Headaches and depression linked

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Anyone who has suffered from chronic headaches knows how depressing the endless days of pain can be. And since headaches are a common feature of CFS and FM, people with those illnesses are particularly susceptible to its accompanying symptom of depression. But many headache sufferers wonder…what came first, the depression or the headache?

Well, researchers have finally confirmed that headaches, specifically migraines, do indeed cause depression, not the other way around.

The first research to examine migraine’s impact shows that even “typical” migraine sufferers consistently report lower mental, physical and social well-being than people without migraines.

Two new studies published in the September 12 issue of Neurology, the scientific journal of the American Academy of Neurology, measure health-related quality of life and are the first to include “typical” migraine patients, rather than just severe migraine patients who seek treatment in a headache center. The studies include data from three countries — the United States, the United Kingdom and the Netherlands. The U.S. and U.K. data also shows a strong link between migraine and depression.

“This is the bigger picture of migraine, as prior studies have demonstrated the impact of migraine on absenteeism and work productivity,” said Richard B. Lipton, MD, professor of neurology and epidemiology at the Albert Einstein College of Medicine in the Bronx, NY and lead author of the U.S./U.K. study. “Quality of life measures the impact in human terms. We’re not just robots who go to work, but individuals who lead full productive lives, which can be limited by illness in many dimensions.”

Forty-seven percent of the migraine sufferers experienced depression, compared to only 17 percent of people without migraine. However, research shows that while migraine and depression are linked, they have independent causes and both cause a reduced quality of life.

“It seems logical migraine patients would be depressed because of their pain,” said Lipton. “But it goes the other way too — depressed patients are more likely to have migraine. We think the two disorders must have a common neurobiology.”

The studies surveyed the general public and included migraine sufferers who have not have seen a doctor. In the U.S./U.K. study, 768 people were surveyed — 389 with migraine. In the Dutch study, 5,998 people were surveyed — 620 with migraine within a year of the survey.

The surveys focused on quality of life — including being able to fulfill social and emotional commitments — as well as general health perception. In the U.S./U.K. study, participants were asked about any limitations in activities ranging from moving a table to playing golf to visiting friends. Limitations could be physical or emotional.

“We knew the people who saw a doctor experienced limitations in their quality of life, but now we see more clearly how everybody with migraine is affected,” said Lenore Launer, PhD, at the National Institute on Aging in Bethesda, MD, and senior author of the study based on Dutch data.

The Dutch study also compared quality of life of migraine patients with that of patients suffering from asthma and chronic musculoskeletal pain. Migraine patients consistently rated their quality of life lower in the mental and social aspects, but higher in the physical aspects.

“Migraine sufferers are very affected emotionally,” said Launer. “It may come from the unpredictability of when attacks occur, and the limited ability to control it once it starts.”

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