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        Cluster Headache Help and Support >> Cluster Headache Specific >> Cluster induced PTSD
        
(Message started by: floridian on Dec 21st, 2006, 6:47am)
Title: Cluster induced PTSD
Post by floridian on Dec 21st, 2006, 6:47am
Was just in the anxiety thread where someone said they have been pain-free going on 3 years, and they still think about it clusters every day. Not surprising.

What is surprising is that no one in the medical community seems to recognize cluster headache induced post traumatic stress disorder.  And some people here kinda recognize it, although that term is not widely used.

What is PTSD?  A group of measurable changes to the brain and endocrine functioning that occur after a traumatic event.  

These changes can persist for years, depending on the individual - their genetics, their life circumstances, the treatment they get or dont get, etc.

Sometimes it goes away on its own. Sometimes it affects a person's ability to function and hold down a job, raise a family, or take care of themselves.

Is there cluster headache induced PTSD?  I would be surprised if there wasn't, and I suspect it is fairly common - maybe 20 or 30% of people that get hit hard. Which is to say about 20 or 30% of people with clusters.
Title: Re: Cluster induced PTSD
Post by georgej on Dec 21st, 2006, 8:56am
Not saying yes or no, since I simply don't know how one would define what constitutes PTSD as a consequence of experiencing CH, as opposed (or contrasted) to simple anxiety or aversion--which I think are nearly universal reactions to CH.  Obviously PTSD resulting from CH would be more extreme--but would it differ from anxiety or aversion in some qualitative way as well?

If measurable changes occur, how are they measured, and what do they consist of?  I don't know.  This is nothing more than simple ignorance on my part.

There is no question that people react differently to the event of CH, just as they react in different ways to other events that are intense, painful, or life-altering.  Certain personality types, I understand, may be more vulnerable to PTSD, and those (if I am not mistaken) can be identified and/or predicted.  

So--does PTSD as a consequence of CH exist?  If so, how would it be identified?  If it does exist, who is vulnerable, and how are they identified?  If identified, what is appropriate treatment?

Best wishes,

George
Title: Re: Cluster induced PTSD
Post by TonyYZF on Dec 21st, 2006, 12:49pm
Floridian,

Very interesting concept.  I don't think I have considered it until you mentioned it.  I know that I find myself obsessing about my CH daily.  Granted I have not gone into remission so I am given reminders in the way of shadows every day.  I have a obsessive personality anyway, so my dwelling on the matter may just be a personality thing like George alluded to.  Hard to gauge whether my personality type would be more susceptible, my circumstances drive my reaction or this is simply my natural reaction.  Either way, the difficulty in quantifying and/or establishing a baseline by which to judge if one has a PTSD reaction seems a bit overwhelming to me...of course if I have PTSD, maybe it just seems overwhelming to me...sorry just kidding.  Still an interesting concept.

Tony
Title: Re: Cluster induced PTSD
Post by BobG on Dec 21st, 2006, 1:28pm
PTSD? Is there really such a thing? I think it's more a catch-all phrase that overused, if it even exists.
The term PTSD was invented in the 1970's as a replacement for battle fatigue and a scam to set up treament 'clinics' to steal money from the taxpayer of million$ to treat make believe symptoms.
Title: Re: Cluster induced PTSD
Post by seasonalboomer on Dec 21st, 2006, 1:41pm
Or, by virtue of the CH sufferer's incredible tolerance to traumatic pain, would CH sufferers have a far lower likelihood of experiencing PTSD?
Title: Re: Cluster induced PTSD
Post by Redd715 on Dec 21st, 2006, 2:32pm

on 12/21/06 at 13:28:35, BobG wrote:
PTSD? Is there really such a thing? I think it's more a catch-all phrase that overused, if it even exists.
The term PTSD was invented in the 1970's as a replacement for battle fatigue and a scam to set up treament 'clinics' to steal money from the taxpayer of million$ to treat make believe symptoms.



After a very serious assult March 17 1998 (and another traumatic event of June that same year), I suffered quite severe PTSD for nearly a year.  Even after he was finally convicted and in prison, the effects still lingered, however to a lesser degree.  

Some of the worst symptoms were cold sweat anxiety attacks from strange noises or quick unexpected movements from people near me.  Sleep walking episodes 2 or 3 times a month where I would find myself in my basement.  I had to cancel my home phone because he still had people calling me for him, and I wouldn't be able to function for days.  I'd bawl for hours out of nowhere.  

This exists Bob...with enough support from my therapist and a very empathetic lawyer at the time I recovered quickly all things considered.
Title: Re: Cluster induced PTSD
Post by E-Double on Dec 21st, 2006, 2:48pm
http://www.mental-health-today.com/ptsd/dsm.htm

309.81    DSM-IV Criteria for Posttraumatic Stress Disorder

A. The person has been exposed to a traumatic event in which both of the following have been present:

(1) the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others (2) the person's response involved intense fear, helplessness, or horror. Note: In children, this may be expressed instead by disorganized or agitated behavior.

B. The traumatic event is persistently reexperienced in one (or more) of the following ways:

(1) recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions. Note: In young children, repetitive play may occur in which themes or aspects of the trauma are expressed.

(2) recurrent distressing dreams of the event. Note: In children, there may be frightening dreams without recognizable content.

(3) acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those that occur upon awakening or when intoxicated). Note: In young children, trauma-specific reenactment may occur.

(4) intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.

(5) physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.

C. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by three (or more) of the following:

(1) efforts to avoid thoughts, feelings, or conversations associated with the trauma

(2) efforts to avoid activities, places, or people that arouse recollections of the trauma

(3) inability to recall an important aspect of the trauma

(4) markedly diminished interest or participation in significant activities

(5) feeling of detachment or estrangement from others

(6) restricted range of affect (e.g., unable to have loving feelings)

(7) sense of a foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span)

D. Persistent symptoms of increased arousal (not present before the trauma), as indicated by two (or more) of the following:

(1) difficulty falling or staying asleep
(2) irritability or outbursts of anger
(3) difficulty concentrating
(4) hypervigilance
(5) exaggerated startle response

E. Duration of the disturbance (symptoms in Criteria B, C, and D) is more than one month.

F. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Specify if:
Acute: if duration of symptoms is less than 3 months
Chronic: if duration of symptoms is 3 months or more

Specify if:
With Delayed Onset: if onset of symptoms is at least 6 months after the stressor

 
[b][/b]
Title: Re: Cluster induced PTSD
Post by floridian on Dec 21st, 2006, 3:07pm

on 12/21/06 at 13:28:35, BobG wrote:
PTSD? Is there really such a thing? I think it's more a catch-all phrase that overused, if it even exists.
The term PTSD was invented in the 1970's as a replacement for battle fatigue and a scam to set up treament 'clinics' to steal money from the taxpayer of million$ to treat make believe symptoms.


Battle-fatigue doesn't describe the same thing. PTSD is more than being tired, and it doesn't go away with a little R&R.

The military opposed any change in thinking about this topic, because they would lose some soldiers that really had this, and some that just wanted out.  So they argued for 'common sense' test - if you have all your limbs, if you don't carry shrapnel or have stitched up bullet wounds, then you were not physically affected.  

Thanks for digging up the diagnostics, E^2.  That is what is used in 99% of the diagnoses.  There are functional image scans and biochemical tests that were used to establish the reality of the disease, but which are not often used in day to day diagnosis.





Quote:
PTSD displays biochemical changes in the brain and body, which are different from other psychiatric disorders such as major depression.

In PTSD patients, the dexamethasone cortisol suppression is strong, while it is weak in patients with major depression. In most PTSD patients the urine secretion of cortisol is low, at the same time as the catecholamine secretion is high, and the norepinephrine/cortisol ratio is increased. Brain catecholamine levels are low, and corticotropin-releasing factor (CRF) concentrations are high. There is also an increased sensitivity of the hypothalamic-pituitary-adrenal (HPA) axis, with a strong negative feedback of cortisol, due to a generally increased sensitivity of cortisol receptors (Yehuda, 2001).

The response to stress in PTSD is abnormal with long-term high levels of norepinephrine, at the same time as cortisol levels are low, a pattern associated with facilitated learning in animals. Translating this reaction to human conditions gives a pathophysiological explanation for PTSD by a maladaptive learning pathway to fear response (Yehuda 2002). With this deduction follows that the clinical picture of hyperreactivity and hyperresponsiveness in PTSD is consistent with the sensitive HPA-axis.

Swedish United Nations soldiers serving in Bosnia with low pre-service salivary cortisol levels had a higher risk of reacting with PTSD symptoms, following war trauma, than soldiers with normal pre-service levels (Aardal-Eriksson 2001).

Neuroanatomy

In animal research as well as human studies, the amygdala has been shown to be strongly involved in the formation of emotional memories, especially fear-related memories. Neuroimaging studies in humans have revealed both morphological and functional aspects of PTSD. The amygdalocentric model of PTSD proposes that it is associated with hyperarousal of the amygdala and insufficient top-down control by the medial prefrontal cortex and the hippocampus. Further animal and clinical research into the amygdala and fear conditioning may suggest additional treatments for the condition.

(wikipedia)
Title: Re: Cluster induced PTSD
Post by purpleydog on Dec 21st, 2006, 7:00pm
PTSD does exist. I lived with it for years since I was a child, and then I had a traumatic episode also in my very late teens. It took me years to get over it.

As far as PTSD associated with CH, when I was episodic, and in cycle, I lived in fear of getting hit. Especially after the cycle got really going. They would last a min of 4 months, and I would get hit HARD, and long. At the time, no meds were working. Every time I had a sign a hit was coming on, I'd get scared, worried, and became very aware of my surroundings, trying to think of how to stop it (get away). Even for a couple months or so after the cycle ended. There were other reactions too, but I think it exists.

I am now chronic, and have the hits under control somewhat. But when I go into a "cycle" that lasts more than a week, the same thing happens. It's not as severe, because I have learned to live with it much better. But it is still there.
Title: Re: Cluster induced PTSD
Post by BobG on Dec 21st, 2006, 7:31pm

on 12/21/06 at 15:07:14, floridian wrote:
Battle-fatigue doesn't describe the same thing. PTSD is more than being tired, and it doesn't go away with a little R&R.

The word fatigue in battle fatique has nothing to do with being tired. And thinking R&R means rest, think again. I went on R&R and came back more tired (and hung over) than ever.
Title: Re: Cluster induced PTSD
Post by Linda_Howell on Dec 21st, 2006, 7:43pm





               oh God, I pray...  let me hold my typing fingers
Title: Re: Cluster induced PTSD
Post by FramCire on Dec 21st, 2006, 9:27pm

on 12/21/06 at 19:43:00, Linda_Howell wrote:
               oh God, I pray...  let me hold my typing fingers



I'd hold them for you but unfortunately my wife might get jealous.  Do you do any crafts instaed?
Title: Re: Cluster induced PTSD
Post by Jonny on Dec 21st, 2006, 9:53pm

on 12/21/06 at 06:47:21, floridian wrote:
What is PTSD?  A group of measurable changes to the brain and endocrine functioning that occur after a traumatic event.  


Oh My!

I guess im fucked for life, 30 od years chronic.......LMMFAO ;;D
Title: Re: Cluster induced PTSD
Post by brewcrew on Dec 21st, 2006, 9:57pm

on 12/21/06 at 21:53:07, Jonny wrote:
Oh My!

I guess im fucked for life, 30 od years chronic.......LMMFAO ;;D

I've read that beer counteracts those endocrinetic effects.
Title: Re: Cluster induced CUJP
Post by Mr. Happy on Dec 22nd, 2006, 12:22am
PTSD's been overused, and had too much press.

CUJP
Complete and Utterly Justifiable Paranoia. Works for me. Carry a pocket triptan 24/7/365 since '02, and never had to use it. That's paranoid enough for me.

CUJP.
Hap (Hopelessly Always Paranoid)
Title: Re: Cluster induced CUJP
Post by JohnM on Dec 22nd, 2006, 4:17am

on 12/22/06 at 00:22:13, Mr. Happy wrote:
PTSD's been overused, and had too much press.

CUJP
Complete and Utterly Justifiable Paranoia. Works for me. Carry a pocket triptan 24/7/365 since '02, and never had to use it. That's paranoid enough for me.

CUJP.
Hap (Hopelessly Always Paranoid)


Me too - I'm over 4 years PF but visit this board almost daily - so I still think about my CH most days.

I am constantly on the lookout for any signs of a cycle about to start - even the smallest headache can get me fired up and ready to take evasive action - my Detox plan is always at the ready if need be :)

You have to remain vigilant with this bastard as it can strike when you are not looking and least expect it.

I am flying to the England tommorow for Christmas to see my family, and guess what is at the top of my list of things to take?

My imigran injection kit (expiry dated June 2003) "just in case"

And Brewcrew - I am looking forward to drinking lots of Real English Ale while I'm there, yum ;;D

John
Title: Re: Cluster induced PTSD
Post by floridian on Dec 22nd, 2006, 9:05am

on 12/21/06 at 21:53:07, Jonny wrote:
Oh My!

I guess im fucked for life, 30 od years chronic.......LMMFAO ;;D


Not at all.  Some people walk through the fire unscathed.  Others get heat stroke when its 95 degrees.
Title: Re: Cluster induced PTSD
Post by Bob_Johnson on Dec 22nd, 2006, 11:03am
The idea of PTSD in cluster folks is interesting but I'm highly cautious about applying this concept to us unless there is some good research to support the move. I could only find one decent research piece as PTSD might apply to a medical condition (here, breast cancer). Most of the positive  reports I found involved civilians involved in trauma (accident, crime, earthquake, etc.) where you would expect a higher rate.

If disease was a trigger for PTSD I should have expected to see more research reports show the effect since these kinds of medical problems (chronic cancer, major physical trauma, etc.) have been a part of lives forever. (Yes, I grant that this is a new concept being applied to a new population and so not much research yet. But....)

There is, however, a very significant body of research linking various medical problems to anxiety conditions and depression. These conditions are not to be confused with PTSD (see the message with the diagnostic criteria for PTSD.) I've tried to address this link and how we can buffer ourselves in an article found at: http://www.ouch-us.org/chgeneral/painvsuffering.htm .

A big body of research in psychology focuses on individuals who see themselves as relatively powerless to cope with problems vs. people who believe that they have reasonably effective ways of handling these stressors. As you might expect, the second group tend to develop less anxiety/depression--regardless of the source of the stress.

It's this perspective which leads me to reject the label of "victim" or "sufferer" as it applies to either my experience with cluster or cancer. These, essentially, negative labels only create negative emotions which drain our coping powers. But now we have some powerful research which proves that it's possible to learn how to alter our thinking/emotional responses to distressing situations, reducing the possibility of disabling emotional & behavioral responses.

(I'm writing here about coping with CH. None of this is applies to what is happening our folks in Iraq or to any like situation.)
Title: Re: Cluster induced PTSD
Post by georgej on Dec 22nd, 2006, 11:31am

on 12/22/06 at 11:03:47, Bob_Johnson wrote:
The idea of PTSD in cluster folks is interesting but I'm highly cautious about applying this concept to us unless there is some good research to support the move.

<snip>

If disease was a trigger for PTSD I should have expected to see more research reports show the effect since these kinds of medical problems (chronic cancer, major physical trauma, etc.) have been a part of lives forever.

<snip>

It's this perspective which leads me to reject the label of "victim" or "sufferer" as it applies to either my experience with cluster or cancer.


In light of this excellent post by Bob, and considering the diagnostic criteria for PTSD submitted by Eric (thank you, Eric), I'm growing doubtful whether cluster-induced PTSD actually exists--although it is clear that there is differential experience with anxiety, depression, aversion and fear of CH.  

I'd like to see persuasive evidence to the contrary.  

Bob's reluctance to use the labels "victim" or "sufferer" in connection with his own experience with CH also struck a chord with me.  I have always considered myself to be a person who happens to have CH--which has certain consequences--but do not refer to myself as a "victim" or "sufferer".

Interesting thread.  

Best wishes,

George      
Title: Re: Cluster induced PTSD
Post by floridian on Dec 22nd, 2006, 4:11pm

on 12/22/06 at 11:03:47, Bob_Johnson wrote:
There is, however, a very significant body of research linking various medical problems to anxiety conditions and depression. These conditions are not to be confused with PTSD (see the message with the diagnostic criteria for PTSD.) I've tried to address this link and how we can buffer ourselves in an article found at: http://www.ouch-us.org/chgeneral/painvsuffering.htm .

A big body of research in psychology focuses on individuals who see themselves as relatively powerless to cope with problems vs. people who believe that they have reasonably effective ways of handling these stressors. As you might expect, the second group tend to develop less anxiety/depression--regardless of the source of the stress.

It's this perspective which leads me to reject the label of "victim" or "sufferer" as it applies to either my experience with cluster or cancer. These, essentially, negative labels only create negative emotions which drain our coping powers. But now we have some powerful research which proves that it's possible to learn how to alter our thinking/emotional responses to distressing situations, reducing the possibility of disabling emotional & behavioral responses.


I agree fully that a postive mental attitude offers a good deal of protection from depression, anxiety, etc.  No side effects, which makes it the place to start - though it may not be enough.

Reject the label of 'sufferer' for people with clusters? No, not me - if the pain of clusters doesn't cause suffering, then maybe they are no big deal. Making a distinction between pain and suffering is good, but the two cannot always be separated. Positive thinking and changing what we call things is fine, but it can be taken too far.  People are free to describe the world as they wish, but objectively, people do suffer when intense pain.

If a K9 or K10 is not traumatic, please tell me what is.

I would suggest that the definition of PTSD does apply to some people with clusters, although the definition was written with external events in mind.  From a biological perspective, I see the causes of intense or persistent fear/anxiety as less important than the fact that these cause similar changes to the body. And I also believe that some develop a Post-Intense-Pain-Syndrome, even if there is nothing in the literature.  
Title: Re: Cluster induced PTSD
Post by BMoneeTheMoneeMan on Dec 22nd, 2006, 7:30pm
I guess we could argue about what PTSD is, but I think I definately suffer from it.  My last cycle ended in August and it took me until December to get my head working well again.  Couldnt concentrate, had no motivation, needed lots of sleep (8 hours) and was just in a daze.  

I dont think the PTSD would be caused from the pain, but probably from the emotional toll it takes.  Course, I am not Dr MoneeMan, but thats my [smiley=twocents.gif]
Title: Re: Cluster induced PTSD
Post by Opus on Dec 25th, 2006, 12:34pm

on 12/21/06 at 13:28:35, BobG wrote:
PTSD? Is there really such a thing? I think it's more a catch-all phrase that overused, if it even exists.
The term PTSD was invented in the 1970's as a replacement for battle fatigue and a scam to set up treament 'clinics' to steal money from the taxpayer of million$ to treat make believe symptoms.


No, it is a term for a condition AKA "Shell shock". It was first seen in WWI when war took on horrors never seen before.

I'm sure with any illness there is miss diagnoses and fraud. That doesn't make it not a real problem for some peaple.

I'm sure I don't have it. I can't remember what a 10 is like, and when it does happen the pain is always a shock.

Paul
Title: Re: Cluster induced PTSD
Post by Kevin_M on Dec 25th, 2006, 3:32pm

on 12/25/06 at 12:34:42, Opus wrote:
No, it is a term for a condition AKA "Shell shock". It was first seen in WWI when war took on horrors never seen before.


There are perhaps relatable similarities but "shell shock" would be different, catatonic incapacity being inclusive.
 It could be perfectly normal for combatants to suffer muscular tension, freezing, shaking and tremor, excessive perspiration, anorexia, nausea, abdominal distress, diareah, urinary frequency, incontinence of urine or feces, abnormal heartbeat, breathlessness, a burning sense of weight oppressing the heart, faintness and giddiness.  These can be normal autotomic responses to fear.  Of course this is from the "Bulletin of the United States Army Medical Department" by Lt. Col. Stephen W. Ranson, chief of 7th Army Psychiatric Center.
 
The (WWI) Western Front experienced the phenomenon of "shell shock" trapped in trenches but not on the Eastern Front among Russians and Austrians where movement for "fight or flight" was available under artillery fire.  The Battle of the Somme (Western) was notorious for many cases the English have well documented.
 In any event similar cases of PTSD would not be new to the 20th century, people stayed for months in many spas throughout Europe for an older term of "hysteria", and later "neurasthania", again, with distinctions and similarities.






on 12/21/06 at 14:48:58, E-Double wrote:
B. The traumatic event is persistently reexperienced...


I was surprised to find the Freudian observation ;) from "shell shock" related from a behaviorist, re-experiencing the situation to confront it again.  
 I just had to Eric.      ;;D
Title: Re: Cluster induced PTSD
Post by Racer1_NC on Dec 25th, 2006, 5:04pm

on 12/22/06 at 19:30:23, BMoneeTheMoneeMan wrote:
I guess we could argue about what PTSD is, but I think I definately suffer from it.  My last cycle ended in August and it took me until December to get my head working well again.  Couldnt concentrate, had no motivation, needed lots of sleep (8 hours) and was just in a daze.  

I dont think the PTSD would be caused from the pain, but probably from the emotional toll it takes.  Course, I am not Dr MoneeMan, but thats my [smiley=twocents.gif]


You are not alone. Happens to me too......
Title: Re: Cluster induced PTSD
Post by E-Double on Dec 25th, 2006, 6:43pm

on 12/25/06 at 15:32:25, Kevin_M wrote:
I was surprised to find the Freudian observation ;) from "shell shock" related from a behaviorist, re-experiencing the situation to confront it again.  
 I just had to Eric.      ;;D


How is that psychoanalytic??
Side-note and sorry if hijacking....I recently had to lecture to a few hundred NY board of ed psychologists...most of them being psychoanalysts...I was able to put the entire Oedipal conflict into Behavioral perspective... wa quite fun ;;D
Title: Re: Cluster induced PTSD
Post by Kevin_M on Dec 25th, 2006, 8:05pm

on 12/25/06 at 18:43:07, E-Double wrote:
Side-note


just roots before behaviorism, pm.   :)
Title: Re: Cluster induced PTSD
Post by Opus on Dec 25th, 2006, 11:50pm

on 12/25/06 at 15:32:25, Kevin_M wrote:
There are perhaps relatable similarities but "shell shock" would be different, catatonic incapacity being inclusive.
 It could be perfectly normal for combatants to suffer muscular tension, freezing, shaking and tremor, excessive perspiration, anorexia, nausea, abdominal distress, diareah, urinary frequency, incontinence of urine or feces, abnormal heartbeat, breathlessness, a burning sense of weight oppressing the heart, faintness and giddiness.  These can be normal autotomic responses to fear.  Of course this is from the "Bulletin of the United States Army Medical Department" by Lt. Col. Stephen W. Ranson, chief of 7th Army Psychiatric Center.
 
The (WWI) Western Front experienced the phenomenon of "shell shock" trapped in trenches but not on the Eastern Front among Russians and Austrians where movement for "fight or flight" was available under artillery fire.  The Battle of the Somme (Western) was notorious for many cases the English have well documented.
 In any event similar cases of PTSD would not be new to the 20th century, people stayed for months in many spas throughout Europe for an older term of "hysteria", and later "neurasthania", again, with distinctions and similarities....


Solders heart and shellshock, past names for PTSD (http://www.pbs.org/wgbh/pages/frontline/shows/heart/themes/shellshock.html)

shell shock (also called "war neurosis" or "combat stress" and now recognised as Post Traumatic Stress Disorder or PTSD) (http://www.bullyonline.org/stress/ww1.htm)

Shell Shock to PTSD: Military Psychiatry from 1900 to the Gulf War (http://shm.oxfordjournals.org/cgi/content/citation/19/2/370)

Military medical researchers, Tornberg said, determined decades ago that shell shock was "a tremendous disabler" that pervaded among fighting men during World War I. (http://www.mental-health-matters.com/articles/article.php?artID=416)

War veterans are the most publicly-recognised victims of PTSD; long-term psychiatric illness was formally observed in World War I (http://en.wikipedia.org/wiki/Post-traumatic_stress_disorder)

Need any more examples? Let me know.

Paul
Title: Re: Cluster induced PTSD
Post by Bob_Johnson on Dec 26th, 2006, 10:14am
We are still some distance from an answer to this interesting question.
------------------------
J Behav Med. 2006 Feb;29(1):61-7. Epub 2006 Jan 6.  Links
The contribution of pain-related anxiety to disability from headache.Nash JM, Williams DM, Nicholson R, Trask PC.
Centers for Behavioral and Preventive Medicine, Brown Medical School/The Miriam Hospital, Providence, Rhode Island, USA. Justin_Nash@brown.edu

Disability associated with headache cannot be fully accounted for by pain intensity and headache frequency. As such, a variety of cognitive and affective factors have been identified to help explain headache-related disability beyond that accounted for by pain levels. Pain-related anxiety, a multidimensional construct, also has been found to contribute to disability in headache sufferers. What is not known is whether pain-related anxiety is unique in contributing to disability beyond the role of headache-specific cognitive factors and emotional distress. The present study examines the influence of pain-related anxiety on disability, after controlling for pain, cognitive (self-efficacy and locus of control), and affective factors (emotional distress) in a sample of 96 primary headache sufferers. Pain, headache-related control beliefs, and emotional distress accounted for 32%, with locus of control related to health care professionals contributing unique variance. In the full model, with the addition of pain-related anxiety, only pain-related anxiety was a unique predictor of disability. These findings suggest that pain-related anxiety may have a unique and important role in contributing to disability in headache sufferers.

PMID: 16397822 [PubMed
Title: Re: Cluster induced PTSD
Post by Kevin_M on Dec 26th, 2006, 12:23pm
Thank you Paul for finding the classifying of the many war's syndromes being now consolidated into one affliction, PTSD.  The History of Psychoanalysis, those who worked with the victims, examining, describing, observing, concluding, and the period writing of WWI makes no such naming reference that the websites posted seem to do.  This being all one affliction now since:

http://en.wikipedia.org/wiki/Post-traumatic_stress_disorder

However, PTSD in and of itself is a relatively recent diagnosis in psychiatric nosology, first appearing in the Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1980.



Though labeled the same, there is still a descriptive difference maintained in your medical post despite PTSD being the catchall now:

http://www.mental-health-matters.com/articles/article.php?artID=416

The doctor noted that military health professionals have dealt for decades with PTSD — more commonly known as "shell shock" or "combat fatigue" in military circles. It can lead to stress or anxiety that causes people to do things they wouldn't normally consider — like abuse alcohol, drive drunk, road rage or even suicide.

Military medical researchers, Tornberg said, determined decades ago that shell shock was "a tremendous disabler" that pervaded among fighting men during World War I.



After seeing pictures of the catatonic shell-shocked in the hospitals during WWI, classified now the same as those with roadrage and alchohol abuse symptoms from war, as described above, it is still difficult for me to refer to both as symptoms resulting from the same affliction, PTSD, seeming too generalized and applying to situations from all wars now.

Sorry Paul.
Title: Re: Cluster induced PTSD
Post by vig on Dec 26th, 2006, 2:06pm
after about a month or two of my first pain free period, I had a few shadows, but I also had a few interesting experiences.  They were exactly like a Cluster headaCHe attack, but no pain, no tearing, no physical effects, but it was like being right back in the middle of it all.  I concluded it was like PTSD for soldiers, like they were right back in the middle of their battles.  I thought it was kinda cool because I knew it was just a by-product of all we go through.  As the amount of painfree time increased, they went away, but IMHO PTSD happens to us when CH goes away.

(All my painfree time in the last 3 years came as a result of indole-ring chemicals.  see www.clusterbusters.com)
Title: Re: Cluster induced PTSD
Post by Kevin_M on Dec 26th, 2006, 4:58pm
Paul,

I just want to bring up another instance from the Gulf War, which in many cases could be also categorized to be PTSD perhaps but are certainly not.

Immediately after the war, a U.S engineering battalion had blown up Iraqi munitions bunkers at Khamisiyah ammunition depot in southeastern Iraq.  On June 21, 1996, the U.S. Department of Defense disclosed new information obtained by UNSCOM that one of the destroyed bunkers and an open pit had contained roughly eight tons of artillery rockets filled with a mixture of Sarin and Cyclosarin.  The explosions had sent up huge plumes of tainted smoke and dust that had drifted downwind.  Initially, the Pentagon estimated that only about 400 Americans soldiers had been "presumed exposed" to low levels of nerve agents.  Subsequently, however, computer modeling of the incident suggested that the prevailing winds could have carried the Sarin/Cyclosarin plume in a southerly direction as far as 300 miles from the blast site, dropping toxic fallout on as many as 100,000 U.S. troops deployed in southern Iraq, Kuwait, and Saudi Arabia.
 ...controversy developed over... chronic health problems, including fatigue, muscle and joint pain, memory loss and severe headaches.
 ...an intrepid biomedical researcher named Robert W. Haley M.D., at the U of TX Southwestern Medical Center... did a systematic study of sick Gulf War veterans and found that a high percentage of those suffering... reported likely exposures to nerve agents in Iraq.  (More biological wording)
 These findings clearly refuted the claims that Gulf War veterans were either malingerers or were suffering from the psychosomatic effects of "stress".*


In this case also, it would be "generally convenient" to start using PTSD, but it would be incorrectly applied to these perceived "malingerers and victims of war stress"


Each war has it's story, I shy away from general terms.



Peace



*358.3 T
Title: Re: Cluster induced PTSD
Post by Opus on Dec 26th, 2006, 5:06pm

on 12/26/06 at 12:23:43, Kevin_M wrote:
.....After seeing pictures of the catatonic shell-shocked in the hospitals during WWI, classified now the same as those with roadrage and alchohol abuse symptoms from war, as described above, it is still difficult for me to refer to both as symptoms resulting from the same affliction, PTSD, seeming too generalized and applying to situations from all wars now.

Sorry Paul.



Kevin,

I have only two points to add and then I am done.

1. Even if you disagree with what something is called, you still have to use the defined name to be understood. I hate the name Cluster headaches And I think it should be called Cluster Attack Syndrome, but if I went to a doctor and asked him if he has ever treated someone with Cluster Attack Syndrome he would stare at me blankly until I mentioned it is Cluster Headaches, granted he may still stare at me blankly even then. Using the correct term even when it doesn't fit is required to be understood.

2. I see the different symptoms displayed by solders from different wars as the result of the different traumas that were unique  to each war. Even though how the solders displayed PTSD was different on a whole for each war, and even for different battles, doesn't mean that it is a totally different syndrome that is in need of it's own label. Being subjected to constant shelling is different from having to kill children to protect yourself, but both traumas, produced problems for the men after the stress was endured. It may finally come to the point where Gulf War Syndrome, is labeled as PTSD because the stresses of working a foreign society was too great for the solders and the stress caused weekend immune systems.


Paul
Title: Re: Cluster induced PTSD
Post by Kevin_M on Dec 26th, 2006, 5:28pm
I will agree with you to an extent Paul, however, I glanced over


Quote:
(More biological wording)


MRI scans of the individuals from the Gulf War indicated they had suffered physical damage to specific areas of the brain...  sick Gulf War veterans tended to have low levels of an exzyme called type Q paraoxonase.  To treat them as having PTSD would be not helpful toward recovery.  
 With WWI shell shock, men were trance-like, frozen in weird shapes.  The bullyingonline.com link you posted didn't acknowledge 120,000 British soldiers received disability pensions, 6000 would not emerge from insane asylums in their lifetime, due to shell-shock.  Treated as PTSD, again, seems not appropriate.


Thank you for the conversation Paul.     :)
Title: Re: Cluster induced PTSD
Post by Opus on Dec 26th, 2006, 6:30pm

on 12/26/06 at 17:28:27, Kevin_M wrote:
MRI scans of the individuals from the Gulf War indicated they had suffered physical damage to specific areas of the brain...  sick Gulf War veterans tended to have low levels of an exzyme called type Q paraoxonase.  To treat them as having PTSD would be not helpful toward recovery.  
 


Kevin,

 I definitely agree with this statement, unfortunately illnesses that cannot be defined are sometimes seen as being mental in origin until they are proved otherwise.

It has been a great conversation on my side too.

Paul
Title: Re: Cluster induced PTSD
Post by Kevin_M on Dec 26th, 2006, 6:45pm

on 12/26/06 at 18:30:34, Opus wrote:
 unfortunately illnesses that cannot be defined are sometimes seen as being mental in origin until they are proved otherwise.


You are very correct here, Paul, and things would have remained that way, unproved, if it were not for a strong believer in Gulf War illnesses.  Private grants from eccentric billionaire Ross Perot was the only funding for Dr. Haley's findings.  Intense scepticism of the Pentagon, VA, and a series of blue-ribbon committees were content to leave things "undefined" and "mental in origin", as you described.     ;)
Title: Re: Cluster induced PTSD
Post by UN solved on Dec 26th, 2006, 8:12pm
I'll wait and let others define it ... but I wouldn't be suprised at all if there were changes in the brain after having multiple, severe, daily CH hits for months or years on end.

UNsolved  


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