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.
How one woman realized she need time away from her social media feeds, and what to do if you need a hiatus, too.
One day last summer, I realized I needed a break. Not from a busy work schedule or family commitments—but from my Twitter feed. I would often grab my phone while I was still in bed to scroll through the morning's updates. Before I knew it, 20 minutes would pass and that lovely sleepy feeling would be replaced by the lives and news of the people in my timeline, some of it upsetting. I'd be off-centre before the day even really started.
This isn't the first time social media has got to me.
Four years ago, I quit Facebook. Between comparing myself to others and dealing with political rants I disagreed with, I felt crummy every time I was on the site. When I logged o for the last time, I turned to Twitter; I really enjoyed the short snippets of news and the interesting conversation the platform fostered. But when it started making me feel like Facebook did—gloomy—I knew I had to log off.
Facebook, Instagram, Twitter and the like have become xtures in our media landscape, changing the way we communicate. Mostly, this is a good thing; it makes it easier to meet intelligent and diverse people and to keep in touch with world-changing social movements. But its ubiquity can be overwhelming. Research is starting to show what many of us have already noticed: a link between social media and our mental health.
Pioneering research published earlier this year in the journal Depression and Anxiety looked at the relationship between depression and using one or all of the most popular social media platforms, including YouTube, Twitter, Instagram, Snapchat and LinkedIn. Researchers found that "any level of social media use was associated with an increase in the risk of depression," says the study's senior author, Dr. Brian Primack, director of the Center for Research on Media, Technology, and Health at the University of Pittsburgh. Dr. Primack, also assistant vice-chancellor for research on health and society at the university, notes that the study didn't look at causality; in other words, the question of whether increased social media usage causes depression or vice versa still needs examination. "It's very plausible that it could be a little bit of both," he says.
For most people, however, spending too much time on social media is less about a formal diagnosis and more about a general sense of well-being. A 2014 University of Michigan study about social media breaks (specifically, those who gave up Twitter for Lent) found that "three concerns surfaced with respect to social media use: spending too much time on it, trade-o s of not spending time elsewhere, and a concern about social media not being ‘real life.' "
I knew it was time for a break because Twitter had lost its vibrancy; there was too much scrolling and not enough engagement with what I was reading. Patricia Pike, an addiction and intervention specialist with private practices in both both Vancouver and the San Francisco Bay Area, says that's an important indicator. She advises asking yourself these questions: Are you neglecting interactions with loved ones? Are you distracted and unable to complete day-to-day tasks? Are you living for your next social media hit? If the answer to any of these questions is yes, it might be time to rethink your relationship with social media.
I wasn't planning to leave Twitter for good—I don't think that's possible, or even preferable, in today's connected world. Instead, I decided to take a month off. I deleted the app from my phone, logged out of my account on my laptop and prepared to white-knuckle it through the next four weeks. But it turned out to be surprisingly easy. For the first week, I was constantly reaching for my phone, used to scrolling through my feed on a work break or while wait- ing in line. But then, the desire to log on died down and, perhaps stereotypically, I began to feel more peaceful and focused. I started filling my newfound pockets of time with other interests: reading, knitting and suing my phone to call friends and family (gasp!). When my month was up, I cautiously reentered the fray, but I found I didn't feel the old urge to check in constantly.
The break allowed me to do what Dr. Primack recommends: "Learn what patterns of use are more problematic and what patterns are more beneficial." I realized some social media platforms just aren't for me. (No to Facebook, some- times to Twitter and yes to Instagram; I mostly follow knitters, so it has always felt like an oasis.) And now I know I don't have to be "on" all the time to enjoy the boons of social media; these days, my Twitter usage is much more measured.
It's clear that social media—and our increased Internet usage, in general— plays an ever-growing role in our mental health. But temporarily unplugging is a valid form of self-care, a way to minimize overstimulation and hit the reset button. Give me a break, indeed.
5 steps to a successful social media detox
1. Have a plan. Decide how long your break will be, but resist the temptation to make it permanent. "Shutting social media out of your life completely is a great way to set up failure to control your social media needs," says addiction expert Patricia Pike.
2. Write down your reasons. Think about what you want to achieve this break. Is it figuring out which platform works best for you? Or do you feel overstimualted?
3. Use technology to your advantage. Delete the social media platforms you want to avoid from your phone. (If they're not there, you can't mindlessly click on them.) And on your desktop, use time-management apps like Anti-Social or SelfControl to block sites you want to avoid for a period of time.
4. Enlist help. If you think you'll be tempted to long on prematurely, have a partner or a trusted friend change your password for the duration of your detox.
5. Set limits. When you return to social media, put limits on your usage, says Pike. And give yourself a schedule, says Dr. Brian Primack, director of the University of Pittsburgh's Center for Research on Media, Technology and Health. For example, restrict logging on to your coffee break, instead of intermittently all day long.
If you're craving something different, big or small, Dr. Lorraine Bennington, a Vancouver registered psychologist, shares her top tips for taking the leap.
If you feel like there's something missing in your life, it's time to figure out what adjustments you can make to improve your situation. Revisit the things that made you happy as a child, which Dr. Bennington says are part of your "life blueprint," to direct your first steps. That could mean taking jewellery-making classes if you've always wanted to be a fashion designer, or returning to university if you've long wanted to be a lawyer.
Visualize your future
If the idea of change overwhelms you, imagine what your life will look like in five years if things remain the same, then visualize what it will be like if you take the plunge. "Usually, people will say it looks better with the change," says Dr. Bennington.
Don't listen to toxic people
If you've found that a particular parent, sibling or friend doesn't believe you can succeed (in a new job, with a new partner or as a single parent), it's time to stop expecting that person to miraculously offer support. "Don't share your ideas with someone who is likely to respond negatively every time," says Dr. Bennington. Instead, seek people who are "consistently genuine and supportive."
Rewrite your story
Even if a transition (like a divorce or a layoff) is out of your control, you can choose to see the situation through a positive lens. Maybe there's a part of you that was unhappy for years or secretly wanted freedom from a controlling husband or a nosy boss. "Reframe the change as something good, rather than as something awful that's happened to you," says Dr. Bennington.
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