Depression and Headache

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  • Nowhere are the limitations of current psychiatric diagnostic schemas more apparent than at the interface of Major Depressive Disorder and chronic pain
  • DSM-IV-TR does not list pain as a symptom of any mood disorder and anxiety/depression are strikingly marginalized in the list of symptoms required to meet criteria for a chronic pain disorder
  • Several decades of research demonstrate that this segregation of mood and pain maps poorly onto clinical and neurobiological reality
  • Appears to be more the rule than the exception with a 30-60% co-occurrence rate
  • Evidence suggests that chronic pain and depression do more than co-occur, they also promote the development of each other
  • When comorbid, pain and depression mutually amplify each other, contributing significantly to treatment resistance in both pain and depressive disorders
  • Pain is a major obstacle to achieving remission in the treatment of depression and a significant risk factor for relapse

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