Depression and Headaches: Understanding the Connection

There is more than one type of headache associated with depression, so it’s difficult to clearly define the headache-depression relationship.

The two most common types that co-occur with depression are:

• migraine: can cause difficulties for you in day-to-day functioning
• tension headache: linked to stiff and tense muscles, which are common with anxiety

Migraine, for example, is a primary headache, whereas a headache that’s caused by a sinus infection is secondary.

The results of a small 2018 study found that migraine and depression often occur together.

The connection was strong enough that researchers recommended doctors screen for depression when treating migraine.

The relationship between headaches and depression, in particular migraine, may also be connected to stress and anxiety.

An older 2013 study found that people with psychological distress, like depression and anxiety, had more noticeable physical symptoms, including headaches.

That evidence was further supported in a 2014 study, which found that the combination of anxiety and depression was associated with more frequent headaches.

A 2017 study conducted among twins explored the potential for genetic factors behind depression and migraine.

The results indicated that certain genetic factors did seem to predispose some people to both depression and migraine. This study supports anecdotal evidence that, at least in part, there’s a genetic component at work.

Consequently, if someone in your family also has had depression or migraine, there’s a chance that you, too, could experience these conditions.

Depression also increases the risk of developing frequent tension headaches.

But the connection between depression and tension headaches are weaker than between depression and migraine, according to a cross-sectional survey of 6,624 participants from the EU.

You may also be at more risk for chronic headaches (versus episodic) if you have depression, according to a 2016 Austrian study.

Can depression cause headaches, and can headaches cause depression? That’s what many people with both conditions want to know. There’s no universal answer, but in general, yes and yes.

As several of the previously mentioned studies found, depression, especially when both depression and anxiety are present, can increase the likelihood of headaches.

There isn’t a definitive cause for migraine, but tension headaches may be caused by the following:

• diet
• sleep problems
• medications
• pain

The pain can be debilitating to the point that it interferes with everyday life, which can lead to depression.

A tension headache related to depression is typically:

• non-pulsating
• mild to moderate on an intensity scale
• dull and pressing
• usually on both sides of the head

Migraine headaches are more severe and can have symptoms that include:

• pain lasting 4 to 72 hours
• stabbing or pulsating pain
• light sensitivity
• sound sensitivity
• difficulty thinking or concentrating
• blurred vision
• an aura

Getting a diagnosis from your physician is the first step to receiving treatment. They can help diagnose whether you’re experiencing a primary or secondary headache disorder.

In order to do this, a licensed professional may need to perform a neurological exam, use magnetic resonance imaging (MRI) to view detailed images of your brain, and request lab tests.

But you can’t treat one, the headache or the depression, without considering the other. Treatment options to consider include:

• medication to reduce depressive symptoms
• over-the-counter (OTC) pain relievers
• migraine prevention medications
• migraine rescue medications
• relaxation training, such as mindfulness meditation
• psychotherapy, including behavioral therapy
• developing coping strategies for stress and depressive symptoms
• regular exercise
• healthy diet
• adequate sleep

Be careful of taking too many OTC pain medications for headaches. Your body can experience medication overuse headaches in response to a lack of medication in your system.

If you experience migraine, consider preventive treatment strategies which include antidepressant medications, such as nortriptyline and venlafaxine.

Both depressive and headache symptoms respond to how you interact with your environment and your behaviors.

Behaviors that improve your physical health can also boost your mental health and reduce the chances of headaches. These behaviors include:

• adequate sleep (at least 7 hours)
• a healthy diet that includes fruits, vegetables, and healthy proteins and fats
• regular meals and snack
• regular exercise
• healthy stress management and coping skills

It’s time to seek professional help when either the headache or the depressive symptoms interfere with your ability to function on a day-to-day basis.

Consider whether or not the symptoms are worsening and how much OTC medication you’re taking to manage your symptoms.

If you’re taking OTC medications more often than not, you may need to consult a doctor to find alternative options.

Depression can lead to headache disorders, and those with chronic headaches may develop depressive symptoms. If symptoms of headaches or depression are interfering with your everyday life, talk with your doctor.

There could be a mix of treatment options that could help, from medication and therapy to a change in diet or increased exercise.

Rest assured that there are many treatments available. It’s a matter of finding the combination that works for you.