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Kids and Headaches: Is It All in Their Heads?

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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."

Aside from the very important short-term reasons for treating headaches, there are long-term reasons as well.

"Headaches are the most common cause of kids using over-the-counter drugs, and if you are used to taking medication as a child, when you are older you are more likely to rely on medications because it will become a habit," Rhee says. She says that chronic headaches might make a child feel unhealthy and weak, which can lead to depression, low self-esteem, and interfere with quality of life. "Also, there is a large cost in terms of lost school days and productivity," she says.

"In the short term, chronic daily headaches are associated with more frequent depression, anxiety, panic," Diamond says. Secondly, "in an attempt to medicate the child so they can keep functioning, we'll sometimes see [pain medication] overuse which can lead to ulcer, kidney, and liver problems. Clearly, the longer you abuse [pain medications], the worse off you are. And again, with anxiety and depression, the longer people have chronic pain, the worse the prognosis. So you really want to intervene and give them a good plan that is a life plan."

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