Depression and Anxiety in People With Cluster Headaches

Is there a link between psychiatric disease and cluster headaches?

A cluster headache attack is a severely painful and debilitating headache that is one-sided and occurs around the eye or temple. While more common in men, they're still quite rare, affecting less than one percent of the population.

With the intense pain that people with a cluster headache endure, it's not surprising that many of them also suffer from depression and anxiety. There is some research to support this linkage.

man with headache laying down
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Research Supporting the Link

In one study in Neurology, out of 21 patients with episodic cluster headaches, 23.8 percent had an anxiety disorder—9.5 percent with panic disorder and 14 percent with generalized anxiety disorder.

In another study in the Journal of Affective Disorders, out of 160 patients with depression, 1 percent also suffered from cluster headaches. This is a higher concentration than the number of individuals with cluster headaches in the general adult population, which is between 0.1 and 0.3 percent.

A much larger number of patients was examined in a study in Cephalalgia: over 600 patients with cluster headaches from the Taiwan National Health Insurance database. Results revealed an increased risk for depression in patients with a cluster headache, similar to that of a migraine.

Depression and anxiety may be higher in patients with chronic cluster headaches compared to those with episodic cluster headache. In a study published in the Journal of Neurology, Neurosurgery, & Psychiatry, out of 107 patients with chronic cluster headaches, 75 percent were diagnosed with an anxiety disorder and 43 percent with depression.

Disputing the Link

A 2012 Headache pilot study of 49 patients with cluster headaches—both episodic and chronic—revealed lower rates of depression and anxiety. Why the discrepancy? The authors suggest that it could be the tools used to assess depression and anxiety. In this Headache study, symptoms were assessed within the last 2 weeks, whereas other studies recorded for much longer periods of time.

Interestingly, the study in Headache did find that if someone with a cluster headache were to suffer from depression, they were also likely to have anxiety and vice versa. In addition, those who were depressed or anxious were more likely to have nausea and other prodromal symptoms during cluster attacks.

A Word From Verywell

If you suffer from cluster headaches and are experiencing symptoms of depression and/or anxiety, please speak with your healthcare provider. While the precise association between psychiatric disease and cluster headaches is not understood, future studies will hopefully help elucidate this. Do not suffer in silence. Be proactive and take charge of your health.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Colleen Doherty, MD
 Colleen Doherty, MD, is a board-certified internist living with multiple sclerosis.