Studies show that emotional problems are 2 to 3 times more likely in migraine patients compared to the regular population. Standardized tests also show that migraine patients are more likely to simultaneously have disorders such as endogenous depression or anxiety attacks.

A disturbance of the serotonin levels is regarded as a biological substrate of such a disorder. Other scientist such as the American K.Merikangas assume that a long-term syndrome exists which starts with anxiety attacks in the early childhood and is later superseded by migraine attacks and is finally followed by depressive phases in later years of life.


One or more episodes in which 5 or more symptoms have to exist in one phase for at least 2 weeks:

– depressed mood

– loss of interest or joy

– insomnia or hypersomnia

– psychomotoric unrest or self-consciousness

– fatigue or loss of energy

– loss of self-worth or exaggerated feelings of guilt

– trouble concentrating or inability to make decisions

– recurring thoughts of death, suicide ideas, plans or attempts

Since it is known that certain types of headaches can be treated with tricyclic antidepressants headaches are rather seen as caused by a depressive disorder if they remit if the depressive disorder is not treated with a tricyclic antidepressant.