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Chronic headaches and depression


Your plate is full.

You have a deadline to meet, you still have to cook dinner, and you need to get the kids to soccer practice and dance class. You have this weekend to look forward to though! This weekend is the first family trip you’ve been able to plan since the youngest was born, and the kids are over-the-moon excited, but you’re struggling to get through this week because the headache is bad today. Three weeks this has been going on now, but today is particularly unpleasant So you take some ibuprofen and push through it because dinner won’t prepare itself.

Maybe you're dehydrated, so you drink some extra water.

Maybe your blood sugar is low, so you grab a quick bite on your way out the door.

You can feel the tension building in your shoulders, so you roll your head and shoulders around to stretch while you’re at a stop light.

You know what? You’re probably just not sleeping enough. All you need to do is go to bed early and sleep it off. You’ll shut your eyes and drift to sleep and awake the next morning fully refreshed…only the headache is still there.

Dealing with chronic headaches is exhausting. You’re just…there…going through the motions, surviving the moment, but you’re not thriving because this gnawing pain at the base of your skull just won’t go away! When it's difficult to remember the last time you DIDN’T have a headache, how would that affect your mental state or your overall mood?

That sounds depressing, right? And I mean that quite literally. Depression is a common psychiatric comorbidity found in people with painful physical symptoms, such as chronic headaches.

Autonomic nervous system

The nervous system that plays a role in tension-type headaches and depressive disorders is called the autonomic nervous system. There are 2 parts to the autonomic nervous system: sympathetics and parasympathetics.

Sympathetic nervous system

The sympathetic nervous system is the body’s rapid involuntary response to dangerous or stressful situations, otherwise known as the “fight or flight” response. Imagine…you’re camping in the woods by yourself, and for whatever reason you decide to forage for your own food when you stumble across some delicious blueberries! You know who else likes blueberries? That bear standing behind you. RAWR! Oh no, a bear! What are you going to do? Are you going to risk life and limb to fight this bear for delicious blueberries, or are you going to get the heck out of Dodge? Either way, the same thing happens in the body:

  • Adrenaline rush (epinephrine) – you know, because bear!
  • Pupils dilate - all the better for seeing said bear.
  • Heartrate increases - because you need lots of blood to your muscles for running or fighting.
  • Airways relax – to allow for more stamina for the running or the fighting.
  • Bladder relaxes –there’s a good chance you’re going to pee yourself when faced with bear! Just saying.
  • All the digestion processes are inhibited – salivation, stomach, gallbladder, and intestine activities (because making poop is not a priority when bears are involved)

Parasympathetic nervous system

Assuming you can run at least 36 mph and can actually outrun a bear, you’re now at a safe distance away from danger. Congratulations, you made it! Now that you are no longer in “flight” mode, what happens in the body? The sympathetic nervous system starts to back off so the parasympathetic nervous system can take over, otherwise known as the “rest and digest” response. So, what does the parasympathetic system do? Well, pretty much the opposite of the sympathetic system:

  • Adrenaline stops
  • Pupils constrict
  • Heartrate decreases
  • Airways constrict
  • Bladder contracts
  • And the digestive systems restart: salivation, stomach, gallbladder, and intestine activity
**initiate subtle segue to bring us back to the point**

So what does all of this have to do with headaches?

We can all agree that being chased by a bear is no bueno, but the “fight or flight” response of the sympathetic nervous system is necessary to be able to handle these types of situations when they occur. It’s designed to be only temporary for when we need it, but what effects would it have on the body if the sympathetics were firing ALL. THE. TIME. You never get out of “fight or flight” so you never really get a chance to “rest and digest.” What types of long-term symptoms do you think we would see?

Time to get science-y!

Chronic pain and depression can be seen to influence one another through a complex matrix of connections. When someone is under chronic stress (such as headaches, for example), the sympathetic nervous system is working continuously without proper stimulation of the parasympathetic nervous system to counterbalance it (too much “fighting or flighting,” not enough “resting and digesting”). Increased adrenaline (epinephrine) levels can incite an increase of proinflammatory cytokines causing inflammation of the nerves, which can then alter pathways in the brain and result in pain and symptoms of depression. With too many proinflammatory cytokines in the system, this can cause an imbalance/deficiency of popular “feel good” neurotransmitters such as serotonin (wellbeing and happiness) and dopamine (pleasure and reward) which can help to relieve depression and anxiety as well as reduce pain. Here's what typically happens:

Headaches cause pain

Pain increases inflammation 

Inflammation causes more pain and depression

Pain and depression fuels headaches

Headaches cause more pain

Pain increases inflammation

and so on and so forth............

 This is the vicious cycle that leads to chronicity: The trick is breaking the cycle! But HOW???

treating headaches with chiropractic

Chiropractors are notorious for treating low back and neck pain, but do you know the 3rd most common condition chiropractors treat? (Hint: see heading above.) That’s right! HEADACHES! Chiropractors can restore motion to the joints in the neck, stretch and relax spastic muscles in the neck and the base of the skull, and rehab the neural pathways by “turning on” the parasympathetic nervous system so your body can “rest and digest!” Treat the headaches so the body can reduce the inflammation which then helps to manage the depression caused by the stress of chronic pain.

Reduce headaches → reduce inflammation → reduce pain and depression.  Simple as that.

Chronicity dertermines frequency and duration of care

Something else that’s important to understand about headaches (or any type of chronic condition, really) is that the longer you have it, the longer it takes to treat. Our office specializes in long-term correction of conditions and the overall wellness of our patients. We have a deep understanding of how the body heals and how long it’s going to REALISITICALLY take to correct a condition, and headaches are the same way. For example, someone suffering from headaches daily for 2 years can typically see *up to* 75% reduction of symptoms after 3 months of care, and 100% reduction of symptoms after 6 months of care, allowing some room for variability.

So, I ask you… Are you ready to break the cycle??



Chu, E., Ng, M. (2018). Long-term relief from tension-type headache and major depression following chiropractic treatment. Retrieved June 16, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6069670/

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