study of a patient named Barbara, who used biofeedback to manage her migraine pain, may give more insight into the effectiveness of biofeedback treatment. Barbara's migraines seemed to stem from childhood angst with her father. She sought treatment from a psychiatrist because she had learned some migraines can be caused by repressed anger (another form of stress). Her psychiatrist was also a certified biofeedback therapist, and used thermal biofeedback as part of the therapy. A researcher writing about Barbara and her treatment notes,

During the twelve sessions of biofeedback, Barbara learned to control her temperature with her imagery of openness and began to generalize the technique to her home and work situations. Whenever she experienced signals of an upcoming headache, she would begin her relaxation scheme. If she denied herself this relaxation method, the migraine headache would seize her and nothing would help. Within a short time period, she became adept at avoiding the migraine symptoms with prevention behaviors (Lowlis 209).

There are many other studies that indicate biofeedback is an effective method of managing stress, and managing migraines.

It seems that more studies must be conducted to fully analyze the many ways stress can affect the body and the mind. It is clear the physiological condition of stress can create havoc in a person's life and work, leading to both mental and physical problems that often linger long after the stress has disappeared. Stress management techniques seem to be called for in the treatment of most migraine headaches, and in many cases they… READ MORE

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