Headaches are one of the most common health complaints for Canadian women. Here's the rundown on five types of headaches: what causes them, how to proven them and how to feel better faster.
Headache type: Tension
If you've ever experienced a headache—and who hasn't?—this is probably one you've had. "It's your regular garden-variety headache, with aching around your whole head and more steady pressure than migraines," says Dr. Michael Zitney, the director of the Headache & Pain Relief Centre in Toronto. You're not likely to have any nausea, and there won't be sensory sensitivity. "You can usually still watch TV or work at your computer, for example, through a tension headache," he explains.
Why they happen: Doctors used to think tension headaches were caused by too-tight muscles in the neck, shoulders, face and head, but experts now believe they might be due to inflammation of the lining and main nerve areas in the brain. "Some of the triggers can be similar to migraine triggers," says Dr. Farnaz Amoozegar, a neurologist in Calgary. These include stress, sleep and dietary factors.
Treatment options: Most tension headaches will go away on their own, but taking ibuprofen, acetaminophen or acetylsalicylic acid (Aspirin) can help. There are also preventive medications that can help reduce the frequency or severity of chronic tension headaches, ones that occur more than 15 days a month; your doctor might recommend a muscle relaxant or an antidepressant (amitriptyline and nortriptyline are a couple of the common forms), though the latter needs to be gradually increased and can take a few weeks to start working.
Headache type: Migraine
These headaches, which typically last four to 72 hours, are one of the most common in women—about one-quarter of us suffer from them, compared to about eight percent of men. The diagnostic criteria are very specific, says Dr. Sian Spacey, a neurologist, physician and director of The University of British Columbia's Headache Clinic in Vancouver. Patients must have two of the following characteristics: throbbing, moderate to severe pain, unilateral pain (on one side of your head) and pain that worsens with activity. They must also experience nausea and vomiting, or sensitivity to light and sound.
Why they happen: Frustratingly, it can be hard to pinpoint the cause, but it seems to be a mix of genetics and environmental factors. If you have a family history of migraines, you might be more prone to them. And there are common triggers, says Dr. Zitney. These include substances found in foods (MSG, nitrates and other preservatives, aspartame, alcohol and ca eine), lifestyle factors (skipping meals, dehydration and getting too much or too little sleep), weather changes, stress and fluctuating hormone levels thanks to our menstrual cycles.
Treatment options: Dr. Zitney recom-mends three stages of treatment. "The simplest and easiest thing to use is an anti-inflammatory," he says, adding that over-the-counter ibuprofen is a good option, as are prescription medications such as naproxen. If those don't o er relief, the second stage is triptans, migraine-specific medications that target pain at its source. "Migraine pain develops from a circuit of neuronal pathways and molecules in the brain,"says Dr. Amoozegar. "Once these path- ways were discovered, scientists began working on medications that specifically target them." There are seven triptans approved for use in Canada. They're available by prescription and come in oral, injectable and nasal-spray forms— but they're not an option if you have heart problems, as they can increase your risk of a serious cardiac event. You can also use a triptan and an anti-inflammatory in combination, as they approach pain in different ways. The last stage is a stronger painkiller, used sparingly—and only if you aren't at risk for addiction.
It's also worth asking your doctor about preventive meds, like antiseizure medication, beta-blockers and even Botox (which works by inhibiting the release of pain-related molecules). And if your menstrual cycle triggers migraines, you can also look into hormonal manipulation. "If it's safe for you to use the birth control pill or the hormonal IUD, you can fool your body into not having periods, which stops menstrual-related migraines," says Dr. Zitney.
Headache type: Medication-overuse
Formerly known as rebound headaches, these tend to occur in patients who have a high frequency of headaches and take a lot of painkillers, says Dr. Amoozegar. Folks who get migraines tend to be more prone to this type of headache, especially those who take medication for their migraines more often than they should.
Why they happen: It's the headache we cause ourselves due to regular, long-term use of painkillers, says Dr. Zitney. "If you take medications too often, they can turn around and bite you," he adds. "The head- aches start to come more often. Then, when the medication wears off, you have to take more, which brings on another headache. It's a pattern that's very hard to get out of once you're in it." As a general rule, it's OK to use medication (either over-the-counter or prescription) to treat headaches about 10 out of every 30 days. But if you find your-self using drugs more than 15 days out of the month for three consecutive months, see your doctor.
Treatment options: Education is key. "People need to know that their meds are the culprit," says Dr. Amoozegar. "Depending on what they're using, they need to gradually stop taking painkillers and start taking preventive medication." Beta-blockers and antiseizure medication aren't painkillers, but they can help reduce the frequency of migraines.
Headache type: Cluster
This is a rare, distinct type of headache. Cluster headaches are often seasonal or occur during the same time every year (or every couple of years). "These are shorter headaches that last from 15 minutes to three hours. They're unilateral and accompanied by symptoms like tearing, a droopy eyelid, a change in pupil size and nasal congestion on the side of the face where the pain is," says Dr. Spacey. This is the most severe type of headache you can get, and it's been dubbed the "suicide headache" because of the sufferers who have either committed suicide or thought about it during a cluster attack. Though they're more common in men than women, a 2012 study in the Journal of Neurological Sciences found that when women do get cluster headaches, they tend to have more daytime attacks and worse pain during nighttime attacks.
Why they happen: Causes haven't been pinpointed, but there's evidence that suggests abnormalities in the hypothalamus (the part of the brain that regulates sleep- wake cycles) could be part of the problem. Cluster headaches usually occur in the spring or fall, and triggers vary widely. Alcohol can worsen an attack.
Treatment options: Over-the-counter drugs won't make a dent in treating a cluster headache, nor will triptans (the attack is usually over before they kick in). For the drugs that do offer relief, opt for injections or nasal sprays, which are often faster acting. Giving the sufferer oxygen via a mask can also help some patients.
Headache type: Sinuses
You know those throbbing headaches where you also have a fever, a runny nose, congestion, an icky green discharge and pain in your face? That sounds like a sinus headache, says Dr. Amoozegar. But, she adds, they're often misdiagnosed. Many headaches that occur in the face are actually migraines; it can only be a sinus headache if you also have a sinus infection or another serious sinus issue.
Why they happen: Blame inflammation of the sinuses (a.k.a. sinus- itis), which is caused by anything that stops them from draining properly, such as a cold or flu, allergies or respiratory infections.
Treatment options: The first step is a visit to the doctor's office to confirm you have a sinus infection. If you do, you'll likely get a prescription for antibiotics. Ibuprofen, acetaminophen or acetylsalicylic acid can help ease the pain while you're waiting for the meds to kick in.
Crunchy-Top Blueberry Muffins <br /> Photography by Mark Burstyn Credits: Crunchy-Top Blueberry Muffins <br /> Photography by Mark Burstyn
When Gord Downie of The Tragically Hip was a little boy, his older brother, Mike told him a story that haunted him forever. In the Feb 1, 1967 issue of Maclean's, the cover story described the harrowing tale of a 12-year-old Indigenous boy, who in late October 1966, died trying to run away from the Cecilia Jeffrey Indian Residential School in Kenora, Ontario. Chanie was trying to make his way home, which was 400 miles northeast of Thunder Bay, Ontario on a reservation. Instead, his lifeless body was found by the railroad tracks not far from the school.
Marking the 50th anniversary of Chanie Wenjack's passing, Downie created Secret Path, a multi-media project that includes an illustrated book, album and television program documenting this tragedy. The Secret Path acknowledges a dark time in Canada's history, but Gord hopes that awareness through this project and the Gord Downie Secret Path Fund, that the path to reconciliation will move the country forward. "Chanie is my brother now. His story is Canada's story. We are not the country we thought we were. History will be re-written. We are all accountable," says Downie.
The hour-long, commercial-free animated film Sunday, October 23, 9:00 pm (9:30 NT), CBC.
Gord turned the poems he wrote about this tragedy into a ten-song album.
The 88-page graphic novel is illustrated by award-winning author Jeff Lemire, and visually tells the story of 12-year-old Ojibway Chanie Wenjack. Secret Path, $26.99
*Proceeds from Secret Path will be donated to The Gord Downie Secret Path Fund for Truth and Reconciliation.
If you think you're not good enough, you can join the club, because many women experience impostor syndrome. But, contrary to popular belief, it turns out that a little self-doubt isn't such a bad thing after all.
Tara Sutton is an award-winning war correspondent and documentary filmmaker from Toronto. She has a master's degree in journalism from New York's Columbia University, and she was the first foreign reporter to enter Fallujah, Iraq, after the siege in 2004 to document human rights abuses during the Iraq War. She's also given talks all over the world. But, sometimes, Sutton feels like a fraud.
"When I was in Iraq, I was the only video journalist and I was freelancing," says Sutton. "Everybody else had security experts and crews and flak jackets, and I didn't have any of that stuff. I'd lie there at night thinking, You're so useless. You don't know what you're doing. Why are you even here? I always felt so inferior, like I wasn't as qualified as everyone else."
What is it?
Though impostor phenomenon, or impostor syndrome, as it's commonly called, was first identified in 1978 to describe high-achieving people who dismiss, minimize or ignore evidence of their abilities, Sutton only recognized the symptoms in herself after reading an article about it in The New York Times. Since then, high-profile people—from Mike Myers (who famously said, "I still expect that the no-talent police will come and arrest me") to Facebook COO Sheryl Sandberg—have publicly admitted that they had a problem.
In an article published in the International Journal of Behavioral Science, research estimates that 70 percent of us will, at least once in our lives, fear being exposed as frauds, no matter how successful we are. "People who feel like impostors have a hard time internalizing and owning their accomplishments and, instead, ascribe them to things like luck, timing, connections or computer error," says Valerie Young, the author of The Secret Thoughts of Successful Women: Why Capable People Suffer From the Impostor Syndrome and How to Thrive in Spite of It.
These feelings are especially common for students and people in creative fields such as writing, acting and music. "You're judged subjectively and are perceived as being only as good as your last book, film, show or assignment," says Young. "You have to continually prove yourself in ways you wouldn't if you were in an accounting department or in customer service." That self-doubt is also more common among women, minorities and people who grew up poor or working class. "Whenever you're in a group for whom there are stereotypes about competence, you're more susceptible," says Young.
How to make impostor syndrome work for you
Alicia Liu first blogged about her brush with impostor syndrome in 2013, and she has revisited the topic several times since. The Canadian computer programmer, who now lives in San Francisco, wrote about how feeling like a fake made her reluctant to speak up for fear of sounding stupid. "The stakes were even higher because I was the only female engineer on nearly every team I've been on, so I felt I was representing my gender," she wrote. "I quietly avoided doing things I didn't think I'd be good at, even though the only way to get better is to do them." That's one of the problems with impostor syndrome—it can hold you back from learning. It may even make you overprepare, which "leads to unnecessary work and potential burnout," says Liu.
But Pamela Catapia, a registered clinical counsellor in Vancouver, says there can be benefits to feeling this way. "If you have impostor syndrome, you're likely a caring, conscientious, talented person who has both the desire and the capacity to improve the world," she says. She points to her clients as evidence; many of them tell her they feel like impostors, but, for the most part, they're actually extremely competent with unrecognized or underutilized leadership skills.
While Catapia admits that impostor syndrome can lead to procrastination, self-sabotage, anxiety and overwork, she says it is possible to make those feelings work for you. The secret is to recognize the good and the bad of impostor syndrome—and hang on to the good. "If overpreparing for things is working, keep that strategy. But if you're feeling burned out and exhausted, dial it down," she says. Young agrees. "I don't like to hear people say 'stop being a perfectionist,' because that's not helpful. You do things because you're getting something out of it. So I ask people, 'What's the good part about being a perfectionist that you want to keep?' If you care deeply about the quality of your work—not everyone does—keep that part, but let go of any shame you might feel over minor and very human imperfections."
Sutton credits impostor syndrome with helping her become a better journalist, though she didn't realize it at the time. "The benefit of feeling that way is that I asked so many questions. I had no assumptions that I knew what was going on," she says. "It also led me to do a lot more listening than talking."
There are still days when Sutton's self-doubt resurfaces, especially when it comes to public speaking. "Whenever I start to write a speech, I feel like I don't have anything to say. Now I know it's just a feeling, but in the beginning, I believed it was true."
Make peace with your inner critic
Though impostor syndrome can push us to achieve, it can also do more harm than good, leading to anxiety, procrastination and burnout. Here's what to do if the negatives start to outweigh the positives.
1. Know that you're normal
We often assume that struggling with confidence in a new situation is proof that we're impostors, says self-help speaker and author Valerie Young. But those feelings are normal. "Of course you're going to feel off base at first," she says. "If you're starting a new job, instead of thinking, I don't belong here, try, This is going to be hard for a while. This is new for me, and mastering or taking on new things is hard." She adds that, unless you're a narcissist, you should have feelings of self-doubt every now and then. "If it's your first time doing something, you haven't had time to develop the confidence that comes from prior experience."
2. Put it in context
Consider why feelings of inadequacy are there in the first place, says computer programmer Alicia Liu. "It's not merely a personal issue—though impostor syndrome is too often framed as purely personal. For me, it also reflected the discrimination and stereotyping in the tech industry and wider culture." Your own experience may be rooted in childhood or exacerbated by dismissive coworkers or cultural stereotypes. "You need to sort through your beliefs about yourself and your talents and to examine which belong to you and which came from others," says clinical counsellor Pamela Catapia. "Think about the beliefs that protect, guide and encourage you to grow versus the ones that shame and control you and keep you stuck." When you acknowledge how other people's attitudes might be holding you back, it's easier to feel worthy and confident.
3. Change your mind
"If you want to stop feeling like an impostor, you have to stop thinking like one," says Young. "This means reframing the way you think about competence, failure and fear. If you get an assignment that feels beyond you, instead of thinking, I have no idea what I'm doing, the reframe is, Wow! I'm really going to learn a lot," she says. And remember, your body doesn't know the difference between fear and excitement—sweaty palms and a dry throat come from both. "As you're walking to the podium or going to meet with your boss, just keep thinking, I'm excited. The best part is that, over time, you will be."