Headache Treatment with Cognitive Behavioral Therapy in Albuquerque, New Mexico

Effective long-term management of patients with headaches can be challenging because headaches are complex, often having both sensory (pain location, intensity, and quality), physical (tightening and stretching of the musculature in the head, neck and shoulders), and affective (depression, anxiety, distress) components.    As a result, effective treatment of headache cannot rely solely on medications that regulate the chemical and electrical signals within the pain pathways associated with headache. Treatment must also address their cognitive behavioral, and physical components.  Since the migraine headache has begun to be recognized as a chronic disease – treatment also needs to also reflect care for chronic pain.   A comprehensive, multidisciplinary treatment program blending traditional and holistic health care for mind and body wellness is the sensible choice for a long-term positive outcome for those suffering from headaches. 

It’s worth noting non-pharmacological approaches to treating headaches are appropriate for a wide range of patients, including patients who are pregnant or planning to become pregnant, patients for whom medications should not be used, patients who have not found medications effective, and patients who prefer not to take medications. Relaxation and nutrition training, biofeedback training, and cognitive behavioral therapy have a robust evidence base, and are recommended in treatment guidelines for both migraine and tension-type headaches.   These treatments can be combined with each other for effective management of migraine and chronic tension-type headache. 

For headaches, cognitive behavioral therapy intends to modify both thinking and behavior patterns to improve quality of life.  Behavioral components commonly involve keeping a diary of headache symptoms along with any relevant behaviors (such as medication adherence, sleep, stress, and diet); determining goals to modify these behaviors; and possibly employing relaxation and biofeedback techniques. Cognitive components include improving a sense of self-control to manage headaches, and identifying and challenging unhealthy thought patterns. Self-monitoring of cognitive factors by keeping a record of situations, thoughts, and emotions that co-occur with headaches is necessary to identify unhealthy thought patterns. 

For example a common unhealthy thought pattern in migraine headache sufferers is expecting the worst possible outcome of a situation, commonly referred to a “Catastrophizing”.   Though catastrophizing has been associated with higher headache-related disability, the good news is it can be reduced effectively with cognitive behavioral therapy.   Massage can target the headache sufferer’s attention on alleviating patterns that lead to headache escalation and with the therapist’s guidance can help avoid the headache if intercepted in the early stages. 

A number of psychological treatments, including relaxation, biofeedback, and cognitive behavioral therapies, have been shown to be effective for the treatment of headache disorders, reducing both the number and severity of attacks.  The added benefit is cognitive behavioral therapy often helps reduce reliance on prescription remedies, which is especially useful for patients suffering from rebound headaches caused by extended medication usage. Our treatment typically involves educating patients to normalize known headache triggers, particularly stress, sleep, and diet, which can help patients gain control over headache onset and exacerbation. For patients having difficulty managing these triggers, a course of behavioral treatment to normalize sleep or to decrease stress may be appropriate. Treatment of psychiatric disorders or conditions, most commonly depression and anxiety, can also improve the quality of life of patients with headaches. 

Research published in the journal Headache found 83% of patients who completed a short course of cognitive behavioral therapy had fewer headaches.  It is thought that cognitive behavioral therapy can modify responses in key brain areas dealing with pain that explains how this therapy helps with migraines.  Reach us if you would like to have a more comprehensive conversation on how we can help you.  

Designed Health Options, LLC

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