The cause of MOH is unclear, but there are several factors that seem to contribute, including psychological comorbidities such as anxiety and depression, a personal or family history of substance abuse, gender (women are more susceptible than men), and possibly abnormalities in certain neurotransmitters and hormones. Most MOH sufferers improve after discontinuing the medication they were overusing, and return to a condition where they will respond to the drugs when used in the future, but there is a relatively high rate of relapse, particularly in the first year after withdrawal. Keeping a medication and symptom diary can be helpful.