HeadWise HeadWise: Volume 2, Issue 2 - Page 31

can rest assured that treatment is available and hope can be restored. A TWO-WAY STREET Depression Among Other Headache Types People with chronic migraine are more likely to have depression than people with episodic migraine, according to the American Migraine Prevalence and Prevention Study (sponsored by the National Headache Foundation). Further, migraineurs are more likely to have major depression than people with other types of headaches. For this reason, the comorbidity of migraine and depression has been studied in more depth than the comorbidities of depression and other headache disorders. However, depression does exist among other headache populations. Among patients with common subtypes of chronic daily headache, 70 percent of patients with transformed migraine experience depression and 59 percent of patients with chronic tensiontype headache experience depression, according to research published in the Nov.-Dec. 2011 issue of the journal Headache. A study from the January 2011 issue of the journal Headache showed that 51 percent of patients with New Daily Persistent Headache, a rare chronic daily headache characterized by new onset of daily headache, had a history of depression. Interestingly, though research into the comorbidity of depression and cluster headache is rare, one study published in the April 2012 issue of the journal Headache showed only 8 percent of people with cluster headache experienced anxiety and depression. The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) classifies major depressive disorder as a mood disorder characterized by “feelings of sadness or emptiness; reduced interest in activities that used to be enjoyed; sleep disturbances (either not being able to sleep well or sleeping to much); loss of energy or a significant reduction in energy level; difficulty concentrating, holding a conversation, paying attention, or making decisions that used to be made fairly easily; [and/or] suicidal thoughts or intentions.” For people who experience head pain and depression, the headaches are likely to be migraines and they often arise in the early morning along with other significant depressive symptoms, notes Robert Shulman, MD, associate chair of clinical services in the department of psychiatry at Rush University Medical Center in Chicago. This is called a “diurnal variation,” whereby one experiences the worst of their symptoms first thing upon awakening and may note a lightening of symptoms toward the evening hours. The research is clear that the relationship between migraine and depression is bidirectional, meaning depression can trigger migraine and migraine can trigger depression. According to a study published in the March 2012 issue of the journal Headache: n People with major depressive episodes are 40 percent more likely to develop migraine than people who don’t experience depression, and P  eople with migraine are 80 percent more likely to develop major depressive episodes than people who don’t experience migraines. Some 20 million people in ѡUѕMхѕ́ɥɕͥɑѼѡ9ѥ%ѥѕ́!Ѡєѡ́ɕ͕ͥ́ѥѥ镐ͽ䰁ͼՍͼѡЁݡɕ͕䁹ЁɕЁЁѼѡȁͥ)()]ЁѼȁɔЁɕͥ́ձЁѕ٥܁ݥѠȸMձЁܹ̹ɜՍѥQ}}Mՙɕ̽Ց}YՅ}Q̸)ܹ̹ɜ9ѥ!չѥ((0