Experiencing More Headaches While Social Distancing? A Doctor Explains Why

Even with social distancing mandates easing across the country, many of us are still doing everything we can to stay home and stay safe. As we all know, that comes with its own unique set of challenges and benefits.

Have you noticed your headaches getting better or worse over the past few months? We were curious about the ways in which the side effects of living during a pandemic might affect headaches, so we reached out to an expert.

Dr. Lauren Doyle Strauss is a pediatric headache specialist and assistant professor of pediatric neurology at Wake Forest School of Medicine. She's a pro when it comes to knowing teens and their headaches. We had the opportunity to ask her all about headaches, how to treat them, and why this might be the perfect opportunity to address your headache woes.

Sweety High: What are the different types of headaches?

Lauren Doyle Strauss: Headaches can range from very mild to very severe. They can be on one side of the head or multiple areas of the head, sometimes involving the neck.

Migraine is a very specific diagnosis where you have typically one-sided severe throbbing or pulsating pain of very high intensity that, in a teenager, lasts at least two hours in length. It's the kind of pain where you'd be worried about being active because movement may worsen the pain. Migraine often has other symptoms beyond the headache. You can also experience light and sound sensitivity or nausea, and some people even get to the point of vomiting during their attacks.


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SH: Why can these be so debilitating?

LDS: Unfortunately in this case, the brain is really powerful and it can manifest in very severe pain. I think of it as your body's alarm system going haywire. It makes you more sensitive to your surroundings, and to your body. Perhaps it was a kind of alarm system back in the day. Caveman needed something to warn them when there were intruders or animals coming and when the sun was rising and setting. Maybe this was the alarm system back in the day that now is simply firing.


SH: Are any types headaches most prevalent among teenage girls?

LDS: It's common for children and teenagers to have headaches throughout the years, and as high as 80% of people will experience headaches during childhood. Typically, their headaches are going to be very mild and fit the criteria for a tension headache.

However, migraines can absolutely happen in children. They can happen at any age, and I've seen it in patients as young as age 2. They can be infrequent, happening once a year, or more frequent. Anywhere from 1% to 2% of children will go on to have a chronic daily headache.

SH: What are some of the things we can do to address headaches?

LDS: If you experience headaches with bothersome symptoms, or they happen often, it's worth mentioning it to your parents or pediatrician. Make sure they're aware that you're suffering and need help with medicine management or you might need more of an evaluation.

Know that if you have lots of headaches, it doesn't necessarily mean it's something serious like a brain tumor. People worry about that when they get that throbbing in their head, but it's very uncommon to have a brain tumor in childhood. It's more likely that you're not sleeping well, and that maybe you should improve your sleep schedule. Wake up and go to bed at the same time every day, and avoid naps. Both oversleeping and under-sleeping can trigger headaches.

Maybe they're not hydrating enough. Focus on getting enough water, not only at the end of the day when you realize you've forgotten to hydrate all day. Have fluid first thing when you get up, with breakfast, with lunch, with dinner and also when you get home for the day. Get at least four to five glasses, minimum, or fluid, and if you're exercising, have even more.

Whenever you have a headache, ask yourself when you last ate. Have a cracker or something small if you're not too nauseous, along with a full glass of water, or even better, an electrolyte-containing fluid like Gatorade or Powerade. If it's okay and safe for you, you can also pair it with an over-the-counter drug like Tylenol, Motrin or Aleve.

Another big trigger is caffeine. The relationship between caffeine and headaches is interesting. For someone who has headaches once in a blue moon, caffeine can be helpful to treat that attack, but if you have frequent headaches, be careful because caffeine overuse (more than a few times a week) can contribute to the worsening of headaches. We call them medication overuse headaches or rebound headaches.

Maybe, this is your body's way of telling you you're under a lot of stress. Stress is a trigger for headaches. You may want to identify methods for coping with stress. Everyone has stress, and even good stress can cause headaches. Maybe you're graduating high school and moving on to college. Fun, exciting things can also be stressful. A lot of our patients find it really helpful to utilize apps. Applications such as Calm and iBreathe are different ways you can explore breathing techniques, mindfulness and meditation and get bio-feedback.

Headaches may also signal you to look at what you're doing. Are you balancing too much? In COVID times, everything has changed. Are you expressing your concerns with the changing environment? Maybe it would help to talk with your family or friends, or professionally with a psychologist, or adjust the number of activities you're doing. Maybe you just need to reduce your workload, and cut down on AP classes or other things that are overwhelming you.


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Some patients who experience severe light and sound sensitivity also find it helpful to identify a safe spot at home—we call it a migraine cave—where you can draw the curtains close to make it dark and have quiet space. Some people wear earplugs or noise-canceling headphones. Keep snacks if they're not going to hurt your stomach, and use aromatherapy if available. Some people have roll-on sticks of peppermint that they keep at their bedside, so they can apply to their scalp and the area that bothers them. It can cause numbing and the smell of it may make people feel less nauseous.

Diffusing a lavender scent can also be relaxing. You can keep a sign on the door reading, "I'm having a migraine, please don't disturb me," and then if you need to take a nap, you have protection to do that. Sleep also helps headaches.


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SH: Have you seen any correlation between social distancing and headaches? 

LDS: In the children I treat, I'm actually seeing both positive and negative effects. Many of my severe headache patients are actually able to have a better sleep schedule and more time to sleep. They're eating healthier and focusing more on their hydration. They're using their flexible schedules to take care of themselves and exercise more. Their headaches have improved, and they're worried that when restrictions lift and they go back to their obligations with school and other activities, their headaches could worsen. I tell them that if they've noticed an improvement to note the things that have helped them get there, and to practice so it becomes a habit. Then when they go back to school, they can maintain that.

For the patients who've worsened, sometimes we see that it's because they're not being as social with their friends and support groups. The other day I "prescribed" a teenage boy to set up a Zoom meeting with two of his friends. Scheduling that regular socialization and connecting with people is very powerful. It makes people feel calmer, preventing headaches. Maybe they're closest to older family members who are unable to socialize like younger people. It's still important to celebrate important milestones as a family, like wedding anniversaries and birthdays, to still feel connected.

People also have this sense that they can't leave the house because the messaging is that we need to be careful.  Many of our patients won't even leave the house to go to their backyard or take a walk in their neighborhood or down the street. That's something we can still do, as long as you're being safe and socially distancing and not walking close to other people. Go outside. We have beautiful weather right now in most states. Summer is starting and that's a great opportunity to get back outside.

Shutterstock: Woman sitting on steps with phone texting

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SH: What else should we know about headaches?

LDS: Headaches can be a sign that your period may be starting. Sometimes we notice that headaches can become more bothersome three to six months before a first period. Headaches also change over your life. In younger children, they're more common in boys than girls. Right before puberty starts to come on, it becomes equal in boys and girls, and then after puberty, it becomes more common in girls than boys. Other times in your life when you might feel a correlation between hormones and headaches is when you first start a birth control pill. If you're experiencing new or different headaches, or your headaches have changed, always look at any new medicines you've started.

There's a really fun app called Plant Nanny where you can put a target of how much water you want to drink for the day, and it gives you a flower, and every time you log water the flower gets water and it grows and grows.  When you're thinking about hydration, there isn't a magic number for what's "enough." It's really to the point when you're noticing your urine is a light yellow, near clear. That's how you know when you've got enough hydration.


If you're active on Twitter and curious about headaches, follow Lauren Doyle Strass at @straussheadache.


Feeling extra stressed right now? Click HERE to find out why too much exposure to pandemic news might be stressing you out.