‘Are My Headaches Caused By Stress?’ — Ask Dr. Harry Fisch

Enrique, 26, has been having constant headaches for about a month. They’ve been growing more and more severe. He can’t go to the doctor because he’s unemployed and without insurance. At first, over-the-counter headache medications like Motrin and Advil helped, but they don’t anymore. He isn't on any other medication, except for Zyrtec-D, which is for allergies. He’s wondering if his headaches are related to stress?

Dr. Harry Fisch's advice:

From what you've told us, it does seem that you may be suffering from tension headaches, which people usually feel right across their foreheads.  You’re not having luck finding work and the anxiety around that is causing you not to eat or sleep very well. Both of which can raise your risk of headaches.

You might also be dehydrated, so consider drinking more water—not soda or other sugary drinks. I don’t normally tell people to eat salty foods, because salt makes you retain fluids,  but if you’re dehydrated it’s another story—you may need to eat something salty with the fluid so you can retain the fluids and not just pee them out.

You mentioned that you take the allergy medication, Zyrtec-D. The D stands for decongestant, and this could also be contributing to your headaches. Decongestants work by clamping down the blood vessels in your sinuses.  That clamping down can also affect the blood vessels under your scalp, which can cause headaches.

It does sound like you’re under a lot of stress, so maybe you need to change something in your life to make things easier.  If you’re paying rent and not making a lot of money, maybe you should consider moving back home to save money.  If your headaches don’t go away after you’ve lowered your overall stress level, then you should see a doctor—explain that you don’t have health insurance and maybe they’ll give you a break on the cost.

Dr. Harry Fisch is a board certified urologist at New York Presbyterian Hospital/Weill Medical College of Cornell University.