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Severe headaches tied to suicide attempts

Friday, Mar 23 2012


People with severe headaches, whether migraines or not, may be more likely to attempt suicide, a new study suggests.

The findings don’t prove that headaches caused the suicide attempts, but a number of studies over the years have found that people with migraines tend to have a higher suicide rate than those without the problem.

But it has not been clear whether it’s related specifically to the “biology of migraines,” said Naomi Breslau of Michigan State University in East Lansing, who led the new study.

“We haven’t known if it was the migraines or the pain more generally,” Breslau told Reuters Health.

Based on these latest findings, it may be the severity of the pain that matters, migraine or not, the researchers say.

The study, reported in the journal Headache, followed nearly 1,200 Detroit-area adults. About 500 of them were migraine sufferers, while 151 had severe headaches that were not migraines. The rest Over two years, the migraine and severe-headache groups had similar rates of attempted suicide. Almost nine percent of migraine sufferers said they’d tried to kill themselves, as did 10 percent of those with severe non-migraine headaches.

Migraine Headaches and Adolescent Suicidal Risk

A recent study appearing on WebMD reported that adolescents who get frequent daily migraine headaches have a higher suicide risk.
Those whose headaches were accompanied with auras (visual elements) had an even much higher risk. The author, Shuu-Jiun Wang, M.D., conducted the study in Taiwan. The investigation included 7900 adolescents aged 12 to 14 years of age and its results were published in the May 1, 2007 issue of Neurology. No control groups were used.
One hundred and twenty-two subjects were identified. Each had “15 or more headache days per month for more than 3 months, with each headache lasting 2 hours or more daily.” The two most significant psychiatric problems, besides the headaches, were major depression (21%) and panic attacks (19%). Girls were more likely to have depression: 26 vs 7%.

Suicide risk was measured by their responses to the following statements:

“If in the past month they had

-wished they were dead,
-wanted to hurt themselves,
-thought about killing themselves,
-thought about a way to kill themselves, or
-tried to kill themselves.”

That compared with a rate of just over one percent in the comparison group.

“We’re ruling out that it’s only migraine” that’s related to suicide risk, Breslau said. Usually, she added, common tension-type headaches “don’t come close” to the pain severity of migraines. But they can in some cases.

The difference is that migraines have some distinctive features - like nausea and vomiting, sensitivity to light or sound, and throbbing pain on one side of the head only.

Dr. Harry A. Teitelbaum writes in Psychosomatic Medicine, in a chapter on neurological disorders, that “(m)igraine is a classic psychosomatic cerebral vascular disturbance that some authors consider to be “. . . related to unexpressed anger as well as to associated vasospasm of branches of the internal carotid artery.” (my emphasis) (p. 265)
Neurologist E. Michael Holden believes that migraine may be caused by the repressed memory of torsion of the neck during birth. The person reliving this aspect of his birth with “...extreme stretching of the carotid and/or the vertebral arteries may initiate the reflex vasoconstriction in response to pain… (A) reactive dilation would be expected to occur due to the buildup of waste products in cells supplied by the previously vasoconstricted arteries.” (Holden, op cit, p. 9)

He feels that this sequence may become a prototypic response to head or neck pain endured at birth. As stated, there is “vasoconstriction of cerebral arteries when stressed, followed by painful dilation of those arteries after the stress (e.g., migraine).” ibid, p. 9-10.

In a British publication, Journal of Psychosomatic Research, Vol. 21 pp. 333-339, Holden describes how a migraine patient in primal therapy was able to resolve his migraine attacks within minutes by re-engaging the trauma. He writes that the patient learned that during birth the left side of his head was traumatized and that he had started drowning in amniotic fluid.

He concludes by writing:
“1. Psychosomatic symptoms occur in people who do not feel their early life pain in primals.

2. As soon as one can re-experience childhood pain (editor’s note: “especially pre- and peri-natal pain") in primals, then the biological motive for symptom formation gradually ceases. It is an either/or relationship. One has a choice. One can either have the symptom, or one can re-experience the pain which caused it, complete a sequence of healing, and resolve it.

3. It is almost invariably true in our experience that a symptom represents a fragment or partial representation of an early feeling state during a trauma in infancy. (editor’s note: It is presently acknowledged that most psychosomatic symptoms originate in birth trauma rather than infantile trauma.) This removes the symstery surrounding the general query” “Why one symptom - rather than another?

In this study, severe non-migraines were defined as an intense headache lasting more than four hours.

So why are severe headaches related to suicide risk? Depression plays some role, Breslau said, but it doesn’t tell the whole story.

When Breslau’s team factored in people’s history of depression, anxiety and past suicide attempts, they found that migraine and headache sufferers were still four to six times more likely to attempt suicide than the comparison group.

There may be some biological underpinnings at work, according to the researchers. Certain brain chemicals, including serotonin, are thought to be involved in severe headaches, and dysfunction in those chemicals has also been linked to suicide risk.

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