Medical and physical approaches
Most remedies for headaches and migraines are quite simple and have little or no side-effects, In fact, the most common remedies, such as drugs to kill pain, are widely available, even without prescription. In some cases, prescription drugs are necessary, and in a very small number of cases surgery may be necessary to remove some blockage or obstruction.
The most obvious of orthodox medical therapies is that of analgesia. Indeed, the first response is usually to deal with the pain, and to consider the causes after that. There area great many painkillers, varying in strength, method of action, and toxicity. The three main drugs widely available without prescription are aspirin, paracetamol and ibuprofen. In the short term these can be very effective, but if у our headaches last more than a few days you should stop taking them and see your doctor. This is particularly important because your body can adjust to these drugs in such a way that over a period of time you can actually develop a headache when you stop taking them, just as you can develop a headache when you stop drinking tea or coffee if you normally drink these beverages daily.
Sometimes, especially when you are experiencing headaches due to some kind of allergic reaction – including such things as hay fever – your doctor may advise that you take antihistamines. These drugs suppress the immune system and stop your body reacting strongly to the allergen (in the case of hay fever, this is airborne pollen). Some antihistamines can make you sleepy, which of course means that you should not drive or operate machinery after taking them. Check your information leaflet carefully when you take a drug.
Research in brief: doctor-patient relationships.
Psychologists are very aware of the gap that sometimes exists between doctor and patient. You probably don’t share much with your doctor because his or her life could be quite different from yours, and his or her upbringing or culture could also be different. These things, and others, mean that when you try to talk to your doctor and your doctor talks to you there may be some loss of essential information. People often complain because their doctor does not explain things well, or because the doctor is too busy to listen to them. As psychologists, we are aware that this can have an impact on the success of your treatment, or on the way you follow the advice you have been given. Anne MacGregor (1997), in the journal Neurology, points out that, with respect to migraines, the doctor might have a slightly different agenda from the patient. Doctors are good at curing things, but not always so good at making patients feel better about things. She recommends that doctors should spend time listening to their migraine patients, understanding their triggers, and tailoring their care and treatment to their individual circumstances. Success of treatment can depend on these things. Using the recommendations from MacGregor’s advice to doctors, we can generate a list of things you can expect and ask your doctor to do. They are:
- That your doctor should listen to your expertise about your own headaches.
- That your doctor should identify any triggers that you have noticed.
- That all advice should be clearly explained, and that your doctor should ask to make sure you do grasp what is being said.
- That your doctor should explain any treatments being offered and explain in simple terms why they work.
- That your doctor should want to see you at regular intervals during the course of your treatment to follow up the result of what has been suggested.
In many ways, it is common sense that a combination of medical, complementary and psychological treatments is likely to yield the best results. After all, the cluster of therapies is likely to help to heal both the body and the mind, and neither should be overlooked. Your starting point should be your doctor. Sometimes this is all that is needed. Even with the most horrible migraines, some people can be ‘cured’ quite easily, even though this is rare. As your doctor works with you to discover the reasons for your headaches, it may then become necessary for you to seek help from complementary sources, and to see a psychologist of some type. The more complicated your headaches, the greater the likelihood that you will need a good combination of therapies. Do not forget, however, that things like social support can be just as important. If you are lucky enough to have friends and family to care for you and help you, then make use of that. If this is a problem, consider joining a support group in your area, or a national society, whether it be for migraine, cluster headaches, menstrual headaches or something else. You should not underestimate the amount of help and information you can receive from such groups. Knowing that you are not alone makes a lot of people feel much better very quickly.
A word on placebo effects
A placebo is a substance or therapy that does not have any physical effect on the functioning of the body but, through psychological means, can alleviate the signs and symptoms of illness and disease. In many books you will find placebo effects considered among complementary therapies, for two reasons. First, some such therapies really seem too far-fetched to be genuinely therapeutic, and indeed are money-making schemes for their practitioners. However, some doctors also have very negative attitudes to complementary therapies. There is an increasing body of research to show that this may be unfair, and that some therapies can have a very real effect some of the time.
However, all medicine – orthodox, psychological or complementary – can be associated with a placebo effect. Essentially, having someone to look after you or take an interest in you makes you feel better. For a host of reasons, this can mean that seeing the doctor is just as likely to have a placebo effect attached to it as seeing a reflexologist or a herbal medicine specialist. However, the amount of placebo effect is what is important. Some therapies seem to be entirely a placebo, whereas seeing your doctor rarely is. The drugs and treatments given to you by your doctor are very likely to have a significant effect on your body.