Depression is not an automatic part of CH but can be a reaction. In any case, it needs to be treated quite independently of the clusters.

Part of depression can be the way in which he thinks about his CH. Ask him to explore:

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What meds are you taking for CH?

I have suffered from severe depression because I suffer from ch to the point of being suicidal.  Please have your spouse talk to his DR. and let him know how he is feeling.  Time to be honest.  They can prescribe medicine and counceling for depression.  There is help.  I take effexor for my depression and also attend chronic pain support group.  Helps me get over the why me syndrome.

I don't know whether the two are intertwined but I too deal with depression symptoms. I feel that hopelessness and sadness have a way of burrowing a little deeper into the conscious and subconscious as a result of a life with CH (both on and off cycle).

Is he able to talk about it openly with anyone? If not, I found the freedom of a therapist to be worthwhile.

Scott

The report by Dr. Rozen shows that depression and CH might be related, and that depression is the most common co-morbid symptom with CH.  I think it's a reflection of our goofy brain chemistries -- the chemicals involved in CH are the same ones that get out of control in depression.  So once they figure out exactly which chemicals we need to regulate, both depression and CH can be treated together.
And yes, I too get very depressed when I'm in a cluster, because I can't sleep, afraid that I'll be awakened at 2 a.m. This cycle cost me 19 nights of sleep in a row, and I'm still recovering from those awful impacts almost two weeks later.

I found this piece that I first posted two-years ago. It makes an important distinction about the way the word is used and misued.
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DEPRESSION IN CLUSTER HEADACHE

Is depression commonly experienced with CH? An often asked question and one which cannot be answered easily because the word--"depression"-has been so muddled that using it, without careful definition, is very misleading.

I'm blue, down, sad, in a funk, and so on. In daily speech, we describe these feelings as "depression."

I'm in deep grief over the death of a loved one; or, my house has been destroyed along with all my priced possessions by a tornado. I'm "depressed".

These are wide-ranging emotions but we use the same word to describe them. At what point do we move from a "normal" emotional state to "clinical depression" which might benefit from some professional assistance? As we usually use the word, "depression", the word, by itself,  does not give any help in making this judgment.

The issue is more complex even when we have a chronic pain disorder or chronic disease of some kind. People with such problems are not automatically depressed but they might become depressed! A play on the word: If I have chronic CH, I may experience a bad day but it doesn't last for weeks OR the emotion might not pass.  This factor: duration of the emotion, is one of the key factors to separate normal (ND) from clinical depression (CD).

I'm having a series of CH attacks and that puts me "down" but when I'm not in pain I can enjoy my family or a supper with friends, etc. The ability to have a positive response which would be expected to pleasant activities: Another marker separating ND from CD.

I'm normally a health person for someone my age but, for reasons which don't make sense to me or my physician, I'm always feeling fatigue, pains, gut distress, or any variety of physical complaints. This pattern is suggestive of CD. We might include insomnia which is not explained by a nighttime CH attack.

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"Pain vs. Suffering--research support", a message posted on 1/7/07.

SSRIs used to treat depression have gained a good track record but docs have been long aware of relapses when the med is stopped. Research has lead to a recommendation that the med be continued for up to 18-months after the depression has lifted because this reduces the rate of relapse. Parallel research revealed that this longer use of the meds allows our brain to "rewire" itself leading to better long term outcomes.

The article (available on the OUCH site, last line) "Pain vs. Suffering" is based on cognitive therapy. These forms of counseling/psychotherapy have been strongly supported by good research. Now some evidence is appearing that these therapies act like the SSRIs to stimulate our brains to "rewire", affording protection against strong anxiety conditions. Bottom line: looks like it may be possible to alter brain functioning to build in a permanent reduction of the anxiety which besets many folks with CH. While the gods may not have made a final pronouncement yet, experience with cognitive therapy, so far, really supports its use to treat anxiety & depression. While using "pain vs. suffering" takes time, commitment, and practice, it beats endless use of benzos, etc.

"“My brain is generating another obsessive thought. Don’t I know it is just some garbage thrown up by a faulty circuit?” After 10 weeks of mindfulness- based therapy, 12 out of 18 patients improved significantly. Before-and-after brain scans showed that activity in the orbital frontal cortex, the core of the OCD circuit, had fallen dramatically and in exactly the way that drugs effective against OCD affect the brain. Schwartz called it “self-directed neuroplasticity’ concluding that “the mind can change the brain?’ (TIME, 1/29/07. Major article on the human brain.) (OCD is classified as an anxiety disorder.)

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