I'm posting this article for those who are interested in the biological causes of depression. While we don't clearly understand the connections, we do recognize the role of the hypothalmus in the regulation of 3 neurotransmitters (serotonin, norepinephrine and dopamine) involved with clinical depression, as well as the regulatory function of the hypothalmus in monitoring the hormone cortisol. We often feel shame when admitting we are depressed, and Lord knows, we have reasons to be depressed. This creates a powerful feedback loop of behavior, thought and neurological reinforcements that can only deepen our depression if not addressed properly. Bottom line: we get depressed, our body already has trouble with the flow of powerful neurotransmitters and hormones, and our reactions to that can make matters worse. Knowledge is the beginning of recovery, and acknowledging we have a problem, is the key! Hope this helps. lance

Biological Causes of Depression

Those who research clinical depression have been interested in a particular part of the brain called the limbic system. This is the area of the brain that regulates activities such as emotions, physical and sexual drives, and the stress response. There are various structures of the limbic system that are of particular importance. The hypothalamus is a small structure located at the base of the brain. It is responsible for many basic functions such as body temperature, sleep, appetite, sexual drive, stress reaction, and the regulation of other activities. The hypothalamus also controls the function of the pituitary gland which in turn regulates key hormones. Other structures within the limbic system that are associated with emotional reaction are the amygdala and hippocampus. The activities of the limbic are so important and complex that disturbances in any part of it, including how neurotransmitters function, could affect your mood and behavior.

Within the brain, there are special chemicals called neurotransmitters that carry out many very important functions. Essentially, they help transfer messages throughout structures of the brain's nerve cells. These nerve cells, called neurons, are organized to control specialized activities. We each have somewhere between 10-100 billion neurons within our brains. Whenever we do anything, react, feel emotions, think, our neurons transmit messages in the form of electrical impulses from one cell to another.

Neurotransmitters travel from neuron to neuron in an orderly fashion. They are specifically shaped so that after they pass from a neuron into the synapse, they can be received onto certain sites, called receptors, on a neighboring neuron. Neurotransmitters can fit a number of different receptors, but receptor sites can only receive specific types of neurotransmitters.
Of the 30 or so neurotransmitters that have been identified, researchers have discovered associations between clinical depression and the function of three primary ones: serotonin, norepinephrine, and dopamine. These three neurotransmitters function within structures of the brain that regulate emotions, reactions to stress, and the physical drives of sleep, appetite, and sexuality. Structures that have received a great deal of attention from depression researchers include the limbic system and hypothalamus.
It is unknown whether changes in levels of neurotransmitters cause the development of depression or depression causes changes in neurotransmitters. It may happen both ways. Researchers believe that our behavior can affect our brain chemistry, and that brain chemistry can affect behavior. For instance, if a person experiences numerous stressors or traumas this may cause his or her brain chemistry to be affected, leading to clinical depression. On the other hand, that same person may learn how to change depressed thoughts and behavior and cope with stressful events. Doing this may also change brain chemistry and relieve depression.
Another area of research in determining the causes of clinical depression is focused on the endocrine system. This system works with the brain to control numerous activities within the body. The endocrine system is made up of small glands within the body, which create hormones and release them into the blood. The hormones that are released into the body by the glands regulate processes such as reaction to stress and sexual development. It has been found that a great number of people who are depressed have abnormal levels of some hormones in their blood despite having healthy glands, especially the hormone cortisol.
Problems with hormone levels may be intertwined with the changes in brain chemistry that are seen in clinical depression. The endocrine system is connected with the brain at the hypothalamus which controls many bodily activities such as sleep, appetite, and sexual drive. The hypothalamus also regulates the pituitary gland that, in turn, controls the hormonal secretion of other glands. The hypothalamus uses some of the neurotransmitters that have been associated with depression as it manages the endocrine system. These neurotransmitters, serotonin, norepinephrine, and dopamine all have a role in the management of hormone function.
The hypothalamus may be the culprit when it comes to excessive levels of cortisol in the blood. It is responsible for starting the process that leads to the secretion of cortisol by the adrenal glands. The hypothalamus first manufactures corticotrophic-releasing hormone (CRH). The pituitary gland is then stimulated into releasing adrenocorticotrophic hormone (ACTH). This hormone then makes the adrenal glands secret cortisol in the blood. When the endocrine system is functioning properly, the hypothalamus monitors the level of cortisol that is in the blood. When the level rises, the hypothalamus slows down its influence on the pituitary gland in production of CRH. When cortisol levels become reduced, the hypothalamus causes the pituitary gland to produce more CRH. In a person who is depressed, the hypothalamus may continuously influence the pituitary to produce CRH without regard to the amount of cortisol that is in the blood.

I am certainly one of the lesser educated when it comes to the chemical reactions involved in the brain function. But when it comes to depression, we can't bring it up enough. Depression, like any mental condition, comes with a stigma that makes people...especially men ;)....shy away from treatment.  Excellent article Lance.

Joe

Thanks, Joe. It's being read but as you say, we tend to stigmatize just admitting we're depressed. I'm kinda hoping a few others will jump in here. If we can admit we need interventions, it seems to me we ought to admit sometimes depression threatens to take us over. As we see here, knowing you are not alone is half the battle. Blessings! lance

One cannot separate the mind from the body - what is going on in the body affects the mind and vice versa.

With what we go through with CH - the pain, uncertainty, lack of control, lack of sleep, etc, I would have to look very closely at the level of emotional insight in someone who has this condition and claims NOT to have issues with depressive thoughts, if not outright depression.

Well said lettucehead.  I have been battling anxiety for many years and most recently some mild depression.  How could we not struggle with it while in cycle?

An interesting article which is prompting me to read up more so I can get a deeper understanding of this subject.

I was recently talking to someone, explaining what I'm currently going through with CHs plus post concussion syndrome, a few issues with medication and some time off work. The interesting comment I got was that I'd probably not be human if I didn't feel a bit depressed at times with all this.

There is a huge stigma about people even possibly mentioning that they might even possibly be even slightly under the weather, never mind mentioning the word depression. It's this very stigma which makes it so hard for many people, especially males, to get the help required to get them through this.

Here in New Zealand there is a big advertizing blitz being led by John Kirwan who was one of the great All Blacks (NZ rugby team). He went through depression himself and his experiences with TV adverts, web sites, etc, is having a huge impact on people here talking about depression. This campaign has won a lot of awards but more importantly it has been shown to have an impact on the statistics, especially for male suicide.

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How could this depression you are talking be treated if there are no good inteventions in life with ch?

what? a therapist will make the pain go away in the most inappropriate times with talking?
or an anti-depressant which hasn't already been given will make the pain lesser and as though fuctional?

if i have understand right from my own reading
hypothalamus plays a major part in chronic pain in general.not only with ch.
But we didn't just wake up one morning feeling depressed and not in pain so what's there to admit?
if it's clinical depression it's another kind of beast.
do people with clinical depression rock back and fourth
wishing all this physical pain would end?
And for sure there is no fullfilling prophecy in our case
that thought manifests a hit in near future.
it's just meant to happen and if we are being cautious
or even smaller sort of speaking,it's because of the experience talking.

now if it is some sort of depression,it's because we keep on fighting beast but we lose on many fights while the war never ends.But that doesn't mean we never stopped fighting.
jobs,friends and that is not cause of depression,but fear of getting hit,misunderstanding,exhaustion, and the something more that would help in keeping up that other healthy people don't require to have.
and nothing in our own life is separated in small apartments.
everything affects each other..

as for the statement men don't admit easily depression as women do.
what kind of funny stereotype is this?
never heard it before.

i ll skip depression in our case.
it's totally different thing.life with ch pain.

there is moto that says
sometimes ideas seem harder to cope than the same facts producing them(hope i said it well)

well not with ch!

nothing here to admit.
i ll skip another uselless bag of meds and a worthless talking with a therapist.


p.s.So this John Kirwan who does what dreamed as kid admits he hurts every day the hell as we do?
he fears maybe to get to next game cause he might get hit and has to get to bent while the stadium misunderstand him??

naaa.....i don't think so.
don't get me wrong depression is another beast.
what we deal with is a different case.

so nothing really to admit here

Oh, my...where to start? OK, here:


Quote:

How could this depression you are talking be treated if there are no good inteventions in life with ch?

There are good interventions as we continually discover on this site: O2, verapamil, lithium, busting, etc. You mean there is no cure. Not the same thing.


Quote:

if it's clinical depression it's another kind of beast

We're talking about clinical depression. Clinical means it is related both to circumstance as well as physiology, usually of a persistent and ongoing character. Real depression, on the other hand (and to which you seem to refer) presents due to a "real life event" which is immediate and often unexpected, like job loss or family death. They present similarly but are treated differently.


Quote:

do people with clinical depression rock back and fourth wishing all this physical pain would end

Some do. Check in with someone who has fibromyalgia.


Quote:

what? a therapist will make the pain go away in the most inappropriate times with talking?

We know neuronal pathways and structures are affected by our speech and cognitions. As a result, one can and does alter neuronal physiology through deep and reflective listening; ie therapy. It was quite a discovery to find that we can and do alter our brains by the way we talk and think.


Quote:

i ll skip another uselless bag of meds and a worthless talking with a therapist

Amitriptyline is a tricyclic drug used to treat depression. It is also used to treat eating disorders, post-herpetic neuralgia (the burning, stabbing pains, or aches that may last for months or years after a shingles infection), and to prevent migraine headaches, and has application for cluster headaches as well.

Neither a bagful nor worthless, apparently. So, black, is your life better knowing you lose more battles with the beast than you win? And does that make you feel? Depressed, perhaps. If so, its one more distraction you do not need, nor need to endure without aid, in our ongoing struggle. And thanks for the enthusiastic reply! Blessings! lance

Quote:

There are good interventions as we continually discover on this site: O2, verapamil, lithium, busting, etc. You mean there is no cure. Not the same thing.

no i didn't mean cure.
these are interventions for pain.i mean interventions in life.secured job,secured health coverage etc
a kind of dissability form that doesn't just give money
but helps the individual earn his self respect and still be productive and useful to society(if not for all at least for those who need it to be availiable)


Quote:

We're talking about clinical depression. Clinical means it is related both to circumstance as well as physiology, usually of a persistent and ongoing character. Real depression, on the other hand (and to which you seem to refer) presents due to a "real life event" which is immediate and often unexpected, like job loss or family death. They present similarly but are treated differently.

what i mean and understand is that not all people with ch go with clinical depression and in case this exists simutanouesly doesn't mean that it isn't just coincidence.hypothalamus plays a bigger role in chronic pain in general and not only in ch.
and what is percepted as pain is a very big chapter.
therefore there are people with clinical depression and no ch or fibromyalgia or any chronic psysical pain.
on the other hand the other kind which i seem to refer
is really due to a real life event but in our case is caused by getting hit repeatedly and ending up losing jobs etc.cause and effect.
Not about the necessary grief of a death in the family(for example)which could last more than a year or the necessary time each needs which differs from person to person but still pass through limits and needs treatment.
therefore that is my objection with this treatment as our case is different.i don't find any use in treating the so called depression for a job lost due to ch as i ll still can't find and secure a job due to ch and the same problem appears again which brings us to o2,verapamil etc and what works best but these are treatments for pain and not treatment for depression.
on the other hand from my own experience i ve been given anti-depressants in the past and in my suprise if i had depression as it was in treatment for ch the neuro explained me that it is used as to try lessen the pain neurotrasmitters are giving to brain(something like that,sorry can't remember well)  but there is no diagnose for depression(that is for sure what he said).And yet i didn't find it helping at all. 


Quote:

Some do. Check in with someone who has fibromyalgia.

exactly.someone with fibromyalgia.
so the question remains.
someone with clinical depression rock back and fourth wishing all this physical pain would end?


Quote:

We know neuronal pathways and structures are affected by our speech and cognitions. As a result, one can and does alter neuronal physiology through deep and reflective listening; ie therapy. It was quite a discovery to find that we can and do alter our brains by the way we talk and think.

true and they do an excellent job.As far as i know cause i find therapy fascinating not cause i ever been
but due to some reading yalom books,goldwin and some others(not too deep reading but enough to get an idea)
but yet i find it very hard to believe how can this change the physical pain that causes all the others.
there where times i raised a question here if this we have is sychological problem and yet if we are re assured that is physical i have my doubts if any treatment will help.

just my thoughts right or wrong :)

Not sure if CH is physical or psychological pain, but I would ask what is Phantom limb pain then? Physical or psychological?

It is hard to say because pain is still reveiced/created by brain yet there is no underlaying cause, there is no limb yet it hurts, it is faulty pain triggered.

I would assume CH is similar, it activates trigeminal nerve but nothing goes around our eyesocket, we feel pain as if someone used knife to dig in our eye, but the pain is faulty, yet physical, because projected by brain and received.

MattyAA wrote on Jun 25^th, 2010 at 12:30pm:

Not sure if CH is physical or psychological pain, but I would ask what is Phantom limb pain then? Physical or psychological? It is hard to say because pain is still reveiced/created by brain yet there is no underlaying cause, there is no limb yet it hurts, it is faulty pain triggered. I would assume CH is similar, it activates trigeminal nerve but nothing goes around our eyesocket, we feel pain as if someone used knife to dig in our eye, but the pain is faulty, yet physical, because projected by brain and received.

Phantom pain is as real as it gets.  In my case it's so severe they call it exquisite pain.  It's never ending 24/7/365. Nothing helps I just endure.  No blood no foul.
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          Potter

Yes Potter but I mean, limb shouldnt hurt if it doesnt exist, yet it hurts, which means it is problem with brain, and CH maybe is similar? That if we could lose head it would still hurt, if only brain was in other place in our body, that our eyesocket would still hurt.

Sorry also that you go through so much Potter, and sorry if I did say something inappropriate in my previous statement, surely you go through double what we go through.

Also if I may ask did they try that trick with mirror box for you? I read somewhere for some it may do the trick.

I have been so embarressed to even post anytihing lately.  I have spen the latst 5 days being hit around the clokcw wotj little tp no slep.  O appologize for mu lack af effectove typing... mu brain has been a total mess the entire time. 
This is day six and im slowly recoverering ... yahoo! my brain still gets confused so pls forgive me.  I get ch every week at lest 3 days a week and sometimes more.  Thist week has been veru7 bad with no relife.  I prayed that God would just take me... nobody understands, except for you thy so very much. I was ready to get rid of all my belongins and call it quits.  The only thing that sto[ed me was that if i couldnt live for myself then i  would live for my lord and saviour who loves me unconditionalltionslly and has given all to me.  I t hurts to be alone in this; nobody understands and Ithink the dr hasme on anti depressents, lithium and topomax, correct me if im worng. the y work good to begin with but anti depressents and i dont get along well and eeventully the cause me to become more depressed and sucidal.  i have an appoint on monday and will discuss this with m y neurol.  iim scared and cant sleep, here noises and am sick to my stomack...i am having trouble woalking and all this is progressively getting worsel  again i appologize for saying such things, its so embarressing.... but depressin is such a major part of my program.


But then I have been chronic, that I am  sure of for a t least a year begging doctors to do something bout my headaches that hurt so bad and keep me from keeping a job.
i want to be normal, work in the flowr garden but cant go into the sun go shopping but am unable to walk far; yeah having extreme troubles walking this week; have to hole on to things.
sorry for the downer but i do believe the some ch gets worse and for many does cause depression, how can it not; you lose so much time with fiamily first and your friends; not to mention if you are chronic you can even be normal enough to hold a job whis is what i want so desperatesly.

i love you all, such geat supporters , with excellent advice and words of love and understanding.



God Bless you all and your familis; you are all wonderful ppl.
I love eack and every one of you.
Sincerly,
Kat

Bless you Potter, I think of you sometimes when I am dealing with a scale tipper and feel a momentary gladness that that is the only pain I am feeling at the time it's exhausting enough to deal with, without phantom pains added to it.  People like you help give the rest of us strength.

Kat, it is possible to be chronic and keep a job.  I am doing it, but then I am also blessed with a very understanding supervisor (so far).  I don't often call off work due to CH but on occasion I have to do so.  They have seen me at work with a nasty CH hit and it has freaked a few people out.  Scared one of the cleaning crew at our building last week as a matter of fact when I went to the bathroom armed with my Imitrex. After I recovered a bit I saw her again and explained a bit about it to her after she asked me a couple of questions about CH.  Most of the people who know me at work can tell just by looking at me if I am dealing with a hit even a milder 3 or 4 kip, I get very pale and of course the water eye starts.  I have had a past sup. really freak and order me to the sick room...That didn't go over well with me since I don't appreciate the added attention to it or being told to sit in a room when all I really want to do is get back to work so I at least have something else to try to concentrate on.

Anyway...
The point I am trying to make through all this rambling is that you can NOT let CH rule your life!

In dealing with Life and CH you must take the bad with the good and get through it, giving up is not living a proper life.  The beast will take time and energy from you, but you have all the other time that you are not suffering a CH hit to live life to it's fullest.

Keep your chin up, you are most likely stronger than you think.

Ging...

Kat -
Hang in there...
Don't stop trying, don't stop hoping...

Kat, have you tried dosing with shrooms, LSD or seeds. Good advice around here and all say it will help. In the meantime is o2 working for you? You didn't mention your treatments so just asking. but whatever you do, we are here for you. Jay from Baltimore.

About depression...The terms are simple, different and clear. "Situational" and "Clinical". A bit like Episodic and Chronic for us but not really. I have been successfully treated for situational depression, first with a therapist and now with Sertraline, for 3.5 years since my wife of 25 years told me she wanted a divorce. I am a 56 yr old male who sought treatment immediately. Don't know if that makes me the exception or the rule, but needed help and got it just like I did when the first CH episode hit me 17 days ago. Treatment for deprssion works and Sertaline does not interfere with CH meds (natural or pharma). I encourage you all to cunsult your doctor about mild anti-depressents and consider therapy because if you ever feel depressed it is not "just CH", it is situational depression potentially caused by an onset or just the thought of dealing with this beast for along time.

Basic litmus test for diagnosis for whether you need meds is "have you ever considered suicide? (everyone does), but then, have you ever considered how you would do it? Have you ever planned it or taken the first step? If the ansewer to these questions is yes, as it is for me, you should see a therapist and have them advise you if you should use meds. If CH is the cause, like it is for most of us, (me too, now) then it is probably situational and treatable. Just like people told me don't wait...get o2 and then dosee. I am saying if you have conisdered how you would off yourself, or lay aound in bed rather than making an effort to get out and live, then get help. It's there and it works, Jay

I didn't think depression affected me in my thirties and early forties, and the link between depression and CH seemed tenuous for me then.

That is no longer the case.

Kat, oh dearest Kat. We have talked before about the two greatest weapons in our arsenal against CHs: hope and faith. We all hope for a cure, an effective preventative and an abortive that will work all the time. These are not unreasonable hopes to hold, and they are grounded in the reality that some research is heading us in the right direction, sometimes preventatives work and some abortives are effective. It is our faith, however expressed (like you I am a Christian), that gets us up in the morning, or in the middle of the night, to do what is at hand: work between hits, live between hits, battle the beast, whatever. The funny thing about faith and hope is one cannot truly be sustained without the other. And both are communal in nature. It's why you're here. And it's why you're going to stick around, get some Dr to really hear you, and lean on us when you are most afraid. I know what it's like to be afraid to sleep. I was afraid, and slept little, for the past 3 years. But I prayed for and received grace to help in between bouts. This became my defining reality no matter how much the CHs tried to defy me. If you want to talk more w/o embarassment, although I see no need to feel embarassed, shoot me a pm. In the meantime, God bless darlin'. lance

I was reading the posts regarding depression.  Isn't there a link between pain and depression?  I am not a sufferer but I am a supporter.   
I went through a period of time where I had so much neck and back pain that my best friend who lived out of state could tell a good day from a bad day just from my voice.  When I finally got treatment for my issues, she could tell just from the change in my voice.  During the time I suffered I know I battled with depression.  I also know that my boyfriend who has CH's does as well.  I am just wondering if anyone has any further thoughts on this issue.  I know for him, CH started in his teens and he is now 49.  During most of this time, depression has been an issue as well from what he has told me.  Has any one heard of any link between anti-depressant meds and CH?   Can those meds exacerbate the cycles?

Having been chronic since '97, I can say that depression (I don't know clinical from any other) can hit without me even knowing it... sometimes it just dawns on me that for days I haven't done a damn thing except sit and stare at things...

I've been taking an antidepresent for the past 10 or so years (trazadone) - the doc has tried other things but I don't tolerate meds well, so we just stick to trazadone (it counters the side effects of topamax I guess). But the point is - depression STILL hits at times without warning.

What I've found over the years (and this is not in the clinical archives) is that "I'M" the only one who can pull me out of the depression ... literally .. and NO it's not easy sometimes.. But when I realize that's what's going on, I have to get my act together and literally pull myself out of the stupor and "make" me start doing stuff (get out of the house, talk to people, etc).

Sometimes I come to this MB and "whine" and that helps some, but in the long run - I think it's up to me. There are some on here who can kick my rear and that will sometimes pull me out of it.

Guess what I'm saying is that whatever the cause of depression, we all have to find our way of pulling out of it.

I've always thought that our attitudes toward CH play a big part in our depression (at times I've had trouble with attitude - it's hard to pull out a good attitude when you're hurting like hell). I have CH and it hurts! I can let it get the best of me or I can fight like the devil and lead a normal life... it's MY choice. For years I let it get the upper hand, then I CHOSE to fight back... Now, for the MOST part I'm winning and the bastard can go to hell... I have things to do and he's NOT going to stop me...

Insofar as working with CH - I've managed to run a pretty successful business thru the years, gotten hit in front of co-workers, clients, at parties, on the street, etc.. and have yet to apologize to anybody... I have a rare form of headaches that I CANNOT help - so get over it... (that's my "attitude"). The people that "matter" don't mind and the people that "mind" don't matter.

My big hope is that someday there will be a "cure" for these damn things and my grandchildren won't have them (my oldest grandson already has stomach migraines).

But in the meantime, I'll just have to live with my screwed up hypothalmus and do the best I can...  :-*

Shell wrote on Jul 1^st, 2010 at 1:17am:

I was reading the posts regarding depression.  Isn't there a link between pain and depression?   Has any one heard of any link between anti-depressant meds and CH?   Can those meds exacerbate the cycles?

Yes there is a link between pain and depression: neural, hormonal and psychological. And if you read the potential side effects warning of the antidepressant, you will see many come with a warning that it may cause the very thing you are trying to avoid: deeper depression.

BarbaraD wrote:

Quote:

I've always thought that our attitudes toward CH play a big part in our depression (at times I've had trouble with attitude - it's hard to pull out a good attitude when you're hurting like hell). I have CH and it hurts! I can let it get the best of me or I can fight like the devil and lead a normal life... it's MY choice.

I couldn't agree more! Our attitude is also responsible for neural, hormonal and psychological condition through a complex feedback system. Bottom line: the way you think and react towards pain can go a long way in solving depression. BUT...sometimes there is a need for pharmacological intervention. That, too, can be part of what "works" for someone. Blessings! lance

BarbaraD wrote on Jul 1^st, 2010 at 6:21am:

I've always thought that our attitudes toward CH play a big part in our depression

I absolutely and unequivocally agree.  No question, our attitudes play a HUGE part in our ultimate happiness in life. 

However - one cannot WILL oneself out of a real depression.  Yes, there are things you can do to help yourself - i.e. exercise, eat right, get enough sleep.  However, sometimes the disease of depression itself takes the ability away to do those things. 
Endogenous depression is a chemical change in your brain - you cannot will it away any more than you can will yourself out of hypothyroidism or (haha) cluster headaches.

The reason I'm being so vehement about this is I know too many people suffer for too long with depression - thinking they're 'weak' if they admit they need help...

I'm with Lettuce on this one...and this link has just come full circle. ;) As Barbara said, you yourself will often times not realize how deep you have sunk into depression. That's when it's great to have a supporter...or a support group...who recognizes depression and realizes how significant a threat it can be. And will push you to seek medical intervention, regardless of the stupid stigmas that are sadly, still attached to seeking help for it.

To those of you going it alone, with no support network, please reach out to us. Depression is not a head cold that will always just go away on it's own.

Joe

Touchee Lettuce. CH sufferers by defintion are prone to depression. As a man (56) otherwise healthy and socially capable, I found myself unable to deal with my wife's deciosion to seek a divorece 3 years ago. I couldn't bear the thought of being alone after 28 years. Not too proud to talk to a therapist and after two sessions he said I had situational depression. Sertaline twice a day and a year of therapy helped me keep from sitting around feeling sorry for myself. Doin pretty well three years later as a matter of fact (now divorced)and then a funny thing happened 19 days ago. My head started hurting like a bitch. It would stop and then come back in a few hours. Even woke me up from a dead sleep pounding. WTF this was worse than the migraines I'd had as a kid. Went to a doc. She said that's not a migraine or a sinus infection. you have CH. Went home and read that this may never go away. Thought to myself. You know if I wasn't still taking Sertaline and if I hadn't learned to recognize the symptoms of depression and the coping skills...this could be a downer. But instead I found this place. Developed and plan of attach and am fighting the Beast with all I have. Loss of control and feeling helpless are classic triggers for depression. Fight the beast, have a plan, have a back up plan, be in control, but when you feel like none of that is working...see a good psycholocist and get a good anti-depresent that doesn't fight other meds we take. Just my 2 cents..and thanks to all of you for being out there!

jayhedges wrote on Jul 1^st, 2010 at 2:06pm:

CH sufferers by defintion are prone to depression.

I beg to differ. While the incidence of depression may be higher amongst CH sufferers, you cannot say that being prone to depression is part of the definition of CH.

My neuro told me once..."Jim, you look like you are depressed. I said.."I have cluster headaches and I am in high cycle, wouldn't you be depressed?

He laughed and said yeah I guess I would.

But I agree with Lettuce (I wish you had a different name lol) When you are clinically depressed you can't just snap out of it or will it away. It is an entirely different animal.

Brew wrote on Jul 1^st, 2010 at 2:13pm:

jayhedges wrote on Jul 1st, 2010 at 2:06pm: CH sufferers by defintion are prone to depression. I beg to differ. While the incidence of depression may be higher amongst CH sufferers, you cannot say that being prone to depression is part of the definition of CH.

I don't think that Jay was implying that depression is part of the definition of CH. 
My interpretation of his post was that with the chronic severe pain, lack of control, lack of sleep, social isolation, etc, of CH comes an understandable element of despair, helplessness, hopelessness - these issues then lend themselves to the development of depression. 

I think one would find a similar domino cascade in many chronic pain conditions - it is not that depression causes CH, but that the relentless 'side effects' of CH causes depression...

And, Jimi, my name is Kirsten...   ;)

Phew....Kirsten.....that rolls off the fingers much easier then Letuce! ;D

My sufferer is taking effexor.  I took it at one point because a doctor I had thought I had fibromyalgia due to a family history.  I have a mother and two aunts that have been diagnosed with this and I may very well have it.  I quit taking it because the doctor told me I would have to take it the rest of my life.
I have noticed that when my boyfriend forgets to take his, there is a noticeable side effect. 
I have not been able to observe a linkage between the med and the CH's as of yet.  When I told him I had joined this site, he offered to have me go with him to see his headache doc.  This is one of many questions I have for the doc. 
If anyone has any feedback on this, I would appreciate it!  I am trying to find ways to lessen the attacks and conquer the "beast"!
FYI, he has a oxygen tank and is on verapimil and taga...something(can never rememeber what this one is!).  The verapamil seems to help but tanks the sex drive.  I notice a definite moos shift as he starts these two meds up each cycle. 

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I notice a definite moos shift as he starts these two meds up each cycle.

This is something he should talk to his doctor about if the meds are a cause of mood shifts.  On the other hand the cause could just be the CH and the fact he knows what kind of HELL he's in-for for the next few weeks or months depending on how long his cycle lasts. 

You should have him join the site as well.  It may offer him something he doesn't know or at least some added support we all need at times.

Shell wrote on Jul 2^nd, 2010 at 3:40am:

I have noticed that when my boyfriend forgets to take his, there is a noticeable side effect.

Effexor has a reputation as a pretty good med for depression, but it also has a reputation as a med that can be hard to stop because of side effects.  Often when people stop taking effexor abruptly they can have some temporary mood lability, lightheadedness, dizziness, even some tingling in their extremities - these are all temporary symptoms and not particularly dangerous - just uncomfortable.  Often people have to wean off of effexor very very slowly - i.e. go from 225mg to 150mg for several weeks to 75mg for several weeks to 75mg every other day for several weeks, then stop.  How fast you can wean depends on how uncomfortable you find the weaning side effects...

The verapamil seems to help but tanks the sex drive.

A common side effect of Verapamil for many. For me it wasn't a reduction in the DESIRE to, just the ABILITY. Like the beast hasn't taken enough away he wants to deprive me of that too! :-/

Joe

Yeah, sorry to say I understand Joe. And if that ain't cause for depression I don't know what is...oh yeah, the pain, and the side effects, and.....well, you know. Blessings! lance

Guiseppi wrote on Jul 2^nd, 2010 at 9:25am:

The verapamil seems to help but tanks the sex drive. A common side effect of Verapamil for many. For me it wasn't a reduction in the DESIRE to, just the ABILITY. Like the beast hasn't taken enough away he wants to deprive me of that too! :-/ Joe

Maybe you could consider growing some Bishops Hat (epimedium grandiflorum) in your flowerbed. seems to work wonders for goats, and people too.

(edited for spelling)

It has taken me a while to get around to reading these posts because I tend to avoid anything to do with depression - the reason being that it frightens me.  Silly I know.

Kat I'm sorry to hear you are hurting so much.  I wish you all the best for your doctors appointment and hope that you get the help you need.  The only advice I can offer is that 'this too shall pass'.  Hang in there, don't give up....take each day as it comes, I'm sure one day the sun will come out and you will start to feel better.  And don't be affraid to post here, no one is going to judge you!  This is a support site after all :-)

I find it interesting to read of the link between CH, depression and chronic pain.  Not just that pain causes depression, but that they stem from similar area of the brain.  I have suffered from depression on and off since I was a teenager.   In 2001 I took a near fatal overdose and ended up on life support for three days.  Having had depression before I thought I would get through it... but I gave up too soon.  I had recently been diagnosed with fibromyalgia and my CH was driving me insane!! - still undiagnosed.

But here I am today, very happy to be alive, now a mum, and life is so much better.  When I feel myself falling apart I actively work on my attitudes, get out, take a daily walk, talk to people etc etc and thankfully it passes.

Thanks for posting the article, very interesting.

Kate   

Kate in Oz wrote on Jul 6^th, 2010 at 10:41am:

It has taken me a while to get around to reading these posts because I tend to avoid anything to do with depression - the reason being that it frightens me.  Silly I know. But here I am today, very happy to be alive, now a mum, and life is so much better.  When I feel myself falling apart I actively work on my attitudes, get out, take a daily walk, talk to people etc etc and thankfully it passes. Kate

No, not silly Kate. Who likes to talk about depression? It's depressing, or can be. The point is, you are very right about attitudes and the effect the right mindset can have on helping us cope. It isn't just a psychosomatic thing; it is a complex psycho-soma interaction. The way we think, our "self-talk," and our attitudes effect our brain and our brain effects neuroreceptor/transmitters.

Just being here has helped me tremendously. Not just for the practical advice, although that's been a goldmine, but because being supported and being in support of others has a positive effect all by itself.

Thanks for jumping in and being so open, Kate. I was hoping you'd respond. lance

Awesome post Kate, NOTHING speaks like real life experiences. So glad you're in a happy place now. [smiley=hug.gif]

Joe

Depression is one word that was often used in my childhood to describe a passing feeling which was, still, more severe than sadness. Then came my university years and flatmate, who was diagnosed with severe depression.

The same flatmate saw me when my second cycle got me so down that she said to me: "I've never seen anyone who is that depressed", and she meant it. Since then I've been through two depression cycles and few one-off hits, which brought me so down that it worried me.

Now things are much better, but who knows? I found out that both my grandmother and father went through depression-like bouts, which could naturally make me a bit more vulnerable to get such feelings than someone else. Knowing that has made things easier for me.

I also know where depression can lead. My boyfriend's father killed himself because of it, my flatmate has thought about it on several occasions. When/if those darker feelings begin to arrive on my horizon I can be more prepared now.

Still, it does help me in great deal that I told my partner about this side of ch before he told me about his father....

Sanna

Well done, Sanna. Like CHs, depression works its evil in silence. Yes, it is somatic too, but keeping things up front and out in the open, allows supporters to really support, and not just wish they could do something to help. And knowing you are vulnerable, and when another bout may hit (hey, just like CHs!) is a great defensive weapon. May you stay pain and depression free! lance

[smiley=hug.gif]

This place really has been a godsend to so many of us.  Just knowing that you're not alone in suffering is a tremendous help!  And having a place to vent/moan etc when life gets us down is great - especially when others who no doubt care, really struggle to understand.

Again, thanks for such an interesting/helpful topic!

Kate



Kat you are in my thoughts, I hope you are keeping well and looking after yourself.

something interesting you may want to read.
diagnostic criteria for depression.

Major Depressive Episode

A. Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.

Note:  Do note include symptoms that are clearly due to a general medical condition, or mood-incongruent delusions or hallucinations.

(1) depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful). Note: In children and adolescents, can be irritable mood.

(2) markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation made by others)

(3) significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. Note: In children, consider failure to make expected weight gains.

(4) insomnia or hypersomnia nearly every day

(5) psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down)

(6) fatigue or loss of energy nearly every day

(7) feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick)

(8) diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others)

(9) recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide

B. The symptoms do not meet criteria for a Mixed Episode.

C. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

D. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hypothyroidism).

E. The symptoms are not better accounted for by Bereavement, i.e., after the loss of a loved one, the symptoms persist for longer than 2 months or are characterized by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation.

Major Depressive Disorder


Single Episode

A.  Presence of a single Major Depressive Episode

B.  The Major Depressive Episode is not better accounted for by Schizoaffective Disorder and is not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified.

C. There has never been a Manic Episode, a Mixed Episode, or a Hypomanic Episode. Note: This exclusion does not apply if all the manic-like, mixed-like, or hypomanic-like episodes are substance or treatment induced or are due to the direct physiological effects of a general medical condition.

Recurrent

A.  Presence of two or more Major Depressive Episodes.

      Note: To be considered separate episodes, there must be an interval of at least 2 consecutive months in which criteria are not met for a Major Depressive Episode.

B.   The Major Depressive Episodes are not better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified.

C.  There has never been a Manic Episode, a Mixed Episode, or a Hypomanic Episode. Note: This exclusion does not apply if all the manic-like, mixed-like, or hypomanic-like episodes are substance or treatment induced or are due to the direct physiological effects or a general medical condition.

source
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Quote:

The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hypothyroidism).

Black, I do find it interesting. I also am a bit confused as to why you posted it here. The original article was about the physiology behind depression, not the symptoms, and the role the hypothalmus plays in the symptomatic appearance of depression. The DSMR (Diagnostic and Statistical Manual Revised) gives criteria (generally for billing purposes) of a clinical diagnosis, but is not a "leading edge" for research purposes. It is constantly under examination as new research comes to light and as such its finding, and its publication, revised.

Having said that, you seem also to be taken with the idea that we cannot be depressed because we have a medical disorder, since a medical disorder by diagnostic criteria cannot be the cause of depression. Hmmm...we said the hypothalmus, through a complex feedback mechanism, is the center of neurotransmitter/neuroreceptor hormones that are identified as contributory to depression, and it is probably the hypothalmus that is involved in the triggering of cluster attacks. If A, then B...the same organ which triggers depression and controls hormones related to depression, also triggers CH attacks. If it is faulty in one area, then it is logical to question its faultiness in the other area as well.

And whether or not circumstantial criteria can be considered when making a determination of clinical depression is not as settled as you make it out. Here is an excerpt from the university of Berkeley:

Stress: Psychological and environmental stressors can contribute to a depressive episode. Common stressors among college students include:


academic demands
transitions-re-entry to school, being new to Berkeley
balancing school, work, family, social life
financial responsibilities or worries
family concerns
social isolation
difficulties in relationships with friends and romantic partners
being on one's own in a new environment
exposure to new ideas, new people, and temptations
awareness of sexual identity and orientation
preparing for life after graduation, career decision-making

A major loss, chronic illness, relationship problems, work stress, family crisis, or unwelcome life changes can often trigger a depressive episode, even in individuals without a family history or genetic predisposition.

All of the above in bold can accompany the Clusterhead, especially chronics. They therefore can "act as a trigger" for a depressive episode.

Denying depression cannot cure it. It is biological in basis and must be addressed as such.

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Sorry to have made this so technical, but you opened the door. Blessings! lance

I have always been intrigued by the possible connection between depression/serotonin and CHs.

All I know is that mine started when I developed depression and began taking SSRIs..................

I read somewhere, sometime ago (sorry to be so vague about it but maybe someone has a more specific reference) that CH's may be preceded by a serotonin storm...something which can by itself be pretty deadly. Any input on this? lance