Daily headaches are relentless in their frequency: they occur every day or nearly every day. Though only moderately intense, they are notoriously difficult to treat, and understandably, they often produce anxiety and depression. To make matters worse, most people with daily headaches also experience more severe headaches on a regular basis.
Most daily headaches develop from intermittent tension or migraine headaches, although about a quarter of people with the condition developed it without any precursors. When daily headaches evolve from intermittent headaches, the process takes about 10 years and generally occurs before age 40. The change isn't merely one of frequency. The characteristics of the headaches evolve as well.
A daily headache usually begins in the morning and worsens through the day. In contrast, a tension headache generally starts in the afternoon then wanes, and a migraine often develops at night. People with a history of migraines who develop daily headaches find that the pain starts to resemble the steady, vice-like grip of a tension headache although throbbing often continues at the temples. In addition, the aura (see “The aura”) often diminishes. Meanwhile, those with a history of tension headaches often develop nausea and vomiting, sensitivity to light and noise, and throbbing in the temples, hallmarks of a migraine. This range of commonly experienced symptoms highlights the problem, in some cases, of trying to classify headaches as either pure tension or migraine.
The transformation of an intermittent headache to a daily headache often results from the overuse of over-the-counter or prescription pain-relievers. As many as 50% to 80% of daily headache sufferers report having used headache medicine every day, but how these medications might lead to a daily headache remains unknown. Researchers suspect that continued, regular use of such treatment interferes with the body's natural painkilling system. Because pain-killers only mask the symptoms of the pain, its actual cause may worsen. As the pain becomes more intense, medications are less able to control it.
Depression: A biological relative of the headache?Recurring headaches that resist treatment can leave you feeling helpless, hopeless, and worried. If these feelings become as persistent as the headaches themselves, then you may have depression or anxiety. Scientists are examining a possible physiological relationship between the three conditions. Though more information is needed, research completed over the past generation suggests that deficiencies in the neurotransmitters serotonin or norepinephrine are important contributing factors in both headache and depression. Low levels of serotonin are also linked to anxiety disorder. Thus, these conditions may be manifestations of similar — and perhaps even the same — physiological abnormalities. The symptoms of depression include oversleeping or insomnia, feeling tired much of the time, a change in appetite that can cause weight gain or loss, having trouble concentrating or making decisions, and experiencing feelings of worthlessness or guilt. Typically, someone who is depressed feels sad on all or most days, and this feeling persists for longer than a couple of weeks. On the other hand, anxiety is characterized by irrational feelings of fear, dread, or danger, as well as agitation, insomnia, trembling, and lack of energy. Both conditions can be treated effectively. By treating these conditions, you may find that your headaches disappear. If you think that you may have depression or an anxiety disorder, consult your doctor. |
Because many daily headaches are associated with too-frequent use of over-the-counter or some prescription medications, often the first line of therapy is to stop taking these medications. Talk with your doctor about how best to go about doing so. Many physicians suggest that patients stop taking them at once. However, some of their effects can linger for one to three months. After that point, your doctor will better be able to determine what type of headache you have. Some people who start out with migraine headaches experience tension-like headaches after they stop taking medication. In addition, the headaches may be less intense than they had been in the past. Once your doctor pinpoints the type of headache you have, he or she can work with you to develop a management plan.
Fast factDaily headaches affect approximately 5% of the population. |