MIAMI BEACH – The impact of headache disorders extends beyond the patient and can have devastating effects on family life.
Attention to this potential problem can promote improved family functioning, Alvin E. Lake III, Ph.D., said at a symposium sponsored by the American Headache Society.
The problem can be a cyclical one: Family stressors and pressures, and the need to continue functioning in the family setting, can lead to analgesic overuse, which in turn increases the risk of chronic daily headaches; the headache disorder then becomes an issue that adversely affects family life and relationships.
Studies show that migraineurs often miss family social activities, avoid making social plans for fear of canceling, have difficulty accomplishing normal household tasks like housecleaning, and argue more with spouses and children.
In one study of 389 migraineurs who experienced more than five attacks per year, 85% said their migraines caused them to do less housework, 45% said the migraines caused them to miss social activities, and 50% said they were more likely to argue with family members. More than 70% said they also suffered other adverse consequences, said Dr. Lake, director of the psychology division at the Michigan Headache & Neurological Institute, Ann Arbor.
Of 100 spouses who participated in the study, 29% agreed that arguments were more common, and 60% said the migraines had other adverse effects on relationships.
Children are also affected. Another study showed that of 130 children under age 12 with a parent who suffered from migraines, 66% “kept quiet,” 61% experienced canceled plans, 42% received “other child care,” 25% were confused about their situation, and 17% had hostility. Of 88 children over age 12, 87% avoided loud activities, 61% avoided asking for help, 42% had plans canceled, 21% avoided school, and 12% had hostility.
Encourage families to modulate attention to the migraineur's pain. As with patients who have been shown to experience less pain intensity when their attention is diverted from the pain, families will also experience improved functioning if family life doesn't revolve around the pain, Dr. Lake said, and suggested that enabling behaviors should be discouraged.
Families and patients should be advised to set achievable goals for accomplishing tasks or participating in activities, and they should be encouraged to replace all-or-nothing thinking with a mind-set that “some is better than none.” For example, they can agree to attend a social event for an hour rather than avoiding it altogether, he said.
Finally, family members should be encouraged to maintain their own lives. Compromise and balance are key factors in optimizing family functioning, Dr. Lake said.