Neurologists and headache specialists long have suspected that anger can literally make your head throb. Now researchers at the St. Louis University School of Medicine have shown that people who tend to bottle up their anger may be more likely to suffer from chronic headaches.
Dr. Merle Diamond, associate director of the Diamond Headache Clinic in Chicago, said the findings are welcome news as they document something researchers have been observing for years.
"Just like some people get ulcers and some grind their teeth, some people get headaches," Diamond said. "Anger has to come out somehow."
Robert A. Nicholson, a clinical psychologist at St. Louis University, studied 422 people, 171 of whom suffered from chronic headaches and 251 who were relatively headache-free. After setting aside those people with depression and anxiety -- two common causes of chronic headaches -- they found that most of the remaining headache sufferers also had something psychologists call "anger-in," or a tendency to suppress feelings of rage.
The researchers also found that other types of anger don't have the same connection to headaches as anger-in. Hostility, which Nicholson described as "an overall mistrust of others," and trait anger, a strong tendency toward rage, don't appear to cause headaches the way anger-in does.
Whether or not people were angry in general didn't matter, said Nicholson, the study's lead author. "It was what they did with their anger."
Doctors already recognize anger's role in contributing to conditions like ulcers, heart disease and high blood pressure. Only recently, however, have they begun to document how anger may play a role in other pain conditions, such as backaches and arthritis.
Nicholson's research was part of a larger, ongoing study looking at how cognitive traits -- things like people's beliefs, coping skills and tendencies to forgive -- are important factors in chronic pain.
Nicholson hopes his findings will begin to change how headache patients are assessed.
"Paying closer attention to anger can be beneficial," he said.
Medical assessments often focus on depression and anxiety, he said, leaving people who don't have either diagnosis without an explanation for their pain.
Researchers say that people who suffer from anger-induced headaches may be able to manage their pain through lifestyle changes. Nicholson suggests that learning to forgive others and using breathing exercises are two ways to cope with anger.
Diamond suggests more vigorous activities, such as taking up tae kwon do or kickboxing.
"We're always taught to be good, not to be mean, but it's not always healthy," she said. "So I always tell my kids to punch a pillow, but never, never each other."