Traumatic events increase headaches and migraines

Teens exposed to traumatic or terror events may have a higher risk for weekly and daily migraines, according to a study of adolescents who survived a terror attack in Norway.

The findings further the idea that violence and psychological trauma could lead to physical symptoms.

“We have very little systematic knowledge about the physical consequences of terror and violent events, especially since people may not see the association or go to the doctor,” said study author Dr. Synne Stensland of the Norwegian Centre for Violence and Traumatic Stress Studies at the University of Oslo.

“There are people who are not getting the help they need for their physical and psychological complaints, especially when they become more severe or frequent,” she told Reuters Health by phone.

On July 22, 2011, a lone gunman opened fire on the annual Norwegian Labor Party youth summer camp. The man, disguised as a policeman, killed 69 people and severely wounded 33. Many of the 358 survivors saw what happened and risked hypothermia and drowning trying to escape. Most lost friends.

The survivors have been part of several studies to understand how terror and trauma affect adolescents. In this study, published in the journal Neurology, Stensland and colleagues looked at recurrent migraines and tension-type headaches in 213 of the survivors, ages 13 to 20. Trained personnel interviewed the survivors about four months after the attack, again 18 months afterward, and again three years after the attack.

The research team found the terror attack survivors reported many recurring tension-type headaches and migraines, and headaches were generally more common in girls. In particular, the female survivors reported three times more weekly or daily headaches than similar young women in the general population in Norway.

Posttraumatic psychological distress levels were much higher, too.

“We were surprised . . . the link was so strong between terror and headaches, even though we accounted for (many other factors),” Stensland said.

Future studies will continue to observe the physical and psychological symptoms that these teens experience.

“Incidents of terror are unfortunately commonplace worldwide, and although the physical effects are well covered, the invisible scars of psychological trauma receive much less attention,” said Dr. Gretchen Tietjen, director of The Headache Treatment and Research Program at the University of Toledo, Ohio, who wasn’t involved with this study.

“Psychological trauma during critical periods of development affects the brain in ways that alter not only the psyche, but also the metabolic, immune, endocrine and nervous systems,” she told Reuters Health by email. “These changes lead to increased susceptibility to a wide variety of adult diseases that may even be passed on to the next generation.”

These associations extend beyond terror events to childhood maltreatment, emotional abuse and sexual violence, Stensland added. Abuse in peer relationships or social media bullying can have a similar effect.

“They’re keeping a secret and don’t want others to know what happened,” she said. “It’s important for people to know that an increase in headaches could indicate something has happened, and it’s time to talk.”

Stensland would also like to see research on medication and overuse of painkillers. Teens may be able to treat their headaches with over-the-counter medicine, but that doesn’t treat the underlying issues related to the traumatic event, she noted.

“Adolescents medicate themselves, and few go to the doctor, but if you keep medicating like that, it may actually contribute to the chronic behaviour,” she said. “Seek help early. That’s the key.”