The Link Between Mental Illness and Your Headaches

Research shows that many people who suffer from a mental illness also have headaches or migraines. It can be tricky sorting out whether the headache disorder is related to mental illness, or whether they occur coincidentally.

Whatever your specific circumstance, know that mental illness can affect the way you feel pain, especially headaches.

Consider the following three examples of how your headaches may be linked to mental illness:

Depression and Headaches

Many people with depression experience physical symptoms such as fatigue, loss of appetite, a reduction in sexual interest, and sleep disturbances, like insomnia. In addition, headaches and other types of pain, like muscle or joint aches are frequent complaints.

It's thought that tension-type headaches most commonly accompany depression, although depressed individuals can suffer from other primary headache disorders, like migraines or cluster headaches.

When possible, your healthcare provider will try to select a medication or treatment that can address both your depression and your headaches.

Commonly used medications to treat both depression and the headache associated with depression include tricyclic antidepressants, like Elavil (amitriptyline), or selective serotonin reuptake inhibitors (SSRIs), such as Paxil (paroxetine) or Zoloft (sertraline).

Post-Traumatic Stress Disorder (PTSD) and Headaches

PTSD is more common in migraineurs than in the general population. Research also suggests that people who have migraines are more susceptible to developing PTSD when exposed to trauma, like a car accident or abusive partnership, than people who don't get migraines.

Moreover, when headache sufferers have PTSD, they tend to have a higher degree of headache-associated disability than those without PTSD—meaning their headaches impact their everyday functioning and quality of life to a greater degree.​

The good news is that there are effective strategies for treating both migraines and PTSD, including medications like the tricyclic antidepressant Elavil (amitriptyline) or the serotonin-norepinephrine reuptake inhibitor (SNRI) Effexor (venlafaxine). Cognitive-behavioral therapy may also be helpful, either alone or in combination with medication.

Bipolar Disorder and Headaches

Bipolar disorder is a condition that causes periods of depression and episodes of mania. Studies have shown that people with bipolar disorder—especially those who suffer from Bipolar 2 disorder— are commonly affected by headaches, particularly migraines.

Treatment of bipolar disorder and migraines may require more than one medication, although valproic acid may both prevent migraines and act as a mood stabilizer. 

Treatment Considerations

Special care is necessary when considering the use of multiple medications for mental disorders and headaches.

Some considerations:

• Triptan therapy for your migraines can contribute to the development of serotonin syndrome when combined with one of the SSRIs or SNRIs.
• SSRI or SNRI antidepressants can worsen or precipitate mania.

It's best to discuss all your therapy options carefully with your healthcare provider, especially if you are seeing different healthcare providers who are treating your medical conditions. For example, if you are seeing a neurologist or primary care doctor for management of your headaches and a psychiatrist for management of your mood disorder, it's important that each provider—and your pharmacist—is aware of all the medications, supplements, and herbs that you're taking.

A Word From Verywell

Sometimes it's difficult to tease apart the root cause of your headaches. In the end, though, it can be helpful to know that you are not alone in your suffering—and there are effective treatments available for you, whether your headaches are triggered by or associated with your mental illness or are simply a disorder on its own.