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Ms A has had recurring migraines for several years. They seem to come and go on their own accord. She has been to doctors who gave her pain killers, and specific medications for migraines. They helped for a while and then her headaches returned. She saw a homeopath who gave her Arnica and nux vomica – they helped for a month, but her headaches returned as bad as they ever were.

She saw an Ayurvedic physician who adviced meditation, a sattvic diet, and shirodara. This helped her more than other treatments and her headaches reduced in intensity, but they still persisted.
Around this time, she began to notice that she would wake up feeling tired every morning. Her fatigue affected her work, and she began taking time off from work.

At this point, she was taking 3 different medications for pain (an opioid, Aspirin, and Ketorolac). She noticed a decrease in her overall appetite, although this was accompanied with an increased craving for sweets. She didn’t sleep well, and her energy levels were low.
When she went back to her primary care doctor, he noted down her symptoms, "Headaches, insomnia, anxiety, poor appetite, fatigue. "I think you should see a psychiatrist," he said, noting down the emotional symptoms.

"I am depressed because of my headaches, otherwise I would be fine. Get rid of my headaches and my mood will be fine. I don’t need to see a psychiatrist."

"When all you have is a hammer, everything looks like a nail."  

Due to the nature of modern medicine, and the complexity of the human condition, every system of medicine can only have a partial view of the problem.

In order to truly understand the condition, one must attempt to understand the component as well as the whole, one must assess the mind, the body, and the spirit, from a western as well as eastern perspective.

The integrative approach therefore includes a review and exploration of her symptoms on multiple dimensions:

Mind:  From the perspective of western psychiatry as well as Yoga psychology

Body: From the perspective of western medicine as well as Ayurveda

Spirit: A non-religious, non-dogmatic, understanding of the patient’s spiritual strengths.

Of course, even the description above is for ease of explanation. In actual fact, mind, body, and spirit are a unified being. 

Diagnosis

Conventional (ie Allopathic) Diagnosis: "Tension Headache, chronic, recurrent."

Integrative Diagnosis:

  • Physical: Tension of the neck and temporalis muscles in response to stress causing pain. Poor sleep. Eating too many sweets and low glycemic index carbohydrates. Caffeine withdrawal. Not enough exercise.
  • Emotional factors: Stress in relationship with her husband, and mother in law. Irritability. Depression. Poor self-esteem.
  • Spiritual: Lack of meaning, Worried about aging and dying.

Treatment

  • Continue the Ayurvedic treatment. 
  • Start magnesium supplements 400 mg once a day. 
  • Start Fish oil supplements 2g once a day. 
  • Biofeedback training to relax the temporalis muscles and neck muscles. 
  • Meditation training.
  •  Specific exercise and dietary recommendations. 
  • Psychological support and help.

Result

After 6 weeks, Ms A reported feeling even better than she had in a long time. She had a 50% reduction in the frequency of her headaches, and the intensity reduced by 70%. She rated her quality of life as being significantly better. Her self esteem improved, she slept well, she became more assertive, and her relationship with her husband improved.