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...hi mr w, ...stress or coming OFF of stress are CH triggers for many. during an ECH cycle, coming off any significant stressful situation was almost a guaranteed hit for me....staying stressed was (tho less so) preventive. my speculation that it's changes in hormonal (cortisol?) or other physiological systems. CH hits or cycle never seemed connected to my pscyhological well being..... no matter what that was.... .....CH changes...it just does...not necessarily indicative of any significant health changes. one thing it is NOT is a psychological illness....ya can't think it away...have never seen any reports or literature reporting so. just "well meaning" folks who tell us "it's all in your head".... .....i stopped years ago trying to explain my CH to anyone beyond: "REALLY bad, disabling headaches"....anything more and eyes glazed over. how to describe the indescribable is above my pay grade.... best jonathan

I agree with @jon019. In the past when I was young, stress was a full time part of my life and the headaches seemed to be occasional and manageable. Once I worked my way into a quieter less stressful situation the headaches seemed to escalate. Psychological stress seems to make the demon less effective while physiologic stress raises all sorts of hell. (My experience) You will never ever be able to relate the pain and related issues to anyone in a understandable way. There is just no way to do it. Watching a video like the National Geographic piece featuring Dan shows the horror of an attack but most people don’t believe it. Dan is a wonderful human but no one is that good of an actor., It’s on YouTube search National Geographic and psilocybin. Because no one can really understand the unfair hand you have been dealt going to a meeting like Clusterbusters holds is an amazing experience. You are in a room of folks with whom you don’t have to explain a damn thing. Everyone understands so you can discuss coping, treatments and support without having to do any foundational talking. The meeting is in Chicago this year. Come if you can its much more effective than any therapy session.

Hello Mr Watts, So good that you have found this forum, too bad that you’re now part of the family. I live in the Netherlands too and there are a couple of things you can consider already. Get a prescription for verapamil as a preventive as long as you do not have O2. O2 is the safest and quickest abortive, but also get some Sumatriptan as an abortive if O2 is not working anymore or the attack is just too severe. If I were you I would change to another neurologist. Mine is Dr. Couturier of the Boerhaave Clinic in Amsterdam who is an expert in this field of CH in the Netherlands. He has helped me tremendously and will prescribe O2 immediately as well as the meds you are going to need. All the best!