(Conclusion: people who tend to direct aggression inward and have depressive conditions tend to have greater levels of impairment.)
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Cephalalgia. 2012 May;32(7):528-36.
Aggressiveness in different presentations of cluster headache: Results from a controlled multicentric study.
Luerding R, Henkel K, Gaul C, Dresler T, Lindwurm A, Paelecke-Habermann Y, Leinisch E, Jürgens TP.
SourceUniversity of Regensburg, Germany.

Abstract
Background: The hypothalamus has been discussed as a pivotal structure for both cluster headache (CH) and aggressiveness, but little is known about the extent of self-reported aggressiveness in patients with CH. Patients and methods: Twenty-six patients with chronic, 25 with active episodic and 22 with episodic CH outside the active period were examined interictally with a validated questionnaire quantifying factors of aggression and compared with 24 migraine patients and 31 headache-free volunteers. Results: The ANOVA was significant for the subscale 'self-aggression/depression' (F (4,?123)?=?5.771, p?<?0.001) with significant differences between chronic and episodic CH and healthy volunteers. No significant changes were found for other subscales and the sum scale (F (4,?123)?<?1.421, p?>?0.230). Especially in the clinically most affected group of patients (chronic CH and active episodic CH), high levels of "self-aggression/depression" correlate with higher prevalence of depressive symptoms and higher impairment measured on an emotional and functional level. Discussion: Self-aggressive and depressive cognitions with highest scores in chronic CH seem to be reactive as they correlate with depressive symptoms and impairment. They should be considered as an important therapeutic target since they impair the patient's life significantly.

PMID:22665916[PubMed]

Interesting. Good post Bob.  :)

I'm not sure what is unique here. Discovering a correlation between high frequent levels of pain and feelings of aggression/depression is a bit like "newsflash--dog bites man." Unless they are saying self-aggressive tendencies cause chronic CH suffering? lance

Good science is frequently defined by new studies lending support to old "truths". One of the greatest weaknesses in the understanding of all sciences in the general public surronds the complexity/difficulty moving from hypothesis to law (or creating some middle ground which is sufficiently "true" that we can used it as a firm ground from which to work.)

I threw this item out as yet another tease hoping to get folks to pay more attention to their emotional life with Cluster. While we regularly read comments about stress, fear, "depessed", etc., I've become impressed with how little serious attention is paid to trying to understand how to directly focus and cope with the emotional impacts of Cluster. Over the years, I can count on one hand the number of responses to items which have been posted on this subject.

When people see that these are sometimes called "suicide" headaches, I think they think it's an over exaggeration of it. 
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I am lucky enough to be at a place where I have  doctors, and where treatment, for the most part, has been effective for me.  I have been at a place where it's been rough going until things kicked in for a LONG period of time, and my quality of life, my emotions, my relationships, my work life, all suffered. 
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I keep telling my boyfriend that he's fortunate in 2 years to have never seen me really in the grips of an un-managed cycle.
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When i was younger I didn't pay much attention to how clusters affected my emotions, or my life, I just lived to party, and aborted them as they came.  As I've gotten older, and have turned chronic (I think) - I am very careful about them, and try to take actions keep my quality of life up.
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Thanks Bob for bringing this up over the years.

JOSHUA: You're making me feel old! "Suicide headache" was a term introduced by Dr. Seymour Diamond several decades ago--long before we had the effective meds, especially abortives, which have made suicide a historical artifact.

But appreciate your grasping my central point: folks not seriously attending to their emotional life when Cluster is a long term burden.

Ha! It's strange b/c when you look up cluster headaches, it's one of the first lines in the description... "Cluster headaches, sometimes called suicide headaches..."
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It is definitely outdated- but still what people see when they search for the condition.
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Onwards!

The world if full of Drama Queens....

Come on Bob.  You, at least, have been around here long enough to know that some people indeed do commit suicide.  Being flippant about it is, at the least, potentially offensive.

Not all of us find effective medications.  Opiates help me a little but because of a family history of addiction I choose to rarely use them.  If I hadn't had opiates at especially bad points I might have decided it wasn't worth it myself.  It's hard to be rational when you are having back to back hits and haven't slept in a week.

Quite frankly, it's hard for me to believe someone actually has cluster headaches if they don't understand how intense untreatable pain could leave you suicidal.  I suspect it's a normal reaction to the pain. 

Katherine, I certainly wouldn't dare to speak FOR Bob and what he meant by,  "the world is full of drama queens"
but what I personally saw in his comment, is this.

Whoever, "termed" our condition, suicide headaches was being dramatic.  As if EVERYONE  afflicted,  was going to do this. We all know that it DOES happen.  I know of two personally.  But to tag our headaches thus,  is to say we are all SUICIDAL because we suffer from this condition and that is.. in fact being dramatic. 


Linda   ;)

the report of the study the original post is interesting to me: the other day I posted on another  CH support forum my "guilty secret", "sometimes it feels so good to release my CH induced irritation on some poor shmuck who is only doing his job, but seems to be blocking my path!"

I would say that if you're seeking a reason why more folks don't treat their co-morbid emotional condition, look no further than the high stigma that society places on mental disorders.  If I tell my coworkers about my ear infection, they are all sympathy.  Start talking about my anxiety disorder?  Things just got awkward.

"Apple", your comment is true, of course, but at some point we must confront such attitudes in the name of pesonal well being.

If you talk to women of our grandmothers' generation you'll find out how many of them refused breast examinatons for the same reason--only to die of breast cancer. Ditto for men--today--where death from prostate cancer--second leading cause of CA death in men--, but one of the most effectively controlled/cured cancers, because they refuse examinations. And it goes on and on.

I have hanging on my wall:

"I have too much to lose, she said, if I cross that line. Like what, I said. She could not think of anything that day so she said she'd get back to me.

Since then I've been thinking, what I wold lose if I crossed my line & I haven't come up with anything either.

There's always another line somewhere."
      

I have no idea why Dr Seymour Diamond coined the phrase "suicide headaches," but for me it is at least hyperbole: an exaggeration for effect. Those whose headaches are managed, or whose cycles as episodics are only a portion of the year in length, may have some luxury of speaking from relief. But, speaking for myself, a good day is one in which I have only one or two painfilled episodes, every day, 365 days a year. I do not count myself as overly dramatic when I say, I look forward to this pain ending. I am grateful for the abortives I have, and have learned to focus on those times between hits as the life I want to live. I agree with Bob's original defense of the article: sometimes we dismiss even our brothers and sisters who are struggling because we have found something that works for us. Pain is disabling: physically and emotionally. We must not forget that. blessings. lance

Diamond was one of the first serious docs to work with Cluster, founder of the Diamond Headache Clinic in Chicago.

When he coined the term there was virtually nothing to offer for Cluster and in-patient rounds of IV morphine was very common. Under those conditions, "suicide" was only a bit excessive.

Decades ago I recall the story of the woman, having no relief, beat her head on a concrete floor. Caused a stroke and her death. But then, even on these pages, we discussed a not uncommon response to an attack of hitting our head on the wall, etc. It was recognized as a method for shifting the focus of pain from that characteristic of Cluster to the sharper pain of a blow, cutting, etc. which was easier to bear.

Apart from Cluster being described as a "suicide" headache, other descriptions, quoted women as saying a Cluster was worse than childbirth without anesthesia.

That some of these old concepts continue past their useful time hit me a few weeks ago while reading a contemporary medical web site directed at M.D.s. A description of Cluster noted the distinctive facial features and skin trexture of Cluster folks! This was a description which showed up a number of decades ago rejected, of course, rather quickly.

Sometimes we can only take a breath and be amused....

Sometimes (yes, even in this day, with all of our pharmotechnology) people still can fall thru the cracks of the system and be unable to obtain any proper medical care, device, or abortives. These unfortunates still just have to grit teeth and hold up as best they can. How well each person can handle that [i][u]is to be pitied[/u][/i]

I'm not saying I don't confront it, my friend. One of my co-workers has an autistic daughter. We often trade stories.  :)