Dealing With Depression and Headaches
Depression is synonymous with lower moods, poor sleep, poor diet, lower energy, lower motivation and feelings of hopelessness. These symptoms of depression are often talked about, but depression also brings with it a range of somatic issues. Somatic issues are symptoms felt in your body. They are often experienced as pain, numbness or tingling.
Despite misconceptions, psychosomatic symptoms are not fake or imaginary. The source of the discomfort is psychological rather than physical, but these are real feelings of real pain.
Can Depression Cause Headaches?
The relationship between depression and headaches is bidirectional, meaning that more headaches trigger increased depression and increased depression triggers more headaches. Studies show that people with major depression are 40% more likely to experience migraines and frequent headaches. Additionally, people with migraine are 80% more likely to have major depression.
This relationship poses a challenge to the sufferer and the treatment provider, since both depression and migraines must be addressed concurrently. If treatment only targets one, the chance of both improving is smaller.
Medication Options
Many of the top treatment options begin with an effective medication regimen. Identifying and understanding the comorbidity of depression and headaches/migraines is essential to finding the best treatment. Some medication options include:
- Selective Serotonin Reuptake Inhibitors (SSRIs). These are some of the most commonly used antidepressant drugs. SSRIs work by flooding your brain with more serotonin which typically improves symptoms of depression. Oddly, when depression is accompanied by headaches, these medications are less effective.
- Serotonin Norepinephrine Reuptake Inhibitors (SNRIs). This is another group of antidepressants that work to add norepinephrine as well as serotonin into your brain. As with SSRIs, SNRIs have poor results in patients with depression and headaches.
- Tricyclics. For the best results for people with depression and migraine/headaches, you have to look back to 50-year-old medications. The tricyclics are an older generation of antidepressants. Symptoms tend to respond at a quicker rate and at lower doses than with other medications. Tricyclics are generic medications so some prescribers may lack knowledge of them and their efficacy.
- Monoamine Oxidase Inhibitors (MAOIs). This is another older type of medication that is no longer prescribed at a high rate. Low usage is mostly due to higher risks of side effects, but for patients that are knowledgeable and careful with their treatment; these may be a good option.
Others Options to Help Cope With Depression and Headaches
If medications are already in place, or you find little success with medications, trying another set of treatment choices could be a good fit. Here are some awesome options that will manage depression and migraine simultaneously:
Psychotherapy
You already know that therapy is an obvious choice for depression, but experts now recommend that migraine patients seek screening for mental health conditions. A therapist can help you monitor your symptoms and develop effective coping skills. Therapy can also help you understand how your thoughts and feelings affect migraines and your depression. With this information, you can change your response to the pain.
As always, having realistic expectations going into therapy is important. Therapy will not end migraines but it can improve your symptoms and overall well-being. Studies have shown cognitive behavioral therapy works best in conjunction with the interventions below.
Biofeedback
In biofeedback, you are connected to equipment that monitors your physical state. The health care professional teaches you how to recognize and modify your response including heart rate, muscle tension, and breathing pace. Researchers have found that this technique lowers migraine frequency.
Relaxation
Finding a relaxation technique or a series of techniques that works for you can provide great benefit for depression and anxiety. Relaxation can help prevent migraines by lowering your overall stress.
Migraine patients also report that relaxation, along with a cold compress, reduces the intensity and duration of attacks. Deep breathing, guided imagery, autogenic training and progressive muscle relaxation are some of the most useful techniques. Experiment to find the one that works best for you depending on your symptoms.
Lifestyle Changes to Help With Depression and Headaches
Beyond professional treatments, changing your habits and behaviors in your life can lead to symptom relief.
- Limit medications with estrogen. Women are more likely than men to have migraines and depression. Some believe the difference is hormonal. Consult with your doctor about the impact of any medications on your migraines and moods.
- Eat better. This not only means eating better quality food but eating more regularly as well. You may know that avoiding certain foods can help you avoid an attack. You may not know, though, that eating regularly helps avoid low blood sugar, which triggers migraines, depression and anxiety. Know your food triggers and what you are putting into your body.
- Exercise. As mentioned above, interventions that help your physical health also improve your mental health. Exercise is the best example. While you cannot jog while you have a migraine, a walking program will serve well as prevention.
Take Advantage of Good Days
Even people who suffer from severe depression and migraines have some good days. It is what you do on those days that impact the bad days. Follow these tips to make the good days better.
Be Active
After a tough week at work or a bad day with migraines, people too often head for the couch in the name of relaxation. Small amounts of resting in a comfortable spot are helpful for anyone but too much wastes precious hours of a day without symptoms. Watching TV is more of a neutral experience rather than a positive one.
List, explore and engage in familiar positive experiences. Resist the urge to “rest" at home. Being active actually boosts energy and stamina. Too much sitting will leave you feeling drained and sluggish.
Try New Things
Having a migraine means that you are stuck staring at the same walls and laying on the same bed or couch. Good days are the time to break out of that comfort zone and try new things. Be adventurous. Don’t let your depression trick you into staying close to home.
Have a safety plan in place for times when a migraine surprises you. Otherwise, be bold and daring. The positive impact on mood, self-esteem and anxiety will provide an incentive to do it again.
Accomplish Goals
Has there been something that you have been unable to complete because of recent depression and migraines? As long as it is positive, do it now.
Run errands, clean the bathroom or pay your bills. Doing these will lead to a strong sense of accomplishment. However, if the choice is clean the toilet or go on a hike with friends, choose the hike 99% of the time.
Be Social
Migraines often force you into canceling on friends, while depression encourages isolation. You have to break plans when a flare comes unexpectedly.
Use your next good day to be a fantastic friend, spouse or family member. Reconnect with loved ones.
If you are feeling resentful or feeling that someone “has not been there" during your illness, use this opportunity to assertively clear the air and avoid future misunderstandings.
Don’t Have Too Much Fun
Some fun is good, but more is not necessarily better. By now, you know your migraine triggers and the effects that alcohol and poor sleep have on your mood. Be sensible with your fun so you can have more of it.
Conclusion
Because of the level of interconnectedness, treating depression and headaches or migraines together is unlike treating one individually. Work to gain awareness and education about your symptoms while understanding how they impact each other. Speak openly with your prescriber to find the medication choice that is the best fit for you.
With the medication under control, work on your well-being by investing in therapy, improving physical health and making the most of your symptoms-free days.