The Hidden Link Between Headaches & Depression

A mother with a headache, two children fighting in the background( — If you suffer from migraines and depression, you are not alone. There is ongoing evidence of a significant link between severe headaches or migraines and depression.

Depression can often be caused by the unrelenting pain of severe headaches. Just knowing that a chronic disorder is disrupting your life, and that the painful headaches can return at any time, can result in depression. But even if the migraines haven’t upset you in this way, headache experts say that depression can be brought on as a physical byproduct of the same chemical imbalances in the brain that cause the headaches. Regardless of the root cause, if you are suffering from depression, see your doctor because this condition can be successfully treated.

“The average patient with migraines will not be depressed and should not be tagged this way,” says Seymour Diamond, MD, executive chairman of the National Headache Foundation and director of the Inpatient Headache Unit at Saint Joseph Hospital in Chicago. But those with chronic migraines easily become depressed.”

Headache and Depression: Research Finds the Combination

A study at Madigan Army Medical Center near Tacoma, Wash., showed that soldiers returning from combat service in Iraq who suffer from migraines are twice as likely to have symptoms of depression, anxiety, or post-traumatic stress disorder, compared with soldiers who do not have migraines.

That study looked at 3,621 soldiers within three months after their return from combat duty and found that 19 percent suffered migraine headaches. Half of those soldiers with migraines also had symptoms of depression. Those soldiers with the migraine-depression combination also had more frequent headaches, compared with those who had migraines alone.

Another new study, done in Germany, adds further evidence for the migraine-depression connection. Researchers from the University of Manitoba evaluated data from more than 4,000 adults. Of those, 11.7 percent reported migraines. This group also suffered from a variety of mood disorders, including depression. Although the researchers did not uncover a reason for the connection, it may be the first large study of its kind to verify the link.

Headache and Depression: Five Ways to Identify a Problem

The National Headache Foundation reports that people with headaches can develop psychological symptoms and that people with depression can also develop physical symptoms. But there are ways to identify headaches that are caused, at least in part, by underlying depression:

• A depressive-type headache tends to be worse in the morning and evening.
• Depressed people will sometimes say their headaches last for years or for their entire lives.
• Headaches occur at regular intervals of daily life, such as the weekends, holidays, or the first day of vacation.
• Headaches with depression usually have a steady, non-pulsing ache that feels like a band around the head or a vise-like grip.

Until recently, physicians had not always realized or treated this connection.

“It might be a good idea for the physician to work in conjunction with a psychotherapist,” Diamond says. “In these cases, I would prescribe a tricyclic antidepressant such as amitriptyline (Elavil). I would make the distinction that we’re not talking about the new antidepressants, known as selective serotonin reuptake inhibitors, such as escitalopram (Lexapro) or sertraline (Zoloft); they don’t work [for this type of headache]. I also use much smaller doses of the tricyclics than a psychiatrist would.”

Diamond said he can prescribe different tricyclics for people who have migraine, depression, and insomnia, versus those who do not, because about 70 percent of people who suffer from these combinations typically also have sleep disturbances.

It’s important to visit your doctor to have the headache-depression combination identified because therapies are available to help to break this cycle. If your primary care doctor cannot help treat both problems, contact a headache specialist or neurologist, because they may have the more experience in successfully treating the headache-depression connection.

Managing Headache Pain

young man in pain( — Headache pain is so common that it seems to be a natural, though unpleasant, part of daily life. It’s the most typical reason for doctor appointments, yet there’s nothing typical about a headache. The source of pain can vary from headache to headache. Attacks by bacteria, viruses, and hormones can all unbalance the body and trigger headache pain.

Here are some tips on how to deal with headaches:

Take pain relief medication at the first sign of a headache. Hoping it just goes away is not the answer, especially if your headache is a migraine. According to a report by the National Headache Foundation, the addition of caffeine as an ingredient in over-the-counter headache medications containing aspirin and acetaminophen improves their ability to relieve pain by 40 percent. Consider this headache-fighting combo when you need faster, more effective relief.

Drink plenty of water with your headache medicine. Dehydration can cause a headache long before you ever feel thirsty. Air conditioning in the summer and certain types of heat in the winter can dry out your office atmosphere, too, adding to the problem. Keep sipping water.

Take a break from all stressors. Spend a few minutes away from the computer screen, the intense concentration, the ringing phone — all the sensory stimuli that brought on or can worsen your headache. Give your medication time to work before you resume your activities. Pull down the shades or dim the lights for a few minutes to block out distractions.

Here are easy ways to remove or reduce headache triggers:

Get stress under control. Learning how to minimize stress is key to headache prevention. Prioritize responsibilities to gain a sense of control. When your tasks make it impossible to reduce stress, at least take a break from it. Exercise is one way to release stress and tension.

Keep track of headache triggers. Keep a diary to uncover what triggers your headaches, like bright lights, sunlight, loud noises, and certain scents — anything from strong perfume to smoke and cleaning chemicals. Then try to find ways to avoid them, like wearing earplugs or noise-reducing headphones.

Cut down on the glare. If bright fluorescent lights and your flickering computer screen bother you, consider wearing lightly tinted glasses or using a lamp rather than the overhead lights. Get an anti-glare screen for your computer.