Final Case Presentation: Health Psychology

Hi. So my name is Taylor as you know, um and my final

case presentation is gonna be about migraines because

I thought it would be cool to continue

what I was working on all semester uh into this case presentation.

OK.

So first to start out with some general statistics about migraines.

Um So within the last decade decade,

migraines were classified as the sixth highest cause of worldwide

um productivity loss due to disability. Um

migraine sufferers are also much more

likely to experience anxiety and depression.

And

uh both of these sets were from the World Health Organization in 2016.

And then

uh another interesting fact that I found is that migraine headaches and tension

type headaches or TT H are responsible for the majority of primary headache

disorders.

And these constitute 95% of cases presenting to primary or secondary care.

And this was read in an article by

Ahamed 2012. Sorry, I'm not sure if I said his name, right?

Ok.

So to move on to this graphic,

which I actually just presented in my smart goal presentation as well.

Um When a migraine strikes the blood

brain barrier becomes leaky allowing for neurotoxic

molecules such as uh leukocytes or white blood cells to enter the brain.

Once this happens,

glial cells and neurons become reactive and initiate the immune response

as well as a hallmark of inflammatory pathways within the brain.

This leads to the pain that we associate with headaches.

Ok. So next, this is just a slide showing the symptoms of um migraines. Um

I got all of this data from the mayo clinic.

So, migraines are, are uh defined as severe headaches. Often accom

accompanied by nausea, vomiting

and sensitivity to light sound. And these can last from hours to days.

Some experience uh warning signs called auras or these are

mostly visible disturbances such as tingling and these can occur

uh around 30 minutes before an attack and they can extend to during an attack.

Um Treatment treatment for migraines includes currently

self uh health remedies, lifestyle changes, diet changes and

um there are uh pharmacological treatments which I will go over in the next slide.

Um

So migraines occur in four stages. The first stage is a post Rome stage.

This occurs 1 to 2 days before the attack and

you will get um neck stiffness, fluid retention and fatigue.

Um The aura happens around 30 minutes before the attack. When I get a migraine, I get a

um like path in the middle of my vision that's just black. Uh I can't see.

So,

yeah, usually your vision is just distorted. Um

And then uh I also usually get tingling or numbness on one side of the body.

Um,

and usually my aura continues into the attack, but some will stop.

Um,

then it's the attack. The attack la can last from 4 to 72 hours.

Um, and then there's also a post

room stage and, um,

this is just after the attack and you can feel like super drowsy,

super tired or even more elated.

Um,

depends from person to person uh

during the attack, you can get nausea, vomiting, um

uh sensitivity to light sound and then

there's a hallmark of other symptoms. But those are usually the

general

uh

symptoms used for diagnosing a migraine.

Ok. So

some of the current pharmacological treatments are

anna

analytics. I I can never say this, right? Um Tryin

and ergotamine.

Um these are all medications that you take

uh either during or right as you feel that or come on.

Uh these will reverse the the migraine from progressing.

Um There are also uh preventative treatments and these are beta blockers,

antidepressants and calcium channel blockers.

Uh I pulled these specific classes of drugs from

we wether

Hall 2015.

Um

I'm sure there's some others, but these are generally the main classes of drugs.

Ok. Moving on

the

because headache disorders do not result in death, they are frequently tri

trivialized by the general public.

Low consultation rates in developed countries such as the USA suggest that

many people suffering from headache disorders

are actually unaware that treatment exists.

And I also pulled these um data from the World Health Organization.

So as you can see on the screen here,

the World Health Organization estimates that approximately 50%

of individuals with headache disorders are self treating.

Given the significant proportion,

it is critical that we evaluate the barriers to effective care.

Ok. So

these are some of the natural remedies for migraines. Um as you know, by

Markle Yoga is um

a remedy

uh diet, you know,

you can eliminate certain foods from your

diet and then um pressure point stimulation,

essential oils.

These are all used in treating migraines at home.

Um Some more are ice caps, acupuncture, mas, massages, um salmon, peppermint,

lavender oil,

um

ginger and magnesium supplements.

Um Another supplement that I couldn't find on any graphics is riboflavin,

which I think is also vitamin B two

and these are also supposed to uh reduce migraine, reduce chronic headaches. Um

Yeah. So there are a bunch of home remedies which is a

good thing that we are finding more of these.

Ok. So now to assess migraines through the biopsychosocial model,

so,

migraines have a significant biological component involving

intricate uh brain mechanisms and genetic predispositions.

Research suggests that migraines are associated with

abnormalities in brain chemicals such as serotonin,

which is a neurotransmitter that regulates pain,

trans pain transmission and mood.

This is highlighted in an article that I found um by

Gerwal at

all 2012 and this is why ssris may be prevented,

useful preventative treatments for migraines.

Um

When I was reading about how uh antidepressant could be a treatment for migraines.

I was wondering and then I actually stumbled across

a bunch of research that says that serotonin is

very heavily as associated uh

sorry, sorry,

serotonin depletion is very heavily associated with um increased migraines.

Um In addition, according to the American Migraine Foundation,

various triggers can in

can initiate migraines including hormonal changes, stress,

environmental factors, um weather changes, bright lights,

certain foods or drinks, et cetera.

Understanding these triggers is very crucial for

managing migraines effectively from person to person.

Um Migrants are also characterized by chronic inflammation.

Um and due to the large number of self treating individuals,

home remedies that are effective in treating um inflammation such

as yoga may be very effective in thereby treating migraines

because we can reduce systemic inflammation this way.

Uh For social,

the social dimension dimension of

migraines encompasses various external factors

including family dynamics, socio

economic status and cultural factors.

Support systems within the family.

And uh broader social circles can

significantly impact an individual's ability to cope

with migrants,

lack of understanding or empathy from friends,

family or employers can exaggerate stress associated with migraines.

Um I can speak to this on a personal level because I feel that when I had a migraine,

if I didn't have the support system that I need.

And I felt that

I was you know, making up the pain in my head.

Um it would, it would be a lot harder and I feel like those days I would,

it would take me a lot longer to get over the migraine.

Um

According to both Harvard Health and an article by Stewart at all 2013,

socio-economic factors also play a huge role

um as access to health care, financial resources and job flexibility may

affect, negatively affect migraine management.

Those with limited access to health care or financial constraints

may face challenges in obtaining proper treatment or managing triggers.

Effectively.

Furthermore, cultural attitude,

attitudes toward pain can influence how

individuals perceive and cope with migraines.

Um Some cultures may stigmatize migraines or view them

as weakness which can lead to further psychological distress.

Uh Addressing social factors involves

building social networks. Um

advocating for workplace accommodations, promoting awareness of migraines and

um

reducing the stigma that these aren't uh super serious.

Um

Psychological factors may also play a crucial role in the

management of migraines. Uh particularly particularly stress and anxiety

are very, very important in the initiation and as well as the stages

when you're not having,

not having an episode.

Um

All of these like stress and anxiety actually produce physio,

physiological

changes within our bodies such as

uh up regulating that hypo

hypothalamus, pituitary uh access the HP A access which um

increases inflammation and can directly lead to triggering a migraine.

Um

In addition,

cognitive uh factors such as negative thought patterns about pain

can contribute to the perception of migraine uh severity.

Um This is why learning coping strategies going to therapy

can be very useful for people who have severe migraines.

Uh It is very essential to uh con consider

the bidirectional relationship between migraines and psychological well being.

While psychological factors can exacer

mi

migraines,

the experience of living with migraines can also take a toll on mental health.

Addressing psychological factors often

uh it involves a holistic approach that integrates therapy,

stress management techniques and medication when necessary.

As I said before,

uh when I got diagnosed with migraines,

I was actually recommended immediately to be put on an anxiety medication as well.

So this was, that was a very good example of the

uh I guess like the biopsychosocial model being

shown to me by a health care professional.

Um

Overall recognizing and addressing the biopsychosocial factors

influencing migraines is a key to comprehensive.

And

um

you know, recognizing the whole person when

uh improving the life quality of individuals

living with chronic headaches and migraines.

Um

I got a lot of the psychological information that I just used from an article by Minin

at all 2016.

Finally,

some interesting research and interventions that

I spent the semester reading up on

was the effectiveness of yoga and mindfulness

or yogic meditation and treating migraines.

Yoga practices have been linked to enhanced

regulation of the sympathetic nervous system.

And the hypo

hypothalamic pituitary adrenal

axis or the HP I axis,

both of which play crucial roles in regulating the body's immune,

uh an inflammatory response and um stress responses. Um

in a randomized control trial involving healthy

individuals under significant like life stress, daily short yoga sessions,

not only heightened the expression of anti

inflammatory cytokines,

but also counteracted the increased activity of

inflammatory signaling pathways and gene transcription.

Um This was a from a study by Black at all 2013.

They actually examined the NF Kappa B signaling pathway,

which is recognized as the primary primary

physiological pathway responsible for triggering the expression

of pro inflammatory genes such as cytokines,

chemokines, and adhesion molecules.

Um

So,

evidence indicates that stress induced activation of the sympathetic

nervous system triggers this n of Kappa B signaling pathway

and this uh promotes SN activity

and uh dampens PNS activity.

Recent research uh proposes that yoga uh directly increa um

dampens NNFKAB activation.

So this suggests that yoga actually can do the exact opposite of

what this NFC A B pathway does by dampening uh SNS activity and

increasing PNS function.

So ultimately, these at home interventions offer time and cost effective

uh at home treatments for migraines.

Most people have access to some sort of light intensity yoga.

Um So these holistic treatments may decrease some of these barriers that

we see with low ses individuals with attaining drugs and other pharma

pharmacological interventions.

Um I thought the yoga

research in particular was super cool because

um

I just, I feel like that

is such a cool way to think about how this,

you know, this just doing 10 minutes of a short yoga routine.

Each, each day can directly

stop our primary uh signaling pathway involved in inflammation in the body.

Um This pathway is seen in cancer stroke,

um a multitude of other diseases as well as migraines.

So I think it would be, it's awesome to

uh see this research being done and um

see the future effects of holistic and non pharmacological approaches

for a disease like this because this is a disease where

we have the opportunity to look at

uh how at home treatments will really affect

it because it's not something life threatening,

but people are searching for these um at

home remedies.

Yeah.

OK. So these are my resources um references.

I have about three pages of them.

Here's the first page,

here's the second page

and

here is the third page.

My last slide that I just talked about about yoga

uh was from

Basore

Black at all and then

Colin at all and then Lawrence 2009.

All right. Thank you. Bye.

Final Case Presentation: Health Psychology

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