While headaches may be episodic for everyone, some respond to no treatments and bring on thoughts of suicide.

Headaches are something that all of us will experience at some point in our lives, but for some, there is a specific type of headache that is not simply excruciating — it is life-threatening due to the intense pain involved. Even babies can experience headaches, so age is not an issue.

Known as cluster headaches (CH), this specific headache can disrupt a person's daily life in almost every respect –it is one of the most debilitating headache types, and there is little treatment. But this excruciatingly painful condition has been better understood thanks to research and a search for potential treatments for it.

One person in every thousand suffers from cluster headache, a primary headache disorder. Each incident of a cluster headache often lasts no more than a few minutes and occurs in cycles. Aside from the usual unilateral headache, an attack may also include drooping of the eyelid, redness or discharge from the eye, and stuffiness or a runny nose on the same side as the headache.

Some refer to CHs as “suicide headaches.” Since many doctors and nurses have never dealt with a CH patient, a description will assist them and everyone else in comprehending the gravity of this powerful and unbearably painful condition that many sufferers endure for the rest of their lives.

One person in one million takes their own life every year as a result of a primary headache; this accounts for one percent of the total suicide rate. Of these, 70–80% are migraines and cluster headaches. Suicide attempts occur ten times more often than actual suicides. Compared to migraines, cluster headaches are more dangerous.

It may come as a surprise to some, but most doctors and nurses in healthcare have never dealt with a patient who has cluster headaches. For this reason, people with these headaches may be seen as having a mental disorder or seeking sympathy. In short, they are often not believed. Women suffer more migraine and cluster headaches than men, and, for this reason, there may be a tendency to view their symptoms as psychosomatic, requiring therapy rather than medical treatment.

Misunderstanding, drug charges, disrespect, a lack of urgency, or even a lack of education can push a patient over the line to thinking about suicide. Unfortunately, this may occur more frequently than one might think.

Innumerable times, patients experience attacks while sitting in the emergency room for hours. Nobody on the emergency room crew has any clue how much pain they are in. Even the most basic information on this illness and its treatment is unknown to them.

Patients with CH make up only 0.1 to 0.4% of the general population. Around 7 million people across the globe and at least 400,000 people in the United States suffer from this extremely rare condition.

It is well-known that cluster headache attacks cause some of the worst pain a person can feel. The extreme agony experienced by those who suffer from cluster headaches frequently makes them agitated or drowsy. Cluster headaches are characterized by intense, unilateral pain that occurs in clusters or bouts, typically centered around or behind the eyes. Tears, a stuffy or runny nose, a drooping eyelid, and facial sweating are other common symptoms that often occur on the same side as the headache. Many people report feeling a sharp or scorching pain.

Patients may notice:

Eyes are watering more than usual.
The affected eye becomes redder on the side that hurts.
The eyelids swell or droop.
Hampered vision.
Light sensitivity.

Lack of Medical Education

On average, during the four years of medical school, students spend approximately three hours learning about cluster headaches, according to physicians. The seriousness of this disorder necessitates an immediate increase in both classroom instruction and research into such medical topics. Three hours out of five thousand over the course of four years is a tiny fraction of a semester.

Ironically, medical schools in the past have also devoted little more than one hour of lecture time to diet, and yet patients are advised to discuss their diet with their primary care physician. As one person in healthcare told me, "How am I supposed to know about that?"

Throughout its existence, cluster headaches have lacked a sense of urgency in healthcare; however, this inattention needs to be addressed. In fact, people who suffer from these types of headaches can reach the point of suicide in order to obtain relief. Some patients have said, "I'd eat shoe polish if it helped relieve me of this horrible headache." Can you imagine such desperation when we live in a world of advanced healthcare, with artificial intelligence making incredible strides in diagnosis and treatment every day?

No matter the cause of a disorder’s fatality, the level of urgency must be increased immediately if a life is to be saved. Urgency is long overdue for this group of patients. Conditions will, hopefully, gradually improve as a result of increased awareness and education.

The Search for Treatment

In desperation, patients have given up in some cases on traditional medical interventions and sought treatment outside the norm, in psychedelic drugs.

To date, some of the usual traditional treatments include:

1. Oxygen. Breathing in pure oxygen through a mask provides relief for most who use it. People feel the effects of this safe treatment within 15 minutes.
2. 2. Triptans. Sumatriptan (Imitrex) is given as a shot when cluster headache symptoms start.
3. 3. Octreotide. Octreotide (Sandostatin), a shot of a version of the brain hormone somatostatin.
4. 4. Local anesthetics. The numbing effect of local anesthetics, such as lidocaine, might work against cluster headache pain.

Other treatments have also been tried, but there is no universal agreement on a single treatment approach for all individuals. However, medicine is a specialized field that deals with individuals, and differences are inherent to it. Therefore, it would not be wise to expect one treatment for all.

Some people who suffer from this condition have found relief by using magic mushrooms. Clusterbusters is a patient advocacy group that claims to offer both short-term comfort and, in rare instances, long-term symptom remission. The psychoactive component in magic mushrooms, psilocybin, does not necessarily need a full-blown trip to have its effects; in fact, it is usually enough to take low amounts of the compound multiple times. Please note that the inclusion of these substances in this article does not imply endorsement of their use; rather, it indicates that they have been found helpful for some individuals.

Fifty-three individuals with cluster headaches who had sought relief through the use of psilocybin or lysergic acid diethylamide (LSD) had varied responses in terms of their symptoms. Forty-two percent of those who took psilocybin said it stopped attacks; 25 of 48 who took psilocybin and seven percent of those who took LSD said it ended cluster periods; eighteen percent of the 19 who took psilocybin and four percent of those who took LSD said it lengthened remission periods.

This was a small sample, but hopefully, there will be larger clinical trials with these substances, and we will be able to determine if any psychedelics are helpful in some of the patients. We cannot dismiss the utility of these drugs, as they can be beneficial for a number of disorders. Stigma, too, must be addressed, and the need for psychedelics to be found acceptable as a new approach in medicine. Perhaps Dr. Timothy Leary of Harvard was right all along in his research, but the stigma was too ingrained for anyone to see the good in it.

For these patients, research must be approached robustly, because while pain may be intractable currently, the hope is that both the biology of the pain and effective treatments will be uncovered in research in the near future. Of course, healthcare also has a responsibility, not only in the research area, but also in the education of anyone who practices and may encounter patients with cluster headaches. Ignorance in the area is totally unacceptable.