A number of factors may contribute to the development or the severity of a headache disorder as well as the response to treatment of headache disorders. If these problems are not identified and addressed it can be extremely difficult to manage a headache disorder. These include unrecognized and untreated problems around depression, anxiety, stress, difficulty in dealing hostile feelings, poor sleep, substance abuse (tobacco, alcohol and illicit drugs), excessive use of over the counter analgesics, lack of exercise, poor posture, etc.