Dr. Marilyn Ann Kubichek, MD

• Migraines: one of the most prevalent types of headache, migraines typically last from two hours to three days, causing a throbbing pain on one side of the head. Nausea, sensitivity to bright lights, fatigue, and blurred vision all may accompany migraines. While migraines have no known cure, medications and lifestyle modifications may ease symptoms. Avoiding behaviors that may trigger migraines such as lack of sleep or loud, repetitive noises can improve headaches.
• Tension headaches: also known as stress headaches, these headaches are characterized by pain in the upper top part of the head and behind the eyes. Tension headaches are common and have no exact cause; however, certain practices may increase the likelihood of developing them. For example, wearing one's hair up in a tight hairstyle or wearing a restrictive hat can put pressure on the scalp, leading to a tension headache. Other causes of tension headaches may include alcohol or nicotine use, caffeine, teeth grinding, stress, overexertion, and eye strain. Some people find posture improvement, alternating sleeping positions, and neck exercise can alleviate tension headaches. Over-the-counter pain relievers such as ibuprofen (Advil, Motren) and naproxen sodium (Aleve) may also reduce tension-headache pain.
• Sinus headaches: this type of headache causes pain in the sinuses, but may progress to pain and pressure in the eyes, forehead, and cheeks. These headaches are often accompanied by nasal congestion, fatigue, and ache in the upper teeth and may or may not be caused by sinus infections or sinusitis (sinus inflammation). Some sinus headaches are allergic headaches, which arise from allergic triggers such as seasonal allergies (pollen allergies) or hay fever, causing sinus pressure and facial pain. Other symptoms of allergic headaches include nasal congestion, irritated or watery eyes, runny nose, and sneezing. Allergic headaches may be treated with antihistamine medications such as cetirizine (Zyrtec). Allergic headaches are common during pollen season, which is usually around springtime.
• Cluster headaches: these headaches occur suddenly and cause stabbing, sharp pain from one eye down to the one side of the neck. They are often referred to as the most aggravating and painful type of headaches. Other symptoms of cluster headaches include nasal congestion, droopy eyelid, and enlarged pupil on one side of the face. In the past, it was widely believed that cluster headaches were caused by a bevy or "cluster" of multiple types of headaches, such as a combination of an allergic headache and a tension headache. Medical experts now recognize that cluster headaches are a separate and unique form of headache. Cluster headaches last for around twenty minutes to two hours. They may recur throughout the period of a day or several weeks, but usually dissipate within a month. Treatment for cluster headaches includes over-the-counter pain medications such as ibuprofen (Advil, Motren) and naproxen sodium (Aleve). Prescription Prednisone can help with swelling and Verapamil may reduce pain by relaxing the blood vessels.

Living with headaches is challenging; headaches can prevent people from fully enjoying life. Medical treatment and care in avoiding certain triggers can help those with headaches begin to feel normal once again.

OCD frequently revolves around themes such as the fear of contracting germs or the fear of death. Common obsessions include:

• Fear of getting contaminated by people or the environment
• Extreme concern with order or precision
• Fear of death or behaviors perceived as risky
• Fear of accidents, disasters, and traumatic incidents

These obsessions and compulsions often contribute to anxiety, depression, and recurring emotions of fear and disgust. People with OCD cannot "turn off" their patterns of thought or behavior, and thus must continually grapple with urges to behave or think in a certain way, as well as the emotions associated with these urges. Some OCD patients describe their entire life as revolving around their obsessions and compulsions and this can result in their missing out on important school and social activities, travel, and family time. The impact of OCD is extensive and can even make daily activities like drinking, reading, sleeping, and eating extremely difficult.

The obsessions manifest in compulsive behaviors that can have negative implications on one's life. Some examples of compulsive behaviors include, among others:

• Excessive hand washing or showering
• Constant reordering or arranging of items
• Refusal to fly, drive, or participate in other activities
• Refusal to leave one's residence

Obsessive-compulsive disorder affects adults, adolescents, and children. OCD has been observed in children as young as five or six years of age, usually through sensitivity issues, obsessions about dirt or germs, or repeated doubts. The cause of obsessive-compulsive disorder is unknown. However, a person's likelihood of developing the condition may be increased by a number of variables such as family history, stressful life events, and pre-existing mental health disorders.

OCD is diagnosed based on a patients' reported symptoms. For example, a pediatrician or child psychiatrist may ask children (or their parents) how often they wash their hands or experience behavioral urges. Psychiatrists will evaluate patients for other symptoms and may instruct patients to describe their mental processes, thought patterns, and previous traumatic experiences.

While there is no cure for OCD, treatment can greatly improve patients' functioning in daily routines and activities. A common treatment for OCD is cognitive behavioral therapy (CBT), which helps patients identify negative patterns of thought and behavior and learn how to adjust them. Aversion therapy may also help those who have a fear of germs or contamination by forcing them to confront their fear and slowly overcome it. Many patients also benefit from counseling to address the anxiety, stress, and trauma that may accompany OCD. Other treatments for OCD include oral medications such as selective serotonin reuptake inhibitors (SSRIs, which are antidepressants) to normalize levels of a brain chemical called serotonin, which may improve OCD symptoms. Medications such as fluoxetine (Prozac) and sertraline (Zoloft) can help alleviate OCD-related behavioral urges, anxiety, and depression. Many OCD patients also find OCD support groups helpful to learn new coping strategies, to socialize, and to verbalize their emotions and experiences.

It is important to note that while OCD is a common mental health disorder, it is not a personality trait. The term "OCD" is sometimes used to informally describe someone having a tendency towards organization or orderliness. This usage is pervasive but inappropriate - OCD is a severe, life-altering condition. Some people with OCD who successfully manage their symptoms find that they may benefit from other traits that may be associated with OCD, such as high attention to detail and precision.