Q: Good morning, Dr. I need help regarding my health. I suffered depression for the past 3 months but I am getting better now, but for the past 6 weeks I have had difficulty sleeping. Sometimes I don’t sleep for straight 3 days, any time i do, the maximum time would be about 1hr. Therefore, I felt it might be reaction from the depression I had earlier but I don’t know what to do now as I’m not financially strong to visit hospital.

Another reaction is that I have steady headache. Have taken some medications but its not relieving it.

A: Sorry to hear about the health challenges you have faced recently. Depression is never an easy challenge to deal with but glad to hear that you are getting over it. Did you visit a health facility and are you getting medications for the depression? Please ensure that you are getting medical help as you battle this black hole of depression.

Sleep problems may show up as difficulty falling asleep, difficulty staying asleep if one wakes up in the night, waking up too early and being unable to fall back asleep or waking up feeling very tired etc. This is called insomnia. These problems may (secondary insomnia) or may not (primary insomnia) be related to other health/disease conditions. Women over 60 years of age are more prone, people who are stressed and travel long distances across time zones are also more likely to have insomnia.

Causes of insomnia include stress of life (divorce, death of a loved one etc), medications, depression (as in this case), anxiety, pain or discomfort etc. Insomnia without underlying medical conditions can be treated with lifestyle modifications like the under-mentioned ones:

Have a regular sleep routine that allows you (an adult) about 7 to 9 hours of sleep daily. Go for the higher limit, by the way 😀 Cultivate good sleep habits (no TVs in room, no work before bed time, a warm bath before bed etc). Lay off the caffeine and alcohol before bed time too. Regular exercise helps relieve everyday tension but vigorous exercise before bedtime may lead to inability to sleep too. Make your room a haven for sleep and clear out all clutter and be sure that you have invested in a good mattress and pillows. It’s a good idea to ventilate the day’s issues before you actually start getting ready for bed, so you can mentally file every issue away in a ‘to-do’ or ‘done’ box ahead of the next day.

Insomnia due to underlying medical condition needs the medical condition to be addressed. In the case of depression, please ensure that you are taking the medications prescribed by your doctor.

High cholesterol level can be addressed with lifestyle modifications:
Exercise can help increase your level of good cholesterol. Aim for 150 minutes of activity weekly. Be sure to check with your doctor before starting on an exercise regimen, especially if you have been sedentary for a while.
Smoking reduces the level of good cholesterol. So, if you smoke, stop and if you don’t smoke, don’t start
Eat more fiber. Soluble fiber in wheat and oats can help reduce cholesterol levels.
Fatty fish (sardines, salmon, mackerel), walnuts, soya beans etc contain Omega-3 fatty acids which help reduce cholesterol levels.
Use healthier oils to cook. Oils high in mono-unsaturated fatty acids provide health benefits for the body

Your doctor will determine if this is sufficient or you need medication.

The fact that you are not getting enough sleep is enough to give you a tension headache! This is the more common type of headache seen as the everyday sort of headache. It affects both sides of the head as a constant ache. Its causes are not very clear but they can be triggered by stress, hunger, dehydration, etc They can last a couple of minutes to several hours but are not severe enough to stop regular activities. Resting and sleeping well, eating properly and staying hydrated can help prevent this.

Other common causes of primary headaches include:

Migraines: These are felt as severe throbbing pain at the front or side of the head. Some people may experience other symptoms like nausea, vomiting and being sensitive to light. The pain lasts from a couple of hours or can stretch on for days. Thus, it is more severe than the tension headaches and can stop an individual from carrying out their daily tasks. Some find that they need strong medication prescribed by doctors to get relief but others are relieved by using over the counter medications.

Cluster headaches: These cause severe pain around one eye and are associated with red or watery eyes and a blocked nose or runny one. They tend to occur for one or two months at a time at about the same time of the year. Most times medications do not work for these headaches. Your doctor will prescribe specific treatment courses.

Chronic daily headaches may be due to medication overuse. This would occur in people who use pain medications too often and then end up with rebound headaches…the exact condition they were trying to avoid. Moral of the story: Never abuse your medications J Use only as directed by your doctor.

Sex headaches: Yes, this can occur. It’s also known as post-coital headache, orgasmic headache etc. It could occur during sexual intercourse, during orgasm or after sexual intercourse. And it can also occur at any time of the day and during any type of sexual activity. It is felt at the back of the skull just above the neck and is usually described as throbbing. Or it could build up gradually during sexual intercourse and intensifies as the sexual excitement before an orgasm increases. They can last anything from a few minutes to a few hours; may never recur or may happen a couple more times before gradually fading away.

It is thought to be due to the release of adrenaline and rapid rise in blood pressure which occurs as one approaches orgasm. And so in these cases, the headaches may not be a cause for concern. However, it is also a possibility that these headaches are a sign of a more serious condition like bleeding onto the surface of the brain.
People who usually have migraines, who use recreational drugs like marijuana, use birth control pills etc are more likely to have sex headaches.
Should you swear off sex? Yes, if you’re unmarried And no, if you’re married;) If you have just experienced this, try lying quietly for about an hour or two after taking an analgesic (like paracetamol) to handle the pain. However, it is very important to see your doctor as soon as possible to let him/her know what happened. This is important because, while there may very well not be any underlying issue, you want to be sure to rule out any serious medical condition causing these headaches. Your doctor will also prescribe some drugs on a regular or intermittent basis to deal with your symptoms.
Primary headaches may be triggered by stress, skipped meals and dehydration as noted above. However, they may also be associated with alcohol, foods that contain nitrates like spinach and bad posture.

Secondary headaches may be due to dental problems, hangovers ear infections, blood clot in the brain, wearing tight gear on the head like hats or even wigs (yes, I see you ladies :D) or even eating cold stuff like ice creams etc.

So, what should you do? If you find that tight head gear or eating ice cream is the problem, see if stopping helps.

If you find that these headaches are now more frequent than usual, more severe than usual, stops you from going about your daily activities, is no longer responding to the over the counter medications you used to take etc, please see your doctor. If you have been seeing the same doctor, as it appears to be in this case, with no relief, please seek another opinion or request a review by a neurologist.

All the best.

I hope y’all had a great day! 

Big hugs 😀