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Kids and Headaches: Is It All in Their Heads?

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Another cause of repeated headaches could be the pace of daily life, which, like the incidence of these headaches, is increasing. In a recent article focusing on the prevalence of adolescent headaches, Rhee writes that it "may in part be due to a modern society characterized by speed and unpredictability that might overwhelm children's [mental] and physical development."

Merle Diamond, MD, the associate director of the Diamond Headache Clinic in Chicago, agrees. "I think our society is way overstimulated. We are real, real busy, and so are our kids," Diamond says. "They have a lot of sensory input -- friends, school, computers, extracurricular activities. Clearly, in some people, that overstimulation will tip them over the edge."

Does that mean that some groups of children are at a higher risk of developing chronic headaches than others? When Rhee, who is a doctoral candidate at the University of North Carolina at Chapel Hill, conducted her study, she made several new findings and confirmed several older findings.

Among what was already known, Rhee confirmed that whites were more prone to headaches than blacks -- 32% vs. 24%. But when she looked at two less-studied groups, she found that American Indians had the highest rate of recurrent headaches at more than 35%, while Asians and Pacific Islanders had the lowest rate at 18%.

Rhee also confirmed that more girls than boys reported chronic headaches -- 37% vs. 21%. But she discovered that those girls with a history of depression and/or low self-esteem seemed to be at even higher risk, which didn't hold true for boys.

"There are contradictory reports about which comes first. Some researchers say headaches cause depression because headaches interfere with a child's life and they can't do what other kids do," Rhee says. "On the other hand, there's a school of thought that depression might cause headaches" because depression can affect the brain's chemistry. Rhee found that the road from depression -- or low self-esteem -- to repeated headaches is much more common than the other way around.

Diamond calls that finding interesting. "It has been a chronic debate, and I think in our patients, it's different things," she says. "If you ask patients who have [both] which came first, I think you would get varied answers." Regardless of which came first, Diamond says, "poorly-controlled depression or anxiety disorders lead to more frequent headaches."

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