Brain & Nervous System Headaches Causes & Risk Factors The Link Between Headaches and Depression By Colleen Doherty, MD Colleen Doherty, MD, is a board-certified internist living with multiple sclerosis. Learn about our editorial process Colleen Doherty, MD Medically reviewed by Medically reviewed by Claudia Chaves, MD on July 03, 2020 Claudia Chaves, MD, is board-certified in cerebrovascular disease and neurology with a subspecialty certification in vascular neurology. She is an associate professor of neurology at Tufts Medical School and medical director of the Lahey Clinic Multiple Sclerosis Center in Lexington, Massachusetts. Learn about our Medical Review Board Claudia Chaves, MD on July 03, 2020 Print You are not alone if you suffer from both depression and a headache disorder. One could be triggering the other, or you could just happen to be enduring two complex and painful medical conditions at the same time. It's often tricky to tease apart—even scientists are scratching their heads over the precise link. Tom Merton / OJO Images / Getty Images Why Headaches Can Be Associated With Depression Sometimes, individuals do not complain to their doctor or loved ones about "feeling sad or down." They may, instead, complain about physical ailments. These ailments, of course, warrant investigation but, if normal, may be indicative of a mood alteration. Just as a headache disorder, especially a chronic one, can trigger depression or another mood disorder—depression can trigger headaches. It's like the chicken and egg theory and can be puzzling for doctors to tease out. Remember, even if the depression is the root cause for a person's headache, their head pain is still very real. Often times, too, the connection between depression and headaches is not causal—instead, depression contributes to the headache disorder or vice versa. So a person may notice that depression makes their headaches more severe or occur more frequently. Keep in mind, besides a headache, there are other somatic (bodily) complaints you can experience with depression: Pain (neck, back, abdominal)Joint aches and painsConstipationWeakness Definition of Major Depression Disorder According to the Diagnostic and Statistical Manual of Mental Disorders, the criteria for Major Depressive Disorder (MDD) are the following: Depressed mood or loss of pleasure/interest in daily activities for more than two weeks plus at least five out of nine symptoms below, present nearly every day. Depressed or irritable mood most of the day, nearly every day, as indicated by either subjective report (e.g. feels sad or empty) or observation made by others (e.g. appearing tearful)Decreased interest or pleasure in activities once enjoyedEating too little or too much, which may lead to unintended weight gain or lossChange in sleep (insomnia or hypersomnia)Change in activity (psychomotor agitation or psychomotor retardation)Fatigue or loss of energyFeelings of worthlessness or excessive or inappropriate guiltDiminished ability to think or concentrate, or more indecisivenessThoughts of death or suicide, or has a suicide plan Diagnosing Depression The next time you go for your physical examination, do not be surprised if your doctor screens you for depression, especially if you have a history of a chronic pain condition, like migraines or cluster headaches. The Patient Health Questionnaire-9 (PHQ-9) is one of the most common tools used to screen for depression. For elderly patients, doctors commonly use the 15-item Geriatric Depression Scale. Differential Diagnosis of Depression When considering depression, your doctor may also screen you for other psychiatric diagnoses that can mimic or coexist with Major Depressive Disorder. Some of these diagnoses include: Generalized anxiety disorderBipolar disorderDysthymic disorderSchizoaffective disorderSchizophreniaBereavement Your doctor may also test you for these medical conditions that mimic symptoms of depression like: HypothyroidismAnemiaVitamin B12 deficiencyFibromyalgiaLiver or kidney diseaseHigh calcium Treatment of Depression The treatment of depression often entails a combination of medication and "talk therapy," for a period of at least six months.While traditional antidepressants, like a selective serotonin reuptake inhibitor (SSRI), may be prescribed, your doctor may also consider a drug like Cymbalta (duloxetine), which is an antidepressant that is used to treat pain conditions. In addition to medication and "talk therapy," there are lifestyle behaviors that you can adopt to help your depression, such as: Regular exerciseEating regular, nutritious mealsSeeking out support and comfort from family or friendsGetting a good night sleep every night and maintaining a regular sleep schedule, even on the weekendsAvoiding alcohol, which is a depressant A Word From Verywell If you think your headaches could be a sign of depression, or if your headaches are triggering sad thoughts, please seek the guidance of your primary care provider, neurologist, or psychiatrist. You are not alone. Be proactive in your healthcare and well-being. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources 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. Dindo LN, Recober A, Haddad R, Calarge CA. Comorbidity of Migraine, Major Depressive Disorder, and Generalized Anxiety Disorder in Adolescents and Young Adults. Int J Behav Med. 2017;24(4):528-534. doi:10.1007/s12529-016-9620-5 Khan A, Faucett J, Lichtenberg P, Kirsch I, Brown WA. A systematic review of comparative efficacy of treatments and controls for depression. PLoS ONE. 2012;7(7):e41778. doi:10.1371/journal.pone.0041778 Additional Reading Patient Health Questionnaire Screeners. American Psychiatric Association. What Is Depression? Wei CB, Jia JP, Wang F, Zhou AH, Zuo XM, Chu CB. Overlap between Headache, Depression, and Anxiety in General Neurological Clinics: A Cross-sectional Study. Chin Med J. 2016;129(12):1394-9. doi:10.4103/0366-6999.183410