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PTSD And Headaches: What's Post-Traumatic Headache And How Can It Be Treated?

by — 2020-04-05 in Mental Health
"Post-traumatic headache" describes headaches that start soon after a traumatic brain injury — but PTSD sufferers who didn't sustain any kind of head injury are more likely to suffer from headaches, too. What do you need to know?

When you hear the term "post-traumatic headache", you might think of someone who frequently suffers from headaches after living through an emotional trauma — or you may assume that the condition is one in which people have headaches following a physical trauma.

Though the second would be correct, it's more complicated than that. People who suffer from post-traumatic headache are more likely to also have PTSD, because traumatic brain injuries are often sustained during an enotionally traumatic event. And it's not at all uncommon for people with PTSD to be plagued by headaches, in a different kind of "post-traumatic headache". 

What do you need to know?

What is post-traumatic headache?

Post-traumatic headache is a phenomenon in which people who sustained a traumatic brain injury ("traumatic" referring, in this case, to physical trauma such as road traffic accidents or violent blows to the head) start experiencing headaches within seven days of the event or within a week of regaining consciousness. These headaches are most commonly migraines, during which the sufferer becomes sensitive to light, sound, experiences pulsating, and is nauseous, with possible vomiting. Other kinds of headaches, especially tension-type headaches, can also occur. 

While the cause of post-traumatic headache isn't understood precisely, it's thought to be related to muscle tension, physical changes within the brain, or the release of stress hormones. An MRI can give your medical team a better look if you have been suffering from headaches after a traumatic brain injury. 

What do post-traumatic headaches have to do with PTSD?

Since post-traumatic headache can result from violent and emotionally traumatic injuries, the connection between this kind of headache and post-traumatic stress disorder is quite obvious. In one study, 30 percent of the sample of people who had experienced road traffic accidents and developed post-traumatic headaches as a result also suffered from post-traumatic stress disorder. 

How is post-traumatic headache treated?

People who frequently experience headaches of any kind after suffering a traumatic brain injury should tell their doctors as soon as possible. Once post-traumatic headache is diagnosed, medications offer the best form of treatment. The exact drugs used will depend on the nature of your headaches. For migraines, for instance, triptans are very effective.

If the headaches don't go away and you find yourself over-relying on over-the-counter painkillers — which are safe enough when used occasionally, but can increase your risk of dangerous health outcomes if you use them regularly — you and your doctor can explore preventative options. It may seem strange, but those include antidepressants, medications used to treat hypertension, and anti-seizure medications. 

What if you have PTSD and headaches, but didn't suffer a traumatic brain injury?

You are not alone. 

In one study of combat veterans who sustained injuries in battle, 40 percent suffered from PTSD — and the same percentage reported they suffered from frequent headaches. Not all of those had a formal diagnosis, but 12 percent were doctor-confirmed to be plagued by tension-type headaches, 10 percent with migraine, and six percent with both kinds.

Further research indicates that people who suffer from post-traumatic stress disorder have migraines in higher numbers, even in the absence of any kind of head injury. People who already suffered from migraines when they developed PTSD are likely to notice an increase in the severity and frequency of their migraines. People who suffer from both migraines and PTSD will often have experienced physical or sexual assault, but combat trauma, road traffic accidents, and natural disasters are not uncommon traumas in people with migraines, either. 

One interesting thing to mention is that men are more at risk of experiencing migraines after a traumatic event — despite the fact that women are both more likely to develop migraines and to suffer from PTSD. Given this finding, researchers speculate that sex-specific hormones may play a role in causing these migraines. 

Besides that, though the cause of these migraines remains unknown, higher levels of stress hormones coupled with reduced levels of "feel-good" hormones like serotonin are believed to contribute to causing headaches in people who have lived through traumatic events. Post-traumatic stress disorder can have a tremendous impact on day-to-day functioning. Not only are you likely to be trying your hardest to get your life on track after living through an event that rocked your world, the PTSD symptoms you're plagued by can lead to social, financial, and existential stresses. Headaches, it's well known, can be provoked by a high-stress life. PTSD is a high-stress life, almost by definition.

This second kind of "post-traumatic headache" isn't necessarily related to physical trauma at all, then. That doesn't mean no help is available. If you have post-traumatic stress disorder and debilitating headaches have joined your list of quality-of-life-destroying symptoms, seek medical help. Your doctor will find it easier to figure out what they can do for you if you come with a list that details when the headaches started, if you've noticed patterns in the kinds of circumstances that usually provoke them, can describe how you physically feel in great detail, and can pinpoint how often your headaches come along, and how long they last. 

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  • Photo courtesy of SteadyHealth

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