Depression and Headache

By: Brooklyn A. Bradley, BS; Medically edited by Dr. Deena Kuruvilla, MD

Past research has shown that many individuals who have a mental health diagnosis also experience headaches or migraine [1,2]. Living with a headache disorder can trigger depression or other mood disorders, as it may affect the individual’s quality of life. On the other hand, depression also has the capacity to trigger a headache [1]. Mental illness can influence the way you feel pain, especially during headaches and migraine attacks. In today’s blog post, we investigate the potential link between depression and migraine.

Depression affects as many as 40 percent of people living with migraine [3]. Some physical symptoms of depression include fatigue, loss of appetite, and sleep disturbances. Loss of interest or pleasure in routine activities is a core feature of a major depressive episode [4]. Tension headache has been linked to depression and anxiety and is a common headache disorder worldwide. We also know that over 50% of people with migraine, experience anxiety. [1]. Tension-type headache is the most common type of headache disorder worldwide, and can cause head pain, irritability, trouble sleeping, and fatigue [5].

A 2009 study investigating the association between physician-diagnosed migraine and mental health disorders found that migraine was significantly associated with depression, dysthymia, bipolar disorder, panic attacks, panic disorder, agoraphobia, and phobias [6]. In addition, this study reported that 11 percent of people with mental health disorders had migraine attacks that preceded them. These disorders include depression, bipolar disorder, and anxiety disorders [6]. The Anxiety and Depression Association of American (ADAA) also found that there are up to 40 percent of people living with migraine who also experience depression [7].

Treating depression and headache may involve a multifaceted approach depending on the individual. Medications can be used to treat both depression and the specific headache disorder you have been diagnosed with. These medications include tricyclic antidepressants (TCA, i.e.,  amitriptyline) and selective serotonin reuptake inhibitors (SSRI; i.e., sertraline) [1]. Further, Botox injections are a treatment option if prescription drugs are not well-tolerated [7]. It is important to note that treating migraine first may help alleviate depression symptoms. Psychotherapy, a widely used method for depression and anxiety disorders, focuses on modifying thoughts, behaviors, and responses to situations. This technique can mitigate the depressive symptoms long term [7]. Lastly, lifestyle habits can contribute to underlying depression which may be influencing your headache frequency or duration. Diet, exercise, stress management, and complementary treatments (i.e., acupuncture, yoga, massage)  can be important preventive options. For example, following a meal plan that highlights whole foods and strays away from processed ingredients can help fuel your brain and improve overall mood [7].

It is important to discuss all therapeutic options with your headache specialist and care team. In addition, understanding the causes and symptoms of depression experienced concurrently with a headache disorder will help identify effective treatment and preventive measures.

We look forward to helping you at the Westport Headache Institute! – Dr. K

 

References:

  1. Doherty C What Mental Illnesses May Be Connected to Headaches? In: Verywell Health. https://www.verywellhealth.com/mental-health-and-headaches-1719631. Accessed 6 Jun 2023
  2. Antonaci F, Nappi G, Galli F, et al (2011) Migraine and psychiatric comorbidity: a review of clinical findings. J Headache Pain 12:115–125. https://doi.org/10.1007/s10194-010-0282-4
  3. The Migraine and Depression Link: How to Manage Both Conditions at the Same Time. In: MigraineAgain.com. https://www.migraineagain.com/migraine-depression-link-are-you-at-risk/. Accessed 6 Jun 2023
  4. Kennedy SH (2008) Core symptoms of major depressive disorder: relevance to diagnosis and treatment. Dialogues Clin Neurosci 10:271–277
  5. Tension Headaches Are a Common Headache Type. In: Verywell Health. https://www.verywellhealth.com/facts-about-tension-headaches-1719554. Accessed 6 Jun 2023
  6. Ratcliffe GE, Enns MW, Jacobi F, et al (2009) The relationship between migraine and mental disorders in a population-based sample. General Hospital Psychiatry 31:14–19. https://doi.org/10.1016/j.genhosppsych.2008.09.006
  7. (2019) Depression Headaches: Causes, Symptoms, and Treatments. In: Healthline. https://www.healthline.com/health/headache/depression-headaches. Accessed 6 Jun 2023
Published On: June 16th, 2023