I get a headache when I'm nervous. Is this a big deal?

Xiao Xu, a 24-year-old graduate student, suffers from headaches. When there is a cold breeze, long hours of study or insomnia, he will experience neck pain, and even his entire head will feel tight as if wearing a "tightening spell". The pain will last for one or two days. Although massaging the painful area can slightly relieve the pain, it is only a temporary solution and not a permanent solution. The headache comes from time to time, which really affects his study and life.

Are there many people around us who have this situation? This kind of headache is known as "the second most common symptom after the pain caused by tooth decay" - tension headache.

There are hundreds of causes of headaches, ranging from benign, harmless causes to serious diseases that may threaten life. Headaches are like "alarms" of disease, and we must never underestimate them.

Do you really get a headache when you're nervous?

Is this type of headache caused by tension? There is indeed a certain relationship between tension and headaches. There are five main causes of tension headaches.

Mental Health

Many people face stress from work, study or life, which can cause anxiety, depression, irritability and other negative emotions, leading to tension headaches. In addition, people who have experienced severe mental trauma will also experience tension headaches when they are mentally stimulated again.

Bad posture

Working at a desk for a long time, playing with a mobile phone for a long time, etc., will increase the tension of the shoulder and neck muscles, causing excessive muscle contraction, resulting in local tissue and nerve ischemia, and inducing tension headaches.

Sleep disorders

Long-term lack of sleep and poor sleep quality can lead to chronic fatigue and easily induce tension headaches.

Bad eating habits

People who have irregular diet, unbalanced nutrition, or bad habits such as drinking and smoking are also prone to tension headaches.

Age and gender

The disease occurs more frequently in women than in men, and occurs more frequently during menopause and during menstruation.

How tension headaches differ from other headaches

Tension headache is a very common type of chronic headache. More than half of patients who usually have headache symptoms suffer from tension headache.

Tension headaches usually start when patients are around 20 years old. They are less severe than other types of headaches, have a better prognosis, and usually leave no sequelae. During an attack, patients often have a feeling of distension, pressure or tightness in the head. The pain can be located in the occipital neck, frontal temporal region, or the entire head on one side or both sides. The course of the disease can last from a few days to several years, with repeated attacks. The muscles in the painful area are tender or painful, and the muscles of the head, neck, shoulders and back are stiff. Massaging the sore area will make you feel comfortable and relaxed, and can relieve the symptoms of headaches.

How to differentiate between tension headaches and migraines?

Migraine is also very common, with symptoms of recurrent attacks, unilateral or bilateral involvement of the head and neck, but the attacks are often throbbing or pulsating, lasting 4 to 72 hours, and the headache symptoms may be aggravated by light or sound stimulation, and relieved by rest or in a quiet environment. Here are 3 self-test questions to help you make a judgment.

(1) Are you afraid of light (much more severe than when you don’t have a headache)?

(2) Does the headache limit your ability to work, study, or do other things? And does this condition last for at least 1 day?

(3) Do you feel nauseous or have stomach discomfort?

If you answer "yes" to two of the above three questions, you can preliminarily determine that you have a migraine rather than a tension headache.

How to differentiate between tension headaches and cluster headaches?

Cluster headaches are also relatively common, but their characteristics are more obvious. During an attack, the patient will be restless and have a unilateral headache with severe severity, accompanied by conjunctival congestion, tearing, nasal congestion, runny nose, forehead and facial sweating, pupil constriction, ptosis, eyelid edema and other symptoms. Cluster headache patients often feel the pain peak within a few minutes, but the duration is short, generally 15 to 180 minutes, and often have frequent attacks over a period of time (7 days to 12 months), with an attack frequency of 1 to 8 times/day.

In addition, we should also learn to quickly identify those headaches that indicate danger, such as sudden thunderclap headache (pain reaches peak within 1 minute), which often indicates subarachnoid hemorrhage or other cerebrovascular accidents; acute or subacute neck pain, or headache with symptoms such as enophthalmos, pupil constriction, vascular dilation, ptosis of upper eyelids and no sweating on the face and neck, which are common in patients with cervical artery dissection or vertebral artery dissection; headache with fever and changes in consciousness, indicating central nervous system infection; headache with fever, stiff neck and some eye symptoms, tinnitus, and hearing loss, indicating aseptic meningitis.

Tips for relieving symptoms

Although the prognosis of tension headaches is good, they often cause physical and psychological discomfort to patients when they occur. If you ignore the headaches for a long time and just "endure" them, the headaches may occur more and more frequently, the symptoms will become increasingly severe, and the duration will become longer, and minor problems will be "dragged into" major problems.

If the headaches are mild or occur frequently (>15 times/month), the following non-drug treatments are recommended.

Massage: This is the most direct way to relieve pain. When pain occurs, press the posterior neck muscles with the thumb or the other four fingers according to the site of the disease. The pressure should be measured when the nails turn from red to white. Continue for 5 minutes. For the pain point, press with the thumb for 3 minutes continuously with moderate force until you feel the headache is relieved and there is a sore feeling.

Meditation: Lie on your back or sit cross-legged, relax the muscles of your entire body, slow down your breathing, and let go of distracting thoughts. You can imagine yourself lying in cotton or by a calm lake. The best state is to make yourself feel the existence of your body and only retain your consciousness of constructing the world. Studies have found that meditation can reduce the excitability of the parietal lobe of the brain, causing the area to feel less pain, taste, temperature, and pressure. Using mindfulness meditation to treat tension headaches can reduce the intensity and frequency of headaches.

Exercise: Regular and moderate aerobic exercise can bring many benefits, such as reducing stress, regulating sleep, improving weight and cardiovascular function, etc. People who exercise regularly will also increase their threshold for headaches without any adverse reactions. Patients are advised to exercise regularly and moderately, such as jogging, brisk walking, and cycling. The duration of each exercise should be based on what the body can bear, and should be maintained 3 to 5 times a week. Exercise can be used as a regular means of preventing headaches.