Depression and Anxiety in People With Cluster Headaches

Is there a link between psychiatric disease and cluster headaches?

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A cluster headache attack is a severely painful and debilitating headache that is one-sided and occurs around the eye or temple. These suicide headaches are more common in men but are still quite rare.

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 — let's take a look.

Studies Linking Depression and Anxiety to Cluster Headaches

In one study in Neurology, of 21 patients with episodic cluster headaches, 23.8% 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, of 160 patients with depression, 1 percent also suffered from cluster headaches — this is higher than the number of individuals with cluster headaches in the general adult population – which is approximately 0.4 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 were also linked to chronic cluster headaches (CCH) and may be higher compared to those with episodic cluster headache. In a study in the Journal of Neurology, Neurosurgery, & Psychiatry of 107 patients with CCH, 75 percent were diagnosed with an anxiety disorder and 43 percent with depression.

Disputing Study Linking Depression and Anxiety to Cluster Headaches

That all being said, a 2012 pilot study in Headache 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, the scales used assessed for symptoms within the last 2 weeks, whereas other studies – as mentioned above – recorded for much longer periods of time.

Interestingly, the above 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.

What Does This All Mean for Me If I Have Cluster Headaches?

If you suffer from cluster headaches and are experiencing symptoms of depression and/or anxiety, please speak with your doctor. Right now we don't understand the precise association between psychiatric disease and cluster headaches. Future studies will hopefully help elucidate this. Regardless, please know that you are not alone. Do not suffer in silence. Be proactive and take charge of your health.


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Article Sources
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  • Liang JF, et al. Cluster headache is associated with an increased risk of depression: a nationwide population-based cohort study. Cephalalgia. 2013 Feb;33(3):182-9.