Woman in whom #migraine #headaches were triggered by financial dependence on husband

1. 35-year old Mahima- "Dr, my husband locks entire cash in a safe and takes the keys to office. I have no back account, so can't use UPI on mobile. I can't even buy a chocolate for my son."
2. Mahima had been consulting me for three months for frequent headaches, which were suggestive of migraine.
She was properly following my prescription, however, she still used to get 2-3 episodes of #headache every week.
I enquired with her about possible #stressors.
3. She had no interpersonal issues with in-laws or other family members and had no problems in marital life.
She was a housewife and had no source of income. She was dependent on husband for every expense, including buying small gifts for her son and even for emergency expenses.
4. The fact that her friends could spend on their own will, but she needed approval from her husband for spending every rupee- caused her a lot of emotional stress & mental agony. In addition to headaches, her sleep was also disturbed.
I knew, further medicines won't help her.
5. I needed to go beyond my professional duties & asked for review with her husband.
I conveyed to her husband that for migraine treatment to be successful, she needs to control stressors (in addition to taking medicines).
Financial dependence on him was the stressor in her.
6. He patiently listened to me and was somehow convinced that his wife needed financial independence.
A month later, they returned for follow up.
Mahima now had a bank account and could use her mobile for financial transactions.
She had no further episodes of headaches.
7. Financial dependence on husband or other family members is common among Indian women, including working women.
Several women have little idea of banking & investments and depend on their husbands for the same.
Financial dependence reduces self-esteem and can cause stress.
8. Take home message
*In women with refractory migraine or tension-type headache, we should enquire about financial dependence.
*A small session of counselling with the husband can help in significant relief from migraine headaches.
#MedTwitter #NeuroTwitter
#Financial #stress is associated with #migraine.

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