A very difficult issue to sort out and there is not much research on the question.

Can having chronic anxiety/derpession CAUSE Cluster in a person who has not had it previously? No evidence for that and, the recent research on the brain (hypothalamus) as a trigger (perhaps cause) for CH is, for me, evidence that anxiety--alone--is not the cause.

In a person who has CH, well established and recognized, have an attack as a result of high levels of anxiety/depression? It's extremely difficult to sort that sequence out. The old chicken-and-egg question.

Following is a piece I posted some time ago. It's complex and you may need someone to help you understand it. The basic idea is: it is very common for a person to have such a "habit" of anxiety that just the thought of a cluster attack can trigger off an attack of anxiety. It's also clear that different people, each having a CH attack, will have quite different levels/intensity of anxiety response.

Bottom line: it is possible to learn how to moderate/to ease, anxiety. That is something I would suggest for you because it would be of benefit for your whole life.
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Report of a study (from MEDSCAPE.COM):"Patients With Anxiety Disorders More Sensitive to Bodily Changes"

Sept 16 - Patients who have anxiety disorders appear to be more sensitive to bodily changes, which in turn suggests that the perception of panic attacks is reflective of central rather than peripheral responses, according to the results of a study published in the September issue of the Archives of General Psychiatry.

"Physiologic responses of patients with anxiety disorders to everyday events are poorly understood," Dr. Rudolf Hoehn-Saric and colleagues from the Johns Hopkins Medical Institutions, Baltimore, write. They compared self-reports and physiologic recordings in 26 patients with panic disorder, 40 patients with generalized anxiety disorder, and 24 nonanxious controls during daily activities.

The subjects underwent four 6-hour recording sessions during daily activities while wearing an ambulatory monitoring device. The team collected physiologic and subjective data that were recorded every 30 minutes and during subject-signaled periods of increased anxiety, tension, or panic attacks. Primary outcome measures included recordings of heart inter-beat intervals, skin conductance levels, respirations, motion, and ratings of subjective somatic symptoms and tension or anxiety.

Compared with controls, patients with anxiety disorders rated higher on psychic and somatic anxiety symptoms. Patients with anxiety disorders also rated themselves higher on disability scales and on sensitivity to body sensations. Both patients with panic disorder and those with generalized anxiety disorder experienced diminished autonomic flexibility and less precise perception of bodily states.

Patients with panic disorder had a heightened sensitivity to body sensations compared with generalized anxiety disorder patients. Autonomic arousal levels were slightly higher in patients with panic disorder, and this manifested itself in faster heart rates throughout the day.

"These findings suggest that, after having experienced anxiety attacks that are associated with strong bodily changes, patients become sensitized to such changes and may experience physiological symptoms of panic attacks..." [In effect, their bodies are acting as if there was a threatening condition even when this was not the case.]

The investigators note that the diminished autonomic flexibility found in both panic disorder and generalized anxiety disorder patients may result from dysfunctional information processing during heightened anxiety that does not discriminate between anxiety-related and neutral stimuli.

"It is important to measure physiological responses and not rely on verbal reports," Dr. Hoehn-Saric added. "A demonstration that physiological responses during anxiety attacks are milder than perceived can be reassuring to patients," he said. "However, the long-term effect of diminished physiological flexibility is unknown."

Arch Gen Psychiatry 2004;61:913-921.
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Imagine a person who is afraid of, for example, dogs and can experience an anxiety attack by thinking about meeting a dog or even seeing a picture of a dog. (Or, replace "dog" with your own feared thing/experience.) The anxiety is NOT being caused by a real life experience, in this situation (the thought or picture). The mental and body reactions which we call "anxiety" are a kind of habit response which are very real in their effects, however. Anxiety produces mind and body reactions which are measurable and have a real impact on how we function (and even on long term health of the body).  

The anxiety becomes an automatic response, beyond direct control of will. With this development, the person has experiences (anxiety) which are confusing or misleading--they cannot separate the real life threat from their body's automatic ("I'm in danger!") reactions. When dealing with cluster, for example, the effect of this anxiety reaction (and this is true for depression also) is that the person has increased sensitivity and reduced tolerance for pain; their sense of suffering is elevated and the capacity for effective self-treatment is reduced.

Medication can dampen the experience of anxiety but it does not unlink the reaction from the underlying thoughts or misinterpretation about the situation. ("I'm in danger"; "this will never end"; "I can' bear the pain", etc.) Cognitive therapies have been very effective (especially when combined with short term meds use) in teaching folks how to break this link.

well that was interesting reading as far as i could understand.i ll try to make easier the discussion hoping it doesnt get more confused by me.so try and bear me.i am not talking about stress disorder here.during various visits in doc's(not only one's) offices which usually last about 20 min when every preventantive fail and i am saying that imigran is good but not good enough(oxygen doesn't help me) they always end up bringing up the sychological matter but with a lot of blur as THE CAUSE of ch.
statements like
1 lease the stress in your life.(?)
2 maybe its stress that has taken up your whole existence and you cant realize it anymore(??)
3 maybe you always wanted a different job,friends lifestyle e.t.c and the denial to this and in aim to be accepted by others has as a result ch.(??!!first time i experienced was age 13 and i had beautiful childhood.ok now things arent beautiful but ch didnt just ring the bell )
fortunately about a year ago i went in a medical center with a department especially in chronic pain(in general,not only for ch)
in coincedence there was at that time a sychologist(not student,he had his diploma already) who was doing an essay about the correlation of chronic pain and mental health or something like that.so i had  about one hour and a half with him of discussion and sort of examination which means a variety of questions about everything.at the end i asked him the big question.
is it physical or matter of sychology?
the answer was that there is  anxiety(i think thats the proper word not stress.it just came up now)and i feel depressed
but as a result of ch.if the cause,pain of ch could vanish the anxiety and depression would automatically be gone.
but still i didnt find any comfort from therapies in that center(even if i was pleased from general treatment and behavior)and kept changing docs who always made these statements in visits of 20 min duration including time of hi and goodbye.so i guess the reason i ask is(thats really hard to find)if there is something else deep in soul that i/we dont get at all and worth exploring or i/we am/are just messed up by irresponsible statements when everything else fails(stress,anxiety in modern society 

p.s. sorry for any mistakes in language
p.s. sorry if i said i wont confuse u but i did it
p.s. sorry for any kind of oher headache i brought to you

Black,

I think your docs have been giving you a lot of crap.

I'm chronic (have been since 97) and tend to get worse when I get rid of the stress in my life... a lot of us don't handle "relaxation" well, so that kills that theory.

If you haven't been here since 2007, you might want to check out the new stuff about O2. We've come a long way since 2007. You might want to give it another try. It's working for about 70% of us = some that it never worked on before because they were doing it wrong. It might be worth another try.

But as to your docs... some of us can't handle MSG, some can't drink a beer, some can't be around perfume -- what I'm saying is we all have DIFFERENT triggers and so far NO ONE has found a common thread in us, so until someone does - it's all speculation as to WHAT MIGHT trigger these darn things.

Wishing you some PF time....

Hugs BD

This is just MY personal experience.

I'm stressed the fuck out right now. My dog is missing, and has been for a week, lost over at my nephews house. I'm dealing with living without my allergy medicine until canadapharmacy can send it...  Since my family is out hunting the dog I'm staying with the nephews alone and dealing with them during the clusters. Hiding ain't an option. When my throat starts to close up, I have to take epinephrine.

It saves my life, but causes a nasty cluster after it's out of my system.

My hits have not increased. They also haven't decreased. They've stayed exactly the same.

It effects each person in different ways, but for me, it doesn't make it worse.

Mystina

I can think of times in my life when I was completely stressed out and then went into an episode, I can also think of as many times when I thought everything was going great and got hit bigtime. I'm certain it hasn't made a difference in my case. They come when they come.