
New drug offers hope to those with severe migraines - petethomas
https://nytimes.com/2018/05/17/health/migraines-prevention-drug-aimovig.html
======
cududa
I hope this truly is a breakthrough and does more good than harm. As a child I
had near daily migraines. In 2002 I entered into an earlier CGRP blocker study
to extremely ill effect. I took two pills morning and night. After two days I
woke up completely blind. I was lucky it only lasted for three days (I was
instructed to immediately discontinue use of the drug, preventing any long
term damage). The trial was called off shortly after - if memory serves, out
of ~100+ participants in my age group, about five had the same symptoms.

As the article mentions, there’s a risk around toxicity. The approved
distribution, dosage, and delivery seems to be an entirely different process
from 15+ years ago, so here’s to the best. But, there’s really not a single
measurement of residual peptide buildup throughout the entire study.

I worry about long term buildup of proinflammatory mediators that could
eventually strike back fast and hard with long term ocular nerve damage; a
similar effect as the earlier drug iterations of a higher toxicity.

------
positr0n
While people are offering anecdotes about their migraines:

1\. If I don't eat sugar my migraine incidence goes from 8-12/month to
~1/month.

2\. Excedrin works for me every time. The longer I wait to take it the longer
it takes to work though. If I take it as soon as I feel a migraine coming on
it will never progress to a painful stage. Before I discovered Excedrin I
would have to go to sleep to end it, and occasionally throw up from the pain.

Note: My doctor said that Excedrin is a "perfect" drug for drug companies
because caffeine is a trigger for many people, so they will take Excedrin and
it will work, but then the caffeine will cause them to have another headache
tomorrow and need it again. This doesn't happen to me though.

~~~
learc83
If you want Excedrin without the caffeine you can just take a 500mg of
acetaminophen and 500 mg of aspirin.

~~~
ky738
can i replace aspirin with something else?

~~~
jjeaff
Ibuprofen, like aspirin is a nsaid. So it should have similar effect when
combined with acetomeniphin (Tylenol). In fact, acetomeniphin, ibuprofen is
also commonly prescribed together. And some studies have shown it to be as or
more effective than opiods like oxycodone for certain types of pain.

------
EvangelicalPig
I used to get severe migraines from flickering lights and most computer
screens starting on September 5th or 6th 2011. I was born with optic nerve
hypoplasia (and nystagmus in my right eye) but don't recall EVER having any
problem prior to this.

For years I went through the roundabout of doctors offering treatments that
didn't really help (Botox) or give unhelpful advice ("just avoid triggers").
It wasn't a problem before this, dammit. I eventually dropped out of school,
stopped using computers for days at a time and spent over 95% of my time for
over 5 years sleeping being very depressed and suicidal.

It got to the point where my eyesight was degenerative and my doctor suggested
I try topiramate (risk of optic nerve damage and my eyesight was already bad
and getting worse by the day). I tried valproic acid and it made my vision
blurry for a week, but I recovered upon stopping the drug.

In early 2017 I got a medical cannabis prescription from a doctor who
acknowledged that other treatments didn't work for me and it made an immediate
difference. I don't really get migraines anymore and I'm a much happier person
in general whose started going to university and I've made some hilarious
stoner friends as a result, so that's funny too. What's odd is my eyesight has
improved to the point where I don't need as strong as a glasses prescription.
The glasses I got last December are now too strong for me so I am happy about
that. I'm still not 100% yet, but even a year and a half in I'm still
"recovering" from everyday migraines for over half a decade.

I'm blessed to live in Canada and not a place where medical cannabis is
illegal. Even in legal US states (Washington, Colorado, et al) there is still
the hypocrisy of the federal government acknowledging that cannabis has
medical benefits, while still causing vexing legal problems for users.

Be well everyone. Feel free to ask any questions.

------
kuwze
I don't like folksy remedies but I have anecdotal evidence that
headaches/migraines may be caused by a lack of salt. Here is some research to
back that idea up[0][1].

[0]: [http://sci-hub.tw/10.1111/head.12792](http://sci-
hub.tw/10.1111/head.12792) [1]:
[https://www.newscientist.com/article/2101015-does-eating-
mor...](https://www.newscientist.com/article/2101015-does-eating-more-salt-
prevent-migraines-and-severe-headaches/)

~~~
joshgel
Salt is one of the bodies most hormonally regulated substances after maybe
glucose. The electrolytes Na and Cl are routinely and easily measured on basic
blood chemistry panels. My patients with migraines don't have low salt. cant
say I'm a migraine researcher or know what causes migraines but this doesn't
seem like a reasonable hypothesis.

~~~
kuwze
Hey man I am way out of my depth here, but the study really speaks for itself:

> Our analysis population was _8819_ adults in the _1999–2004_ National Health
> and Nutrition Examination Survey (NHANES) with reliable data on diet and
> headache history.

Compare that to Aimovig:

> The _12-week trial_ , presented this week at the annual meeting of the
> American Academy of Neurology, involved _246_ patients suffering four to 14
> migraine headaches a month who had tried two to four preventive treatments
> that either did not work for them or had intolerable side effects. [0]

[0]: [https://www.reuters.com/article/us-amgen-migraines-
aimovig/a...](https://www.reuters.com/article/us-amgen-migraines-
aimovig/amgens-aimovig-halved-migraine-days-in-30-percent-of-trial-patients-
idUSKBN1HO348)

~~~
aodin
You're comparing a survey (NHANES), which is a questionnaire completed by
volunteers, to an active treatment medical study with a placebo control group.
Comparing the N count between these two is essentially apples to oranges.

As to the results of the salt intake survey ( _Pogoda_ _et_ _al._ ), it is
describing a correlation, not a causation. The actual relationship between
salt intake and migraines could also be inverted, or completely independent.

~~~
ianai
It’s easy enough to rule out. When I have a migraine and haven’t had Gatorade
in a while, I’ll guzzle some down (preferably cold enough for a cold
headache). It’s definitey not affecting the large majority of my migraines,
but I at least know I tried that avenue too.

~~~
jjeaff
Sounds like you might be dehydrated, which is definitely a known trigger for
severe headaches.

------
kazinator
> _When investigators infused CGRP into people prone to migraines, they got
> headaches. When they gave the molecule to people who do not get migraines,
> it usually did not instigate one._

Ah, I remember seeing the CGRP acronym all over this paper:

[https://open.library.ubc.ca/cIRcle/collections/ubctheses/24/...](https://open.library.ubc.ca/cIRcle/collections/ubctheses/24/items/1.0224000)
( _The role of monosodium glutamate in headache_ , [2013])

 _" Glutamate can induce vasodilation by several different mechanisms. The
excitatory neurotransmitter can activate sensory fibres, which results in the
release of the potent vasodilatior CGRP (Messlinger et al. 1995)."_ [1.9.6]

~~~
jlebrech
i'm really happy there's a white paper on this, when I try to explain how i
came up with msg being the cause I'm told there's no evidence and i'm just an
anecdote.

when I was younger I experimented to find the migraine trigger, we suspected
msg quite quickly by checking all the ingredients (back before it was masked
by just calling it 'natural flavour' or boullion) I usually happens 1-2 days
after ingesting it as an ingredient.

~~~
kazinator
The nice thing above Melissa O'Brien's above paper is that, a serious
pharmaceutical researcher, she _takes it for granted_ that MSG causing
headaches is real. Like there is no question any more.

It's a _tour de force_. A nice highlight in the paper is when she explains how
she thinned the skull bones of rats, in order to directly observe the change
in flow in brain blood vessels caused by glutamate, without the disruption of
actually drilling through the bone. A real life Amy Farrah Fowler, man! :)

Most of the prior MSG research was largely conducted by shills hired to defend
the food industry. They made serious mistakes like: instead of randomly
sampling, specifically recruiting people with self-reported sensitivities:
that's a good way to gather a motley crue of tin-foil-hat hypochondriacs. If
you recruit that way, then for every person with an actual sensitivity, you
will get 100 others who just feed on mass hysterias. And those people will
predictably claim that they have a headache from a placebo. It's a ploy
designed to lump the real sufferers into the same group as a bunch of flakes
and make them the object of ridicule. Another pattern is the blatant dismissal
of edge results. Oh, only 3 more people had headaches on the real thing than
the placebo out of a whopping hundred. That's just noise! Yes, fuck the
several people who are actually sensitive to CGRP and/or have that genetic
feature that makes them slow to clear glutamate (discussed above paper).

------
drdeadringer
I inherited migraines through paternal lineage, at least x2 generations back
behind me. My personal deal has turned out to be overall environmentally
triggered -- specific foods, specific smells, overwhelming tyrannical stress,
a pinch of "still have to figure it out", and like this. Sometimes it got Real
Bad, like "last night made me doubt that my physical brain matter can't
directly feel pain even though I believe medical science" or "sleeping next to
the toilet as though I were an end-stage alcoholic on a bender" type of Bad.

Visual auras, trouble speaking and actually understanding native language as
if intoxicated or suffering dementia, finger numbness, loss of fine motor
control... all clear signs//symptoms for me.

Thankfully I've been able to mitigate triggering variables for myself.
Apparently my father has not; his situation is worse than mine and I hope this
drug offers some options.

------
yeastaway
I used to get ocular migraines a couple of times a year, but I haven't one in
over four years since getting on a wheat and yeast-free diet. I started the
diet to try and fix an autoimmune disease. It worked perfectly and also got
rid of migraines as a bonus. I spent some time trying to find out why and I
think the reason is simple, although I'm nowhere close to being a biologist.
It might work like this: 1) Migraines and are known to be caused by
inflammation. 2) Yeast is known to cause an inflammatory response in humans
via innate immune system (dectin-1, mannose receptors). 3) Yeast beta-glucans
(that trigger immune response via dectin-1) can pass through the intestines.
Therefore, eating yeast contributes to migraines.

------
thomasfedb
Looks like the drug works (better than placebo), although there's a
significant effect from placebo (about 50% as much as the drug) also. Always
fascinating how strong placebo effects can be, perhaps that also explains some
of the anecdotal fixes discussed here.

[https://jamanetwork.com/data/Journals/JAMA/937048/joi180039t...](https://jamanetwork.com/data/Journals/JAMA/937048/joi180039t2.png)
[https://jamanetwork.com/journals/jama/fullarticle/2681193](https://jamanetwork.com/journals/jama/fullarticle/2681193)

------
mrhappyunhappy
Sent the link to my mom who has been suffering from migraines for 5 years. She
tried every drug imaginable with very limited improvements. At one point she
spoke about ending her life because it was unbearable. She’d get migraines 3
or more times per week, some lasting for 3 hours and some for 3 days. She
would frequently call me saying she’s probably going to die now, that’s how
bad it was. She saw many neurologists, including the one at Mayo Clinic
mentioned in the article, to no avail. Part of me wished for her to go into
peace and quiet because I knew it would end her suffering but the other part
didn’t want to lose her. She is still kicking alive and well and finished her
nursing degree at 55... I don’t know how she did and still does it but I know
I will likely never meet a stronger person. I have had maybe a handful
migraines my whole life and when they do come around I can’t imagine living
with that. If for some reason this is a genetic condition that comes with age,
I can’t say for certain that I would choose to live if I were affected.

~~~
jlebrech
it could be food related, she needs to eat blander food, or at least know
every ingredient she eats.

For me it's Monosodium Glutamate and Aspartame that give me migraines, they
are also 2 different kinds of migraine.

The aspartame migraines happens after drinking a LOT of diet soda, I don't do
think diet soda anymore.

~~~
mrhappyunhappy
Pretty sure she doesn’t ingest any aspertame or msg. I am not around to help
her keep a food log but she does cook a lot by herself and I’m pretty sure
she’s tried keeping the food very basic, free of salt, sugar, msg etc..

~~~
jlebrech
does she put anything that has a barcode into her food, ie. anything like
stock cubes etc.

------
Rotdhizon
I don't think I qualify for saying I get severe migraines daily, but I get
them way more frequently than I should. Ever since I was a kid I would get
them at least 15-20 days out of the month. Not debilitating headaches like
some people get, but still pretty bad in that I had to be inactive for a few
hours a day while I remained in bed and got rid of it. I didn't know it was
unusual until I was having a conversation with a friend one day and he
mentioned that he only gets them maybe once a month, if that. Then I talked to
a few other people and they conveyed the same message, headaches are uncommon
for the average person. I went to the doctor as a kid countless times to get
help for it but they could never find anything wrong. While my headaches still
continue into my early 20s, I don't think I am bad off enough to drop this
kind of cash on a medication. Normal shelf medicine for headaches does work
fine for me, it just sucks that it's basically an every other day thing.

------
throwawayqdhd
I don't know how it works for others, but my migraines are closely linked to
my diet. Certain types of foods, especially anything related to dairy or
fermented things, somehow seems to trigger day-long migraines.

Simply eliminating these from my diet has helped cut down migraines from
2-3/month to 1 in 3 months

~~~
my_first_acct
Sounds like you are sensitive to tyramine (google tyramine migraine for more
info).

~~~
Bombthecat
Wow!

This might be my case ( whole I think I'm lucky enough that it is not a real
big issue.) I remember drinking despados ( some kind of tequila and beer
drink.) And having a huge headache the day after. And getting them once in a
while. I connected it somehow to the beer and stopped drinking it.

That might be the cause... I need to keep an eye on that. Thanks for the tip
:)

------
pkaye
Side effect may include headaches, stomach aches, nausea...

~~~
bkev
So, a friend of mine who’s a pharmacologist explained that one to me. When
drug test subjects take medication, they’re expected to note any side-effects
they suffer from, and that often includes what they’re taking the drug to fix
in the first place. So for example, someone might take headache medication to
mitigate it, but might still be suffering from that headache after taking the
pill. Cause and effect get turned around.

~~~
refurb
If you've ever looked at clinical trial data, you can see the list of symptoms
reported in the placebo arm. It's actually quite interesting. These patient
received no drug, but will complain about a whole list of symptoms.

As a result, drugs with very few side effects will still have a list of "this
drug may cause" that aren't drug related at all.

However, the FDA still requires those to be listed. In such lists you often
see contradictory side effects like constipation and diarrhea, sleepiness and
nervousness and non-specific complaints.

------
benzesandbetter
For me, Picamilon and changing to an alkaline diet stopped my migraines. The
only thing which will still trigger them is if I have prolonged exposure to
chemical vapors, such as enamel paint, or certain cleaning chemicals.
Fortunately, I can recognize those and get out of the immediate area before I
get enough exposure to trigger a migraine.

------
ekianjo
I have seen the clinical results for one drug of the same class for migraines
and efficacy wise its not spectacular. we are talking about reducing the
frequency of severe migraines episodes but not making them go away entirely.
Injectables are expensive too and will not encourage patients to try them out.
Net, its a niche market.

~~~
binarymax
Not sure if you've ever had migraines, but I have. Luckily I don't get them
often but I know those that do (once every couple weeks, lasting for 2-3
days). Reducing the frequency is a godsend.

~~~
gHosts
I use to get about 2 a week.... then I went very low carb diet (keto) for
weightloss.... and found the migraines massively reduced in frequency and
intensity....

Dug around and found that this is a commonly reported side benefit of a
ketogenic diet.

Sounds off the wall until you realize Keto diets were originally used for
managing childhood epilepsy.

~~~
jlebrech
I would avoid anything with masked ingredients, for example "flavourings" or
"natural flavourings" if they don't tell you what's in the flavouring it could
be anything.

------
orthecreedence
Maybe most people who get migraines know this already, but I've been taking
feverfew extract daily for a few years now and it has reduced my migraines by
about 80%. I used to get a few a week, now I get one about ever 2 months.

It really has helped me live my life much more fully. Migraines are truly
awful.

~~~
xab9
God, that shit sure tastes bitter :D But I'm trying the same nowdays, hope
it's going to help.

------
fapjacks
For what it's worth, both my dad and my best friend have had dramatic
reductions in their migraine frequency after they started using kratom on a
regular basis.

------
ape4
Generic name is Erenumab

------
jlebrech
I just avoid migraine triggers

------
mdip
This is very cool as far as I'm concerned. I suffered from migraines for about
17 years and due to sensitivities, I couldn't take most of the usual remedies
(triptans). Migraine is one of those things that is frustratingly
misunderstood -- they're not just "bad headaches"[0], they come with all kinds
of other, fun, symptoms and at least in my case, lasted between one and three
days with light and sound sensitivity[1] and nausea to boot. I could expect to
get them in the fall and spring about once a week. I, literally, wrote a
Visual Studio extension to enhance text on my screen when viewed at the lowest
contrast/brightness setting and purchased a laptop after carefully reviewing
the quality of the display and any hints I could find about how dark the
screen could be made to go (Asus ended up being excellent at the time).

That said, I haven't had been hit with migraine symptoms for two years. If
you're living with this condition and treatment for it has failed, I
_strongly_ recommend changing doctors, and if you haven't gone beyond your GP,
do yourself a favor and go to a practice that specializes in headaches. There
are more than a few older, lesser-known medicines that successfully treat
migraine off-label. In my case, it's a low dose of Depakote[2] -- which is
available in generic form. Outside of my deductible, it's under a buck a
month, inside it, it's under $10. When it was prescribed to me, there were no
references on any of the typical places (WebMD, drugs, et. al) about it being
used to treat Migraine. But when I searched on the medication, there were
plenty of anecdotal reports from patients stating that the medication -- which
was prescribed for bipolar, usually (another off-label use, it's an old
medication that was originally prescribed for seizures) -- had resulted in
elimination of migraine or a dramatic reduction in the pain[3]. When I last
looked, the major sites had it listed as an off-label use. The best part about
the medication (well, other than it working) for me is that my body responds
very well to it -- I've had _nothing_ in the way of negative side-effects,
though there were a few, surprising, positive ones.

Anything dealing with the brain is tricky -- the medications, including the
one I'm taking, have odd and downright scary side-effects. And there's usually
a page full of them. The cause of migraine isn't particularly understood,
either. Considering how different symptoms are for this affliction among those
who have it, it wouldn't surprise me if it's found out to be a large
collection of different maladies one day.

[0] Well, for me, they certainly _were_ bad headaches, too.

[1] Sensitivity is the best word - with light, it was anything bright and
cold, but with sound it didn't have to be loud. The worst pain would come from
nearly any noise emanating from a mobile phone or tablet speaker at any volume
level. It would electrify the pain in my head.

[2] Which, it turns out, might have additional benefits:
[https://www.nytimes.com/2016/10/09/opinion/return-to-the-
tee...](https://www.nytimes.com/2016/10/09/opinion/return-to-the-teenage-
brain.html)

[3] I'd consider it "eliminated" in me. I get them _extremely_ rarely, and
when I do, I can't entirely be sure it's even migraine based on the symptoms
... I still have sensitivities to light/sound but instead of it feeling like
the pain was turned up well past 11, I just feel a sort of pressure/head-
annoyance that's difficult to describe. Honestly, I'd rather deal with that
_every_ day than get a migraine headache even once in a year and I joke
(without laughing) that I haven't had one in so long that if I got one, I'd
probably have to lay in bed for 3 days. It's been a few years now, though, so
my concern about that happening is diminished quite a bit.

~~~
ghufran_syed
Speaking of old, cheap medicines that help migraines, much more so imo than
many newer expensive medicines, it's definitely worth trying metoclopramide
(reglan) or prochlorperazine (compazine).

A lot of docs don't think about using them, because they are cheap, generic
and therefore not advertised :)

They shouldn't be taken regularly, they can have nasty side effects if taken
regularly, but they are a great drug to use even up to once every week or two
weeks to treat an acute severe migraine attack I.e. "rescue medication". Btw,
if the migraines are this regular, you should also see a specialist to
consider some preventive medication)

My own migraines are pretty mild, but I work as an ER doc, regularly treating
patients with migraines that didn't respond to other meds at home.

~~~
mdip
It's somewhat of a downside and an upside with the medication I take -- it's
not a "take it when there's a problem" but a "take it all the time" kind of
drug. In this case, because mine were so frequent, I'd be taking them
regularly anyway so a daily pill as prevention works really well for me.

My body also has a really bad time with anything that messes with serotonin --
I can't take SSRIs (these are sometimes prescribed for Migraine, but usually
as a last resort), I can't take triptans (IANAD, but if I understand it
correctly, they're mode of operation is to boost serotonin levels[0]). I've
had absolutely _no_ issues on Depokote. The _one_ side effect that it has for
me was reducing my anxiety. The crazy thing was that I would have never
identified as someone with an anxiety problem, but once I the medicine started
working, I noticed that my general outlook on life was a lot more 'calm'.

[0] Or the specific triptan I was on did that as a side-effect ... I
discovered this difficulty of mine as a result of getting serotonin
shock/syndrom. That was fun!

------
freshyill
I’ve had migraines, both ocular and the “real” kind, so I know how bad they
can be. I wouldn’t say they were anywhere near frequent enough to take a
preventative drug for it. I’ve also worked with multiple people who’ve had
chronic attendance problems, and migraines were _one_ of their many go-to
excuses. I know that sounds bad, but at least two of the people I’ve worked
with would frequently use migraines as their excuse for coming in late, yet
they never once got one while _at_ work. Stolen cars, sick pets, the bus never
showed up, etc. It was constantly something, more than once a week. If they
were real, and I’m just being judgmental and seeing patterns that aren’t
there, then I’m glad they’ll get relief. If not, it’s one less excuse.

~~~
txcwpalpha
>I’ve had migraines, both ocular and the “real” kind, so I know how bad they
can be. I wouldn’t say they were anywhere near frequent enough to take a
preventative drug for it.

These two sentences contradict each other. If you never had to consider taking
a preventative for your migraines, then no, you do _not_ know how bad they can
be. Migraines are much more than just "ow my head hurts today, I should take
the day easy". For some, they are debilitating to the point of sometimes
making it impossible to do basic tasks like washing the dishes, reading, or
sometimes even watching TV. Sometimes during a migraine you literally cannot
do _anything_ other than sit in darkness and wallow in misery, hoping that
maybe it will ease up for long enough for you to fall asleep. Any kind of
professional work is out of the question during a migraine.

Not getting a migraine while _at_ work isn't uncommon, as sometimes having
something to focus on (like work) can help stave off whatever triggers the
migraines. Migraines also aren't something that just suddenly happens; people
who suffer from chronic migraines often get warning signs that one is coming
on 12-24 hours in advance, and they can take just as long to develop as well.
If someone was already at work, it's unlikely that a migraine would progress
to the point of being debilitating before the workday was over. This is
probably why your coworkers usually call in sick, but never leave in the
middle of the workday. They typically will know before the workday even begins
if it will be a migraine-filled day or not.

Chronic migraines can lead to depression, which can cause a downward spiral of
deteriorating health/diet, which can in turn cause more migraines, and more
depression. Often time migraines can lead to thoughts of suicide because of
how badly it hurts, and how badly it impacts life as a whole.

I understand it's frustrating if your coworkers bail often, and shame on them
if they are faking their "migraines" and just using it as an excuse. But as
someone who has an SO who suffers from severe migraines 15-20 days per month,
and still forces herself to go to work most days _even through severe,
debilitating pain and depression_ precisely because she has coworkers with
judgmental attitudes like yours, I find your analysis insulting.

~~~
ianai
As a migrainer, I too am offended.

My migraines have robbed me of pretty much any really stellar life I could
have achieved. Undergrad was very tough because of the preventative meds I
took. I straight up couldn’t finish grad school and in large part due to the
migraines. Yes, I know I could probably have put up some academic fight. But
this is also at a point where I had essentially no healthcare and no income.
It’s done similar destruction to any social networking desires I may have. I
could go on.

As for frequency, without meds I’m basically getting one every day. With meds,
I get some days free of pain per week.

~~~
mrhappyunhappy
Sorry to hear about your condition :( I really hope you find relief in new
drugs. Many people here by their comments have no idea what a chronic migraine
looks like.

------
flatfilefan
Writing this hoping it will help someone, so being really sloppy on
argumentation. Just take the following as my personal experience anecdote.

If that new (or any) drug works for you - great. But consider that there are
no nerves that are responsible for the pain feeling in the brain itself. So we
must conclude that the pain is psychological and should be treated that way.

For me the treatment was a routine to pull out my (silly) fears from being
consciously or unconsciously suppressed and verbalize them. Once those fears
were verbalized the headache would go away. So in my case the headache was a
signal of an important thinking to be done that I have blocked away.

Verbalizing was initially easier by just writing down all thoughts even most
silly on a piece of paper. Later I could do it in my head.

Maybe it’s a different thing in your case, still chances are you can find an
exit “backtracking through the entrance into your condition”, so to say. The
challenging part is to get the insight as to what your deadend looks like.

~~~
Broken_Hippo
I know this is helpful, please read through to the end.

I think there is danger in the original thought: That the pain is
psychological. This most definitely isn't always the case and tends to make
folks not take the pain seriously. This is a major problem for women: They are
already sometimes told the pain is all in their head with migraines,
especially if PMS and hormones are triggers. And besides, we know that brain
tumors can make folks have migraine-type headaches. Blood pressure can cause
headaches. And so on. I'd much rather it state that psychological issues can
be a contributor: We can't presume the pain itself is psychological.

That said, it'd be silly to think that things like stress never affect it.
This is especially true if you get cluster headaches or if stress is one of
your triggers. My mother is like this: She gets cluster headaches that persist
for months. Part of her treatment is to take an anti-anxiety medication.
Granted, this does not stop the headaches, just makes them slightly less
frequent or at least gives them less intensity on a daily basis.

~~~
flatfilefan
By all means go and try to get to the root cause if there is one. However
taking your example with the blood pressure let me tell you another story of
mine.

So I had been diagnosed with a constantly high blood pressure and prescribed
medication. It was a good thing because I have for first time in many years
realized what normal blood pressure feels like. And it felt good!

My doctor is a good one though and she told me that the medication is not a
solution to my problem as there is no clinical reason to it. I had to find a
way to control my blood pressure without the pills.

And I have found the solution - a power nap. I just have to have some 15-60
minutes siesta after 4 hours of work. The thing is, nobody and nothing was
forcing me to have a high blood pressure, it was me myself. See?

It's easier said than done, you might say. But I have done it and now I'm
telling you about it. And it's not easy to convince you :-)

