Headache won't go away? Check your mental health

Dr Edith Kamaru Kwobah, the Director of Mental Health at Moi Teaching and Referral Hospital. [Mercy Kahenda, Standard]

Most people find that they can easily manage headaches by drinking water or taking painkillers.

However, health experts are warning that persistent headaches can be a sign of a mental health issue that requires examination and treatment.

There are various types of headache disorders including migraine, tension, cluster headache (CH) and medication overuse.

Dr Edith Kamaru Kwobah, the Director of Mental Health at Moi Teaching and Referral Hospital, and a member of the Kenya Mental Health Board notes that depression and anxiety can present with somatic symptoms, which include headache.

She explained that somatic symptom disorders are characterised by an extreme focus on physical symptoms, for example, pain and fatigue that cause emotional distress.

But even people who are distressed and may not fill the criteria for mental illnesses may have headaches.

"People do experience headaches more often, but persistent headaches could be signs of mental illness," says Kwobah.

She adds: "Headaches can be due to mental illness. Mental illnesses can result from unresolved headaches."

Tension headaches and migraines have a strong association with one's psychological state.

Some headaches are associated with sleeping problems (insomnia), burnout, and chronic fatigue syndrome.

"People should seek proper attention because some causes of persistent headaches such as brain tumours, seizures and other chronic infections can only be investigated through CT Scan and MRI," she adds.

Other causes of headaches, she noted, can be stress, dehydration, infections, and dental issues.

Dr George Biketi, a general practitioner says that a headache is not a disease, but a symptom of an underlying health problem.

"The specific site of the headache, timing, duration, and severity determines the type of treatment to be given to a patient. Doctors check blood pressure, ask about any head injuries, and with the examination, advise on a CT Scan of the head as such can be due to tumour or blood clot," says Dr Biketi.

Other causes of headaches include vascular, blood vessels, systematic problems, systemic problems because of trauma and injury in the head, dehydration, overworking, and anxiety disorder.

With CT Scan findings, patients can further be referred to neurosurgery. Those whose cause may be anxiety are referred to therapists and psychiatrist experts.

"If the headache is vascular linked, for example, blood pressure, patients are given painkillers," notes Dr Biketi.

Dr Biketi says that depending on a patient's history combined with laboratory and clinical investigations, most headaches should be able to pick a specific cause and be handled accordingly.

According to the World Health Organisation (WHO), headache disorders are among the most common disorders of the nervous system. WHO estimates that almost half of the adult population has had a headache at least once annually.

"Headache disorders, which are characterised by recurrent headache, are associated with personal and societal burdens of pain, disability, damaged quality of life, and financial cost," notes the WHO report of 2016.

Globally, in 2016, it was estimated that prevalence among adults of current headache disorder stood at about 50 per cent.