Headaches & Holidays

Dr. Joel R. Saper explains the relationship between increased headaches and holidays and provides tips to keep your holidays headache-free, or nearly headache-free!

Why are headaches more prevalent around the holidays?

It ’s a time when the body is subjected to many stresses. People are rushing from store to store during lunch hours; there’s often the frustration of trying to please unpleasable people. Also around the holidays people change their schedules. Your body is used to being home watching the news at 6 o’clock, and instead you’re out shopping. You stay up to party or to wrap gifts. There is growing evidence that when headache-prone people experience a change in patterns their bodies will often react by getting a headache. In addition, depression is more prevalent at this time of year, since it can be triggered by many of the same factors that cause headache.

What causes this reaction?

We’re not absolutely certain, but the most recent evidence points to the defective functioning of cells or chemicals deep within the brain. Serotonin—a neurotransmitter that affects mood, sleep, and pain and partly controls the dilation and contraction of blood vessels—is believed to be part of the equation.

We do know that headaches, which are thought to be a by-product of a biochemical malfunction, are usually triggered by exposure to certain stimuli. Of the hundreds of potential activators of headaches, the most common are biological cycles, weather changes, anger, hormonal ups and downs, and hunger. Some less common but surprising triggers include orgasm, exhilaration and sleeping later than usual.

What is the effect of diet?

Some foods known to provoke headaches are those that contain the chemical tyramine. They include chocolate, aged cheeses, sour cream, yogurt, yeast extracts and vinegar in sauces. Non-tyramine foods to watch out for include citrus fruits, milk and milk products, onions and fatty foods. Remember, though, that susceptibility is highly variable.

And then there’s alcohol.

Right. In general, alcohol affects brain chemistry, which plays a role in headaches. But some people also react badly to specific ingredients in some alcoholic beverages. If you are headache-prone, avoid beers because of the yeast and other ingredients that might be activators. Red wines, sherry, port, and brandy all contain chemicals that can induce a headache.  The drinks that seem most benign are white wines and, in the liquor category, vodka.

How should alcohol-induced headaches be treated?

Most people require some form of medications, ranging from over-the-counter remedies to prescription migraine drugs.  Old-fashioned home treatments—such as resting in a cool, dark room or putting an ice bag over the forehead or neck—sometimes work well too.

For non-alcoholic holiday headaches, what’s the best medicine?

The range of treatment includes everything from over-the-counter analgesics to stronger prescription drugs. For people suffering from migraine headaches, there are already many excellent drugs, such as ergotamine, DHE and Midrin. And, of course, sumatriptan and the new sumatriptan look-alikes. These medications stop pain and nausea in 70-80% of the migraine sufferers studied, even when the headache has been present for many hours. They may also help people with other types of headaches.

What is your advice for making holidays headache-free?

  • Eat three times or more daily on a regular schedule; avoid fasting or postponing meals. Limit caffeine.
  • Don't smoke! Nicotine and carbon monoxide may increase headaches. In addition, avoid a smoke-filled environment (ambient smoke).
  • Do not let the hectic activities surrounding the holidays allow you to forget your medication schedule, and try to maintain your regular patterns. Utilize rest, ice, and/or other methods that may work for you. Avoid excessive use of medications, and keep any appointments you may have with your physician during this time.
  • Anticipate the stress and pace yourself. Take time out to unwind, practice biofeedback, meditation, and other relaxation methods including "brief relaxation" techniques (e.g., several minutes of slow abdominal breathing) to recharge your emotional batteries during long hours of holiday preparation and celebration.
  • Prepare for post-holiday letdown. The holiday season eventually comes to an end and, unfortunately for some individuals, a strong emotional letdown occurs during January and February. This can make them more prone to headaches and depressed mood.
  • As much as possible, keep to your normal daily rhythm. Temper your indulgences. And, above all, keep things in perspective. Don’t expect to please everybody—if you spend the holidays with a headache, you are unlikely to please anybody.