By Howard LeWine, M.D.
Ask the Harvard Experts
Q: Is there a link between depression and headaches?
A: Yes, they are connected. People with depression tend to have more frequent and more severe headaches compared to those without depression. And as headaches occur more often and become more intense, it’s likely that the person will become more depressed.
Of all headaches, migraine headaches have been most frequently studied. Many researchers have observed a close relationship between migraines and depression. For example, in people who have a clear diagnosis of migraine headaches, when compared to a control group, their frequency of major depression is almost triple. The reverse is also true, that people with depression are more likely than non-depressed people to experience migraine.
It might help to review the classic description of a migraine headache, because people sometimes use the word migraine to describe any very bad headache. But not all severe headaches are migraines.
The classic migraine headache is often preceded by symptoms that warn the person that the head pain is on its way. The warning symptoms can include an aura. This may be a visual or auditory experience, such as flashing lights or musical tones. This is followed by throbbing pain on one side of the head.
The headache may last from a few hours up to as much as three days. Physical activity makes the pain worse. People often feel sick to their stomachs. Light or sounds can be intolerable. This is why many people lie down in a dark, silent room when they get a migraine attack.
However, migraine headaches can often be tricky to diagnose because the symptoms may not be the typical ones.
Many experts believe that depression and migraine headaches have common biological or genetic roots. That is, the same biological factors that make some people vulnerable to depression can also make them vulnerable to migraine.
This association led to the discovery that antidepressant medication is useful in decreasing the frequency and intensity of migraine headaches.
(Howard LeWine, M.D. is an internist at Brigham and Women’s Hospital in Boston and assistant professor at Harvard Medical School. For additional consumer health information, please visit www.health.harvard.edu.)