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Michigan Head & Neck Institute

TMJ Blog

11. 21. 2019

Sleep Aches

Are Mood Swings Related to Headaches?

Emotions often play a part in headaches.  Sometimes, the emotions are suppressed, while other times they are apparent at the surface.  A headache is one of the most widespread disorders in the world.  Depression and anxiety, similarly, also have a dominant presence.  Numerous studies have established that mood disorders are comorbid with headaches.  In fact, people suffering from headaches/cephalgia are 4-5 times more likely to have anxiety.

Anxiety and mood disorders coexist in headache patients, and physical symptoms result from both.  Anxiety produces excessive worry, irritability, agitation and concentration problems, while depression causes a lack of energy, fatigue, decreased motivation, weight gain or loss, trouble sleeping and increased overall sadness.

Depression is a psychological response to pain and can disable physical and social activity levels.  It can induce chronic pain by increasing susceptibility to the pain itself (tolerance reducing effect).

Several studies have shown evidence that anger is related to pain, level of severity, and emotional distress.  Anger can be internalized (suppressed) or externalized (aggressive lashing out).  It has been found that headache patients suppress their anger more than non-headache patients.  Patients that experience headaches struggle with anxiety and/or guilt after expressing anger.  Typically, the intensity level of the headache/cephalgia is dependent on the level of depression, emotional distress and reduced quality of life.

Headache/cephalgia sufferers have been known to possess personality traits such as:

-being overambitious

-having a Type-A personality

-appearing inflexible in their mindset

-overstressed

-short tempered

Cephalgia “attacks” or onsets can be related to psychological stress.  In fact, sometimes they occur after the initial stress period is over.  For example, sometimes when people get massages, they get a headache immediately afterward.  It follows in the relaxation phase.  Another example of this would be soldiers during the war who got cephalgia attacks not while fighting, but when they were done fighting.  Some experienced chronic head and neck pain after retirement from the service.

Further to add to this “relaxation hypothesis” would be people who get headaches on the weekends, once they have had a stressful week at work.  This has been called the “weekend headache” in the past.

Moderate stresses of everyday life are also affected by the individual’s level of activity/exercise.  States of increased activity followed by relaxation can sometimes trigger headaches/cephalgia.

Headaches/cephalgia should prompt the treating physician to proactively search for mood disorders (and vice-versa).  Untreated depression is a proven risk factor for low-frequency episodic cephalgia to chronic cephalgia.  Comorbid depression and anxiety also are associated with higher health insurance costs and healthcare costs in general, as well as increased disability rate (related to headache).

Sometimes even when a person appears relaxed, they are actually suppressing their anger and internalizing it, which then causes a delayed headache.

One last factor that can affect mood and therefore headaches/cephalgia is either menopause and/or menstruation cycles.  For all the husbands out there, who think their wives hate them, you are not alone.  This is one of the great stressors on a marriage – women who suffer from headaches and their husbands who take care of them.  When estrogen levels and hormone levels are going up and down, headaches and cephalgia can be the result.  Luckily, these are not permanent situations!

Remember that getting adequate sleep and exercising routinely can help a great deal.  And also as discussed previously, eating the right foods can help with your mood (and therefore headache prevention) as well.  If you would like more information on headaches, cephalgia, and chronic head/neck pain, or to schedule a consult with Dr. Klein, please contact our office at (586) 573-0438.

References

  1. Rammohan K, Mundayadan SM, Das S, Shaji CV. Migraine and Mood Disorders: Prevalence, Clinical Correlations and Disability. J Neurosci Rural Pract. 2019;10(1):28–33. doi:10.4103/jnrp.jnrp_146_18
  1. Baskin SM, Lipchik GL, Smitherman TA. Mood and anxiety disorders in chronic headache. Headache. 2006;46(Suppl 3):S76–87.
  1. Antonaci F, Nappi G, Galli F, Manzoni GC, Calabresi P, Costa A, et al. Migraine and psychiatric comorbidity: A review of clinical findings. J Headache Pain. 2011;12:115-25.
  1. Breslau N. Psychiatric comorbidity in migraine. Cephalgia. 1998;18(Suppl 22):56-8.
  1. Peres MFP, Mercante JPP, Tobo PR, Kamei H, Bigal ME. Anxiety and depression symptoms and migraine: a symptom-based approach research. J Headache Pain. 2017;18(1):37. doi:10.1186/s10194-017-0742-1
  1. Perozzo P, Savi L, Castelli L, et al. Anger and emotional distress in patients with migraine and tension-type headache. J Headache Pain. 2005;6(5):392–399. doi:10.1007/s10194-005-0240-8
  1. De Filippis S, Salvatori E, Coloprisco G, Martelletti P. Headache and mood disorders. J Headache Pain. 2005 Sep;6(4):250-3.
  1. Ekbom K, Dalkvist J, Waldenlind E. Headache and Mood: A time-series analysis of self-ratings. Cephalgia. 1984 Mar; 4(1):45-52.

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