Heading off pain

They are excruciating headaches that last for days and return at a moment's notice. Often, they surface in the teenage years and last through much of adulthood.

It's a condition that has existed for centuries, doctors say. But only recently has it been given a name: "chronic daily headaches," or CDH, defined as migraines or neck- and head-squeezing tension headaches that are present 15 or more days each month.

Some might think it sounds like just another excuse to skip school. But young people such as Rachel Gohmann, an 18-year-old college freshman from St. Cloud, Minn., know how serious the condition can be.

Blinding headaches that often left her bedridden caused her to miss more than 100 days of her senior year of high school -- with her worst migraine lasting nearly a month.

Medication and a tutor helped her make it to graduation. But, now a freshman at St. Cloud State University, she's still missing some classes and making at least one trip a month to the emergency room, where she's given drugs that help her sleep.

Doctors say that anywhere from 1 percent to 5 percent of the population suffer from chronic daily headaches.

Roughly an equal number of boys and girls suffer from them in the elementary years. But once adolescence hits, young women are about three times as likely to have them, partly due to hormonal changes related to menstruation.

Other factors, such as a family history of headaches, stress and depression, also can play a role for both genders.

"It's really sad because these headaches take all the pleasure out of life at a time when high school and college students should be enjoying their lives," says Dr. Michael Cutrer, a neurologist who specializes in primary headache disorders at the Mayo Clinic.

If left untreated, he says, the severity of the headaches often increases -- making it imperative that treatment begin in the early years.

But even the most experienced of headache specialists say that finding relief for chronic daily headaches isn't always easy.

Often, it is a matter of trying various migraine medications. Among the most common are prescription drugs called "triptans," which are marketed under such names as Maxalt, Amerge, Imitrex and Zomig. They're taken at the onset of a headache.

Because chronic headaches often run in families, some doctors give their young patients drugs that have worked on relatives. Others also have found that antidepressants sometimes help, since depression can be an underlying factor. And some accompany the use of prescription drugs with acupuncture or botox injections to relax stiffened head and neck muscles.

Doctors say it's also important that their young patients stay on a regular sleep schedule and avoid stress and skipping meals.

Gohmann has tried all of it -- and says a new triptan medication seems to be helping. Still living at home because of the headaches, she's still hoping she'll be able to go away to college.

In the meantime, she's discovered that several of her classmates -- and even some of her professors -- have trouble with severe headaches, too.

"We swap horror stories," Gohmann says. "It helps when people understand."