Headaches Can Be So Depressing

This article about headaches symptoms is appealing for those interested about this topic is written by David Wilding

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People with headaches, which respond to over-the-counter medication very rarely visit their doctor.

But if the headache is

• happening every day
• is there when the person wakes up in the morning
• hangs on for most of the day
• has been a problem for many months

then the doctor’s alarm bells should ring.

This type of headache is classic in patients who tend towards depression. Depressed people often present to the doctor with a continuous headache, for which no reason can be found. The person often feels that the ‘real’ symptoms of the headache are more acceptable than feeling depressed or low. The stigma of being depressed has lessened hugely over the last 20 years but many people still find it hard to admit that they ‘can’t cope’.

Doctors are taught that the classically depressed person moves slowly, looks sad, speaks slowly in a flat voice and shows little interest. This can be true but is not always the case.

Many people feel ashamed of feeling depressed. They eventually recognize that they need medical help but when finally facing their doctor, they often put on a bright face and minimise their suffering when describing how they feel.

The presence of prolonged headaches is a clue though, along with

• Disturbed sleep – either not enough or too much
• Waking early
• Loss of appetite or overeating
• Smoking and drinking to excess
• A decrease in previously enjoyed leisure pursuits
• A decrease in sexual desire and activity

The type of headache that depressed people complain of is a tension-type headache, predominantly caused by muscle contraction. The patient is tense (sometimes without even realizing it) and the muscles of the neck, jaw and scalp tighten up. If this contraction of the muscles is kept up for any length of time, it may cause tiny blood vessels to break in the affected areas. This affects the blood flow and can cause a severe headache and pain.

Do I have a headache because I’m depressed – or am I depressed because I have a headache?

It is recognized that people with depression develop bodily symptoms. The doctor should know that although the headache is occurring as a symptom of depression, the pain is real. The doctor should take a careful history as depression headaches have a distinctive pattern. They usually occur in the early evening or early hours of the morning. The pain is described as a tight band of pressure, like a vice, around the head. The person may claim that they have suffered from these headaches for months or even years. Pain killing medication rarely works in these cases. The treatment should be aimed at the underlying cause – the depression itself. Antidepressants can be very helpful and biofeedback has shown some positive results.

The flip side of this is that people who are suffering chronic pain often develop depression as a result. In these cases, the physical side of the problem is usually given priority and too little attention is paid to the emotional aspect of all this suffering. The headaches suffered by these people are the same as previously described.

These distressing headaches can be helped – but it takes time, co-operation and complete honesty on the part of the sufferer.