Mental Illness and Your Headaches: What's the Link?

Learn how mental illness can physically hurt.

Depression Hurts and May Be Causing Your Headache
Depression Hurts and May Be Causing Your Headache. Peopleimages/Getty Images

Research shows that many people who suffer mental illness also have headaches or migraines. It can be quite frustrating to deal with pain and depression or anxiety at the same time—and people often question which came first, like the "chicken versus egg" theory.

Whatever your specific circumstance, know that mental illness can affect the way you feel pain, especially headaches.

Consider the following three examples of how your headaches may be linked to mental illness:

Depression and Headaches

Many people with depression experience physical symptoms such as fatigue, a loss of appetite, a reduction in sexual activity, and sleep disturbances, like insomnia. In addition, headaches and other types of pain like muscle or joint aches are frequent complaints.

It's thought that tension-type headaches most commonly accompany depression, although depressed individuals can suffer from other primary headache disorders, like migraines or cluster headaches.

When possible, your healthcare provider will try to select a medication or treatment that can address both the depression and headaches. Commonly used medications to treat both depression and the headache associated with depression include the tricyclic antidepressants, like Elavil (amitriptyline), or selective serotonin reuptake inhibitors (SSRIs), such as Paxil (paroxetine) or Zoloft (sertraline).

Post-Traumatic Stress Disorder and Headaches

PTSD is more common in migraineurs than in the general population.

Research also suggests that people who have migraines are more susceptible to developing PTSD when exposed to trauma, like a car accident or abusive partnership, than people who don't get migraines. 

In addition, when headache sufferers have PTSD, they tend to have a higher degree of disability than those without PTSD—meaning their headaches impact their everyday functioning and quality of life to a greater degree.

The good news is that there are effective strategies for treating both migraines and PTSD, including medications like the tricyclic antidepressant Elavil (amitriptyline) or the serotonin-norepinephrine reuptake inhibitor Effexor (venlafaxine). Cognitive-behavioral therapy can also be helpful, either alone or in combination with medication.

Bipolar Disorder and Headaches

Bipolar disorder is a condition that consists of both periods of depression and mania. Studies have shown that people with bipolar disorder—especially those who suffer from Bipolar 2 disorder— are commonly affected by headaches, especially migraines. Treatment of bipolar disorder and migraines may require more than one medication, although Depakene (valproic acid) may both prevent migraines and act as a mood stabilizer. 

Treatment Considerations

As always, special care is necessary when considering medications for both mental disorders and headaches, especially migraines. For example, triptan therapy for your migraines can contribute to the development of serotonin syndrome when combined with one of the SSRIs or SNRIs.

While this is rare, it's best to discuss all your therapy options carefully with your doctor. 

The Bottom Line

Sometimes it's difficult to tease apart the root cause of your headaches. In the end though, it can be helpful to know that you are not alone in your suffering—and there are effective treatments available for you, regardless of whether your headaches are triggered by or associated with your mental illness (or simply a disorder on its own).


Fornaro, M., Stubbs B. A meta-analysis investigating the prevalence and moderators of migraines among people with bipolar disorder. J Affect Disord. 2015 Jun 1;178:88-97. 

National Headache Foundation Website. Depression and Headache. Accessed: May 22nd 2016. 

Peterlin, BL  et al. Posttraumatic Stress Disorder in Migraine. Headache. 2009;49(4):541-51.

Peterlin BL, Nijjar SS & Tietjen GE. Post-traumatic stress disorder and migraine: Epidemiology, sex differences, and potential mechanismsHeadache. 2011 Jun;51(6):860-68.

Edited by Dr. Colleen Doherty May 22nd 2016. 

Continue Reading