Azulfidine (Sulfasalazine)
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MIGRAINE HEADACHES: EVENTS AND CIRCUMSTANCES THAT TRIGGER AN ATTACK-EMOTIONS: STRESS, FRUSTRATION, DEPRESSION, AND LETDOWN
If you have migraine, you were probably born with a biological migraine predisposition. The frequency and nature of your attacks will be determined by what are called triggering factors. These triggering, or precipitating, factors range from emotionally charged situations to foods and drugs, certain kinds of visual effects, and weather or hormonal changes.
Aside from mere interest in such triggering phenomena, we believe that effective treatment and prevention require a thorough understanding of which headache-provoking circumstances are relevant to your case. Certain triggering factors are obvious; others remain obscure.
Emotions: Stress, Frustration, Depression, and LetdownЂ”Emotions are a very important factor when considering the triggering of migraine attacks, even though emotional provocation is not always apparent to those who suffer from its influence. It is very common for migraines to worsen during periods of increasing pressure. The pressure to achieve what are often unreachable goals typically can lead to a series of attacks. Anger, particularly when not expressed, can trigger migraines. Intense mental concentration, such as studying for examinations, or a competitive business situation, may also be antecedent to headaches.
Some people who are prone to migraine experience attacks only after the emotionally distressing events have passed or lessened, rather than during the period of stress. This has been called letdown headache and can be one of the influential factors in provoking the weekend or holiday migraine. Some of our medical students claim that they invariably get headaches on the first or second days of their vacations rather than during the preparation for their examinations.
One psychiatric theory suggests that some illnesses like migraine actually represent the symbolic acting out of a psychological drama. The headache symbolically represents past or present (or even future) emotional events. For example, some psychiatrists believe that the wheezing in asthma allegedly represents a “crying out” or protest of separation from mother and womb. In the same way, the pounding headache of migraine is purported to be a symbolic enactment of “pounding” one’s head, or perhaps that of someone else, against an immovable obstacle. We do not accept this speculative psychiatric theory; it does not seem to explain the majority of migraine attacks encountered in practice. Nevertheless, in some way not yet completely understood, emotional upset does indeed play a critical role in precipitating migraine in many patients.
Pain Relief/Muscle Relaxantpatient-doctor communications. Many patients feel that their complaints are being dismissed when premature emphasis is placed on emotional factors.
Nevertheless, those who do not believe that emotional factors can cause changes in the body might consider the time that someone scratched/screeched fingernails on a blackboard, causing you to get goosebumps, or the time that someone used an embarrassing word and you blushed, or perhaps when some frightening event caused your heart to speed up, your brow to sweat, your stomach to cramp, and your hands to tremble. All of these represent significant physiological responses to emotional events. They represent not diseases but, for many people, normal and expected reactions. Current evidence suggests that chronic stress may indeed impose significant biochemical and physiological changes on the body. Patients with specific predispositions may indeed be more responsive to these emotionally induced physical changes than others.
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