invisible wounds
By Katherine Osos
Ready , MD , later suggested the pain was perpetuated or worsened by posttraumatic stress disorder ( PTSD ), an anxiety condition some people develop after living through a harrowing event .
“ With PTSD , you ’ re putting undue stress upon yourself ,” Nunnery says . “ Because you ’ re ever-vigilant , you ’ re always on edge , looking over your shoulder , thinking [ something bad is ] still coming . That makes the headaches even worse .”
Stand Down
Exploring the relationship between migraine and PTSD in the military .
The first time he was under fire , a shock wave from a distant explosion knocked him back in his seat . The second time , a mortar attack drove shrapnel into the left side of his head . The third time — the event that eventually forced Sgt . Christopher Nunnery home and required 19 reconstructive surgeries — a rocket-propelled grenade attack demolished the right side of his face .
After more than 10 years of service in the army — and after surviving three brutal encounters in Iraq — Nunnery had to medically retire in 2006 . Today , at age 39 , he lives in Harker Heights , Texas , and is still seeking relief from the intense chronic migraines that began after the second attack .
Although the head pain was initially attributed to his physical injuries , Nunnery ’ s physician , Michael
The military risk factor
Due to advances in body armor and other protective equipment , soldiers today endure injuries and survive blasts that would have been fatal in previous wars , says Alan Finkel , MD , contractor for the Henry Jackson Foundation and Defense and Veterans Brain Injury Center at Fort Bragg , N . C ., and co-founder of the Carolina Headache Institute . But while they survive , one in five soldiers returns home from combat with haunting visions of death and destruction that lead to nightmares , flashbacks , difficulty sleeping and emotional numbness — the signature markers of PTSD .
Military migraineurs are particularly vulnerable to this anxiety disorder . Of 2,200 returning soldiers , 19 percent suffered from migraine , and twice as many migraineurs had PTSD , according to researchers at Madigan Army Medical Center at Fort Lewis in Tacoma , Wash .
A bi-directional relationship
It ’ s unclear whether headaches trigger anxiety in soldiers or vice versa , says Dr . Ready , director of the Headache Clinic at Scott and White Healthcare in Temple , Texas , located just 30 miles from Fort Hood . But what is clear is that the two conditions make each other worse .
20 HEAD WISE | Volume 1 , Issue 3 • 2011