Recognize and deal with emotionally stressful situations in your life. We realize this is easier said than done, but headaches are very commonly associated with emotional stress.

Become familiar with the early signs and sensations of tension, both muscular and emotional. If you can sense tension before a bad headache comes on, you can do something to break the cycle before tension increases. Get out of the stressful situation for a few minutes, do some physical exercise to help release stored tension, meditate, pray, or do anything you find relaxing or joyful (laughter is great for releasing tension).

Learn to relax the muscles that tense up during a headache, so that you can relax them during periods of stress. We suggest you set aside ten minutes or so twice a day for relaxation exercises. Relax your whole body and your head and neck muscles in particular. Spend the last few moments of each period of relaxation imagining yourself in the situation that causes you the most stress--perhaps it's driving in rush hour traffic--keeping that relaxed feeling. After a week or so, youíll start to remember the relaxation sessions whenever youíre in that tense situation, and before long, you'll find that you can maintain greater tranquillity even then. Biofeedback can help you learn to control various physiological processes that lead to tension headaches, as can meditation.

Exercise and massage are both great for relieving tension and lifting your mood. The specialty bodywork practices--such as the Alexander technique, chiropractic, rolfing, or acupressureócan also be helpful in treating or preventing headaches.

Some people get headaches when they are hungry or when they eat foods that donít agree. Pay attention to the pattern of your headaches in relation to diet. We recommend regular meals with an emphasis on fresh vegetables, whole grains and, if desired, lean meats. Avoid sweets and caffeine. Specific foods often aggravate vascular headaches, and since many headaches may be of mixed type, it may be useful to avoid these foods.

If you have any visual difficulties, see an eye specialist. While eyestrain isnít a common cause of headache, sometimes it is to blame for recurrent headaches.

Consider a checkup for misalignment or injury of the temporomandibular joints (TMJ). These joints attach the jaw to the rest of the skull on either side, just in front of the ears. One quick test: Try placing a two to-three inch piece of Popsicle stick or tongue depressor between the teeth to separate the upper and lower jaws. If this relieves your headache, you may have a TMJ problem. Evaluation is best performed by an ear, nose, and throat specialist or a dentist.

For more information on self-treatment of headaches, we recommend Headache Help by Lawrence Robbins, MD, and Susan Lang (1995) and Migraine: What Works by Joseoph Kandel, MD, and David Sudderth, MD (1996). For more details on learning to deal with stress, see Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness by Jon Kabat-Zinn, PhD (1990) and PNI: The New Mind/Body Healing Program by Elliott Dacher, MD (1993).

Migraines and Other Vascular Headaches
Many people use the word ìmigraineî to refer to any really bad headache, but migraine headache, as medically understood, denotes that pain resulting from a complex series of specific changes in the blood vessels of the head and brain. During a migraine, the blood vessels first become overly constricted and then widen abnormally. This sequence of constriction and widening affects the blood vessels on one side of the head more intensely, and often it is especially pronounced in a particular area of the brain.