| Migraine triggers and other causes of headaches can | | | | stress, in addition to learning how to develop good |
| come from many sources. So often we are looking | | | | coping skills for future life stressors. Try too, to |
| for just one thing that causes migraines and | | | | develop a good social structure. Even if you can't |
| headaches when in reality it is a combination of many | | | | participate in activities that your friends may do |
| factors. The most frequent cause of headaches in | | | | (sports), you can still invite people to your place for a |
| general is stress, but all too often mood plays a large | | | | get together once a month or so. Regular human |
| role. | | | | social contact is a form of support and can help |
| Quite frankly, until you are able to recognize and | | | | stave off depression. In fact, more than 6 million |
| accept this, you might not have much success in | | | | women experience depression each year in the USA. |
| getting these headaches under control. The effects | | | | Many people disregard the recommendation to take |
| of lifestyle on headaches cannot be underestimated. | | | | medication for mood in the presence of headaches. |
| Depression and anxiety can greatly affect your | | | | So many times people make this mistake and think |
| headache profile and are recognized by headache | | | | there is something wrong with them if they accept |
| experts as a migraine trigger. Now wait!! Before you | | | | the fact that they are anxious or depressed. Even |
| dismiss the idea, up to 85% of all chronic pain | | | | MILD depression can make headaches worse. Many |
| sufferers have depression and/or anxiety to SOME | | | | of todays medications can treat BOTH mood and |
| degree. It's almost like the chicken and the egg, | | | | headaches. |
| which came first? | | | | SSRI's: This group of drugs are seratonin re-uptake |
| Pain and depression impact each other; the more | | | | inhibitors (what??). Seratonin is one of the natural |
| pain, the more depressed you feel and then that | | | | "happy drugs" in the brain, but is taken up by nerve |
| makes the pain worse. If you have a headache, | | | | endings and recycled, so to speak. By slowing this |
| doesn't crying or being upset make it worse? This is | | | | process, you have more of it in the way you need it |
| the anxiety fueling the headache. Along the same | | | | and feel happier. Side effects include weight gain, odd |
| vein, if you have headaches or migraines on a regular | | | | dreaming, mild episodic vertigo and rarely some of |
| basis, are missing school, work and family outings, | | | | them can cause headaches to be worse. Zoloft, |
| you are bound to feel a bit depressed. | | | | Lexapro, Celexa, Prozac and Paxil are all in this class. |
| Too many times this is one of the most difficult | | | | Paxil and Lexapro are excellent if you have more |
| concepts for people to get their minds to accept; | | | | anxiety. If you are over the age of 60, you may |
| that they may have some degree of depression | | | | need to start at a lower dose than normal. |
| which makes the pain more chronic and more severe. | | | | TCA'S: Tricyclic antidepressants (TCA) are an older |
| Don't be too hard on yourself! The receptors and | | | | class of drugs that are NOT first line for depression. I |
| pathways for headache are similar and sometime the | | | | mention them here because they are used in the |
| same as anxiety receptors in the brain. Without | | | | treatment of headaches and can reduce headache |
| getting in to a medical lecture when they are all firing | | | | pain. |
| off you have a headache and are anxious. One | | | | CYMBALTA: Cymbalta is a drug that functions with |
| basically fuels the other. | | | | two effects. Part of the drug is an SSRI but most of |
| Treatment of Anxiety and Depression in Headaches | | | | the drug functions on another pathway called |
| Just like treating the headache itself, it is important to | | | | norepinephrine. The end result is another brain |
| realize that treating mood is multi-factorial. Counseling | | | | chemical is boosted and you feel happier. It also has |
| with a good psychologist is invaluable. The rule of | | | | and effect of calming back pain in some patients. |
| thumb when getting counseling is to give it at least | | | | Treatment of depression that is fueled by migraine |
| three visits to see if you and the counselor "mesh" | | | | involves treating not only the migraine but the also |
| so to speak. Not all patient/provider relationships are | | | | the mood. Until both sides of the problem are |
| perfect. | | | | addressed, progress may be slow. |
| Counseling will allow you to dump some of the | | | | |