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In the spirit of "the Lord helps those who help themselves", citizen science and understanding the transitional turmoil society is wrestling with these days its hard to do anything "unconventional" with traditional medical support as many who hold licenses are reluctant or not open minded enough to paint outside the lines. When treating individuals who come to a medical provider there is an obligation to follow the rules, protocols and standard of care. While this behavior is most common much latitude exists when addressing uncommon or unclear issues. The problem remains there is no real strong "proof" or data to support many treatment pathways. Experience, individual response and "because that was how I was taught" often color health care delivery. Point being, when addressing difficult to treat, poorly understood problems with unsatisfactory treatments like CH I submit there is plenty of room to explore options on an individual basis while ascribing to the overriding tenant "first do no harm". This philosophy allows exploration of things like psychedelics, vitamin supplementations, diet, nerve stimulation, o2 etc.. Most of these (and other) interventions started from individual case reports, speculation, dream states, desperation, deduction and reasoning. Proof of course proves elusive as the standard of acknowledging an effective intervention requires a control group or some fancy statistical manipulations. This is important info to have to make widespread recommendations but for individual choice the bar is much lower. The point of the blabbering is to suggest gut microbiome issues, diet and physiologic state and even other peculiar interventions are worth exploring when help remains elusive. Proposing ideas, reporting outcomes and supporting each other becomes critical. The horrors of CH are only know to those who suffer them. There is no way to express the pain, destruction of life goals, isolation and despair CH brings. One way to combat this is to feel free to evaluate treatment option no matter how far fetched. And then discuss.

An Exploration of the Psychological Aspects of Cluster Headache Helena Whitley Published by University of East Anglia on October 30, 2025 Link: https://ueaeprints.uea.ac.uk/id/eprint/100852 Abstract: Cluster Headache (CH) is cited as one of the most painful experiences known to humankind. This thesis portfolio aimed to provide a greater insight into the psychological aspects of CH. A systematic review accumulated evidence of rates of depression and suicidality in individuals living with CH and an empirical paper explored the psychological experience of living with CH. A systematic review and meta-analysis was conducted to determine rates of depression and suicidality amongst individuals with CH compared to non-headache controls and individuals with other primary headache conditions (Migraine or Tension-Type Headache (TTH)). Secondly, 13 interviews were conducted with individuals living with CH and this data was analysed using Reflexive Thematic Analysis. Meta-analyses of 20 studies showed that compared to non-headache controls, adults with CH had much higher levels of depression and suicidality. However, there was no significant difference in depression levels between CH and Migraine individuals. Comparing individuals with CH and TTH, the initial meta-analysis found no significant difference in depression levels, but a sensitivity analysis showed TTH individuals having higher levels of depression. Considerable heterogeneity and publication bias were present. Reflective Thematic Analysis identified five themes relevant to the CH experience: “Darkness”, “Battling”, “Shifting”, “Control”, and “Despair”. There were differences within these themes based on whether a person was in the moment of pain or between attacks, whether they had the chronic or episodic form of CH, and how long they had lived with CH. This portfolio highlighted that psychological aspects of CH include increased depression and suicidality. Increased depression was also present for the other primary headache disorders. The empirical paper identified various psychological processes important in the experience of CH which could be the target of psychological treatment. Transcription.m4a