There is a strong association between depression and headaches, particularly migraine headaches. In fact, depression tops the list of co-existing conditions linked to migraines. The exact mechanism for this overlap is still unclear, although many experts believe the disorders share some biology.
Mounting Evidence
Researchers have been accumulating evidence supporting a link between headaches and depression. A 1964 study, for example, found chronic headaches that don't respond to common analgesic drugs, such as aspirin, were major symptoms in patients with depressive reactions. In 2001, another study found that migraine sufferers had a three times greater lifetime risk of developing depression.
Chronic morning headaches, in particular, are associated with depression. About 1 out of 13 people in the general population say they have morning headaches. In a 2004 study, researchers reported that more than three-quarters of cases of recurrent morning headaches were related to an identifiable organic mental or sleep disorder.
One thing is clear: the association between headaches and depression goes both ways. In a large study in France, of the 50 percent of subjects with current migraines, 28 percent also had anxiety, 3.5 percent had depression, and 19 percent suffered from both depression and anxiety.
Headaches, Depression, and Women
Women are much more likely to have migraines than men (18 percent versus 6 percent, respectively). Unfortunately, women with chronic migraine headaches (more than 15 per month) have a four-fold increased risk of depression. They're also three times more likely to report a high degree of headache-related symptoms, including fatigue, insomnia, nausea, dizziness, pain, or problems during sexual intercourse. Among patients diagnosed with severely disabling migraines, the likelihood of major depression increased 32 times if patients also reported other severe physical symptoms.
The most recent evidence comes from an early 2012 analysis of data from the Women's Health Study. The study included more than 36,000 women who had no history of depression at the start of the study. An average of 18 percent reported having some history with migraines. After 14 years, 11 percent reported having a depression diagnosis from a physician. Participants with a history of migraines (whether recent or in the past) were 1.36 greater more likely to develop depression compared to women without migraines. Although this study had some limitations, the large number of participants and length of follow up seem to confirm findings from earlier studies.
If you have chronic headaches, your physician may want to screen you for depression. Treating one disorder generally helps alleviate the other.
Sources:
Anderson, Pauline. "Migraine Linked to Risk for Future Depression." Medscape Medical News. Web. 29 February 2012. http://www.medscape.com/viewarticle/759410
McClure Morris, Charlene, PA-C. "How Should I Manage a Patient With Both Migraine Headache and Depression?" Medscape Medical News. Web. 8 May 2001. http://www.medscape.com/viewarticle/413599
Barclay, Laurie, MD. "Morning Headache Common in Depression, Anxiety Disorders." Medscape Medical News. Web. 12 January 2004. http://www.medscape.com/viewarticle/467092
Maizels, Morris, MD. "Clonazepam for Refractory Headache: Three Cases Illustrative of Benefit and Risk." Headache 50(4) (2010): 650-656. Medscape Medical News. Web. 7 May 2010. http://www.medscape.com/viewarticle/720689
Cassels, Caroline. "Migraine Linked to Greater Risk for Major Depression, Chronic Physical Symptoms." Medscape Medical News. Web. 8 January 2007. http://www.medscape.com/viewarticle/550474
Mayo Clinic. "Headaches." Web.
http://mayoresearch.mayo.edu/mayo/research/neurology/headaches.cfm
