Cluster Headaches & My Mental Health

WARNING! This post reeks of self-pity.

I was diagnosed with cluster headaches way back in the late 1990s. Cluster headaches are a form of migraines that are called cluster headaches because they come in, well, clusters. They are not your typical migraines. No auras or sparklies accompany them. If there is any warning sign at all--at least for me--its a pressure or feeling of warmth above & behind my left eyeball. More often it's the beginning of a pain, also located above & behind my left eyeball. It usually begins as a dull ache but quickly progresses to a sharp, pulsating, relentless pain.

How to describe? 

• How about somebody trying to poke an ice pick through the back of your skull through your eyeball . . . 

• Or pushing a sharp-edged spoon through your left temple, attempting to pry that left eyeball so it pops out? 

Remedies? 

• I take medicine to prevent these headaches. 

• I have an oxygen machine that can help prevent them & also helps sometime when I feel one coming on. 

• I also have three types of medicine that I can use when I feel one coming on. (I'm pretty sure that I am currently over-dosing on them, but when one of these headaches starts turning into a doozy, I get desperate & honestly lose interest in what might happen to me if I overdose.

If I am am fortunate, when I feel one coming on, or, as often happens, I wake up with one, using the medicine and/or oxygen machine keeps the headache from "exploding," (or turning into a doozy) & the headache abates within 10-25 minutes. Laying perfectly still in a dark, cool, place, usually with a fan blowing on me, sometimes with a cool compress on my forehead works. Sometimes I can't stand any pressure on my head at all. If I'm not fortunate & my headache "explodes," it can absolutely knock me off my feet & render me into a pathetic, blubbering, whimpering mess for anywhere from 30 minutes to several hours.

Why am I telling you this other than to, as you may suspect, plead for your pity, especially when this is a "Mental Health Monday" blog entry?

Like I mentioned before cluster headaches tend to come in clusters for reasons that aren't entirely understood. They tend to cluster seasonally, also around certain times of day. For example, they often begin to start for me in April & continue into the summer, or they start in August & continue into the late fall. In my case they started in the spring; here it is the end of July & I'm still getting them.

Lately I've been waking up with a headache just about every night, soon after I fall asleep; also getting one pretty much every day sometime in the early to mid-afternoon.

Now about these headaches & my mental health. First of all, when they wake me up during the night or early in the morning, before I'm ready to get up, they disrupt my sleep. This is especially true if I get a headache that "explodes," & it takes me awhile to get back to sleep. There is definitely a link between insomnia or any kind of sleep deprivation & depressive cycles (at least in my case). So, I've been somewhat concerned about slipping into a significant depressive state, although it hasn't happened yet. They may or may not be linked to stress. They do not appear to be linked to triggers in the same way that migraines are. I've cut back on coffee & other forms of caffeine; ditto chocolate & certain kinds of nuts (no, not talking about relatives)--doesn't seem to have any bearing whatsoever).

Back in the spring of 2013, I began getting cluster headaches after about a year-and-a-half hiatus (also not unusual about these headaches). Despite several treatments & some tweaks in medication, they got progressively worse, peaking until that moment in late June when I found myself in the emergency room at Faith Regional Hospital in Norfolk. True to form, when the doctor met me in the exam room & asked me to describe my pain level, I answered, "12." It was decided I should get an MRI, just to rule out more serious possibilities, like a stroke or aneurism. By the time I was wheeled into the MRI room, my pain level had subsided to a 10. By the time I was back in the exam room & the doctor was ready with her report, my pain level was down to a 7. 

She told me the MRI had turned up "nothing" (That's somewhat of an insult, I commented, i.e. "You took an MRI of my brain & nothing turned up?"), other than a sinus infection on that side of my head, which could be adding pressure to the nerves associated with these headaches. My neurologist, who had consulted by phone, took me off the preventive meds he had changed me over to, put me back on the previous meds prescribed by my P.A., but increased the dosage. I stopped having cluster headaches overnight & didn't have another one until earlier this spring. Again, it's the nature of the beast. I should mention that when I'm in a cluster cycle, I carry all my meds with me, I start using up my stock-piled medicine faster than I can replenish it, & anytime I feel even the slightest pressure or twinge above that left eyeball, I begin to panic. Doesn't help the ol' anxiety symptoms.

But I digress. One of the outcomes of the 2013 cluster cycle was sleep deprivation, a depressive cycle, beginning of a general anxiety disorder (in my layperson's opinion), & an increased inability to get my work done at school (which only fed my anxiety). I always counted on the summer to (1) catch up on those administrative tasks I didn't get finished during the school year, bring closure to the school year, get end-of-the-year tasks to the faculty & staff for them to complete before most of them went off duty for the summer, then begin prepping for the new school year.

I was unable to accomplish all these tasks, so I ended the summer in a deep hole, which followed me into the 14-15 school year, which just fed my cycle of depression, anxiety, & contributed to what I subsequently realized was burnout. It didn't help that I refused to listen to the wise counsel of those I worked alongside, plus perhaps the wisest counsel of all--that of my dear wife. Also, having suffered depressive cycles & symptoms of burnout before, so a side of my brain was telling me that my solutions weren't working, but another side of brain (foolish pride? dysfunctional thinking?) was giving me very bad directions. 

Understand that I take ownership of this. I can't look back on this & blame my cluster headaches for my subsequent "breakdown" & enforced sabbatical.

Another physical health condition late that summer also contributed, I'm confident, to continued burnout & mental health deterioration, but I'll save that for another time. Whether this entry has been useful for anyone, I don't know, but I continue to blog as a form of self-therapy. 

Once again, if you suspect you might suffer from cluster headaches, you have many options. 

• Go to a reputable web site & check out the symptoms. As always, I'm prejudiced toward the Mayo Clinic web site but there are others. 

• You can also Google headache clinics & find reputable specialists who can help you with this condition. By reputable I mean check out their medical degrees. Someone with a medical degree from Tonga may not be the best recourse.

• Over-the-counter medications may do you more harm than good. (SEE "rebound headaches.") Narcotics are notorious for causing rebound headaches. Self-medicating w/alcohol? Tempting. Not a good plan. Medical marijuana? Don't get me started. Literally. 

• A neurologist is probably a better option than a general practitioner, but not even all neurologists are well-versed in the treatment of either chronic migraines or clusters.

• Pray, pray, pray. And when you're done, pray some more.

• Finally, IT'S NOT JUST ALL IN YOUR HEAD!

Wait a minute . . . Yes, it is.