Anxiety Disorders and Headaches
Cathleen Henning, About.com

Study shows they frequently go hand-in-hand
If you have an anxiety disorder and suffer from daily headaches, you're not alone. Researchers in Taiwan have found that the majority of people with chronic daily headaches, particularly women, have either anxiety or depressive disorders.

The researchers conducted the study because there were few studies on the occurence of psychiatric disorders with chronic daily headaches. The study took place at a headache clinic during the period from November 1998 to December 1999. A neurologist examined the participants and took a thorough headache history. Participants were then interviewed for the diagnosis of anxiety and depressive disorders. These disorders included major depression, dysthymia, panic disorder, generalized anxiety disorder (GAD), obsessive compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and social anxiety disorder.

Of the participants, 79% experienced chronic daily headaches.

Chronic daily headaches are those that occur for more than 15 days per month and for more than 4 hours per day if untreated. Of those with chronic daily headaches, the majority experienced either transformed migraines (58%) or chronic tension-type headaches (35%). The remainder experienced other types of daily headaches.
The results of the study show a high rate of comorbidity (or co-occurence) of chronic daily headaches and anxiety or depressive disorders:
o 70% of participants with transformed migraines also had depressive disorders, and 43% had anxiety disorders.
o 59% of participants with chronic tension-type headaches also had depressive disorders, and 25% had anxiety disorders.

More women (67%) than men (36%) with chronic tension-type headaches also had depressive disorders. Additionally, more women (46%) than men (21%) with transformed migraines had anxiety disorders.

Of all the disorders, major depression and panic disorder were most likely to co-occur with chronic daily headaches. Half of the participants with chronic daily headaches had depressive disorders and one quarter had panic disorder. The researchers theorize that the co-occurence of chronic daily headaches with panic disorder may result from the relationship of both conditions with serotonergic dysfuntion. Another theory is that because the symptoms of these conditions overlap, diagnosis is easier.

The researchers feel that further studies, particularly community-based studies, need to be done. In the meantime, they urge health providers to be alert of depressive and anxiety disorders in their patients with chronic daily headaches.

Reference:
Juang KD, Wang SJ, Fuh JL, Lu SR, Su TP (2000), Comorbidity of depressive and anxiety disorders in chronic daily headache and its subtypes. Headache 40: 818-823.