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Dr. Seymour Diamond
interviewed by Anthony Qaiyum on October 6, 1995
"Aspirin is still the greatest drug there is."
Seymour Diamond, MD is the executive director of the National Headache Foundation and the author of the new book "The Hormone Headache"
Tripod: First of all, what are some of the causes of headaches?
SD: There are thousands of different causes of a headache. But basically, I like to divide headaches into three large groups. Vascular headaches -- and this may be a misnomer -- but these are headaches are like migraines, where the basic pain is caused by swelling of the blood vessels. Those due to organic causes, such as a brain tumor or an aneurysm, where an expansion or pull on the blood vessels or nerves causes pain ... And lastly, tension-type headaches, which are probably the most common headaches. It's usually caused by stress, anxiety, frustration, repressed hostility, things like that.
Tripod: How can things like diet or exercise affect headaches?
SD: Depends on the type of headaches. With tension headaches, you should avoid stress, anxiety ... if you're dealing with young people, somebody taking excessive courses without giving ample justification to the time necessary. Or another example is somebody has so many activities that they can't give proper time, and they might develop a headache problem.
Tripod: But how do you propose to find a balance? If someone really wants to take five courses, I mean ...
SD: What I mean by balance is you try to do as much as you can -- not overdo -- but just don't put yourself in an environment that's too much to handle.
Tripod: Are some people more prone to headaches than others?
SD: Yes. For example, women are more prone to migraines than men. Only because one of the primary triggers in women is the change in their hormones in any one month's time, while men's hormones are fairly stable.
Tripod: How does a migraine differ from other headaches?
SD: Migraine is a one-sinus headache. It has nausea and vomiting as part of the symptoms. A significant group of migraine-sufferers have warnings that they're going to have the attack. They may see change of mind, have a blind spot, just prior to the headache.
Tripod: What about headaches from hangovers? Why does that happen?
SD: For two reasons. Alcohol is a dilator, or causes the blood vessels to swell. And in many alchol drinks there are impurities ... Acids, aldehydes, things like that, which can provoke headaches.
Tripod: Is there any way to prevent that?
SD: I try to tell people not to drink excessively, of course. Fruit juice-containing drinks, for example, screwdrivers, bloody Mary, will help. The better the alcohol, usually, the worse the headache.
Tripod: Really, I expected it to be the other way around.
SD: What I'm talking about is the very expensive scotches and bourbons and brandies. They're usually aged, and have more impurities.
"Take a few minutes to relax when you have a headache if you're doing something that's stressful."
Tripod: How can you tell if you're just the type of person who gets a lot of headaches, or if you should be seeing a physician?
SD: If you're getting headaches daily, or almost daily ... if you're missing work, or you're missing school, or social activities because of your headaches, you probably have a problem. If there are any exertional aspects to your headache. If you're getting headaches by running, coughing, sneezing, moving your bowels, you should see somebody about it. If you are consuming excessive amounts of over-the-counter medicines on a daily basis because of your headaches, you should seek competent help.
Tripod: What about over-counter-medicines like Tylenol. As long as you're not using them every day, they're okay?
SD: Yes, they're okay.
Tripod: Is there a difference between, say, ibuprofen and acetaminophen?
SD: There are differences. What I would say is that some work specifically better for certain people than others. Some of the caffeine-containing ones may have a little more effectiveness. Aspirin is still the greatest drug there is.
Tripod: You always hear people propose different treatments, like rubbing the temples. Can you offer any other advice for headache relief?
SD: Some of the tips might be: Take a few minutes to relax when you have a headache if you're doing something that's stressful. An ice pack is usually better than anything else to help relieve it because it constricts the blood vessels.
You can reach The National Headache Foundation at 1-800-843-2256.
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