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Headaches and Holidays:
What To Do
(by Joel Saper, M.D.)
Why are
headaches more prevalent around the holidays?
It ’s a time when the body is subjected to many stresses. People are rushing from
store to store during lunch hours; there’s often the frustration of trying to please
unpleasable people. Also around the holidays people change their schedules. Your
body is used to being home watching the news at 6 o’clock, and instead you’re out
shopping. You stay up to party or to wrap gifts. There is growing evidence that
when headache-prone people experience a change in patterns their bodies will often
react by getting a headache. In addition, depression is more prevalent at this time
of year, since it can be triggered by many of the same factors that cause headache.
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What causes
this reaction?
We’re not absolutely certain, but the most recent evidence points to the defective
functioning of cells or chemicals deep within the brain. Serotonin—a neurotransmitter
that affects mood, sleep, and pain and partly controls the dilation and contraction
of blood vessels—is believed to be part of the equation.
We do know that headaches, which are thought to be a by-product of a biochemical
malfunction, are usually triggered by exposure to certain stimuli. Of the hundreds
of potential activators of headaches, the most common are biological cycles, weather
changes, anger, hormonal ups and downs, and hunger. Some less common but surprising
triggers include orgasm, exhilaration and sleeping later than usual.
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What is the effect
of diet?
Some foods known to provoke headaches are those that contain the chemical tyramine.
They include chocolate, aged cheeses, sour cream, yogurt, yeast extracts and vinegar
in sauces. Non-tyramine foods to watch out for include citrus fruits, milk and milk
products, onions and fatty foods. Remember, though, that susceptibility is highly
variable. (Click here for
a more complete listing of headache-provoking foods.)
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And then there’s
alcohol.
Right. In general, alcohol affects brain chemistry, which plays a role in headaches.
But some people also react badly to specific ingredients in some alcoholic beverages.
If you are headache-prone, avoid beers because of the yeast and other ingredients
that might be activators. Red wines, sherry, port, and brandy all contain chemicals
that can induce a headache. The drinks that seem most benign are white wines
and, in the liquor category, vodka.
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How should alcohol-induced headaches be treated?
Most people require some form of medications, ranging from over-the-counter remedies
to prescription migraine drugs. Old-fashioned home treatments—such as resting
in a cool, dark room or putting an ice bag over the forehead or neck—sometimes work
well too.
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For non-alcoholic holiday headaches,
what’s the best medicine?
The range of treatment includes everything from over-the-counter analgesics to stronger
prescription drugs. For people suffering from migraine headaches, there are already
many excellent drugs, such as ergotamine, DHE and Midrin. And, of course, sumatriptan
and the new sumatriptan look-alikes. These medications stop pain and nausea in 70-80%
of the migraine sufferers studied, even when the headache has been present for many
hours. They may also help people with other types of headaches.
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What is your advice for making holidays headache-free?
Eat three times or more daily on a regular schedule; avoid fasting or postponing
meals. Limit caffeine.
Don't smoke! Nicotine and carbon monoxide may increase headaches. In addition, avoid
a smoke-filled environment (ambient smoke).
Do not let the hectic activities
surrounding the holidays allow you to forget your medication schedule, and try to
maintain your regular patterns. Utilize rest, ice, and/or other methods that may
work for you. Avoid excessive use of medications, and keep any appointments you
may have with your physician during this time.
Anticipate the stress and pace yourself. Take time out to unwind, practice biofeedback,
meditation, and other relaxation methods including "brief relaxation" techniques
(e.g., several minutes of slow abdominal breathing) to recharge your emotional batteries
during long hours of holiday preparation and celebration.
Prepare for post-holiday letdown. The holiday season eventually comes to an end
and, unfortunately for some individuals, a strong emotional letdown occurs during
January and February. This can make them more prone to headaches and depressed mood.
As much as possible, keep to your normal daily rhythm. Temper your indulgences.
And, above all, keep things in perspective. Don’t expect to please everybody—if
you spend the holidays with a headache, you are unlikely to please anybody.
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