Hi, I am lucky enough to only suffer one major bout a year.  My question to everyone is; Does anyone suffer depression before a bout?  It seems to be that before a bout there is a noticable change with myself and whilst I understand it may not be wholely attirbuted to CH's but am curious if it is a common experience.  I do not believe that I am pre-empting the start of a bout and have as yet not had any of the usual syptoms.  Over the years the actual timings of the CH bout's has changed and they have not remained at the same time each year although the 8-12 weeks that the bouts last does remain the same so there is no guarantee that the bout will start at the same time as last year.  I know many people including myself experience depression during a bout but I do not remember noticably suffering from depression before bouts.  I appreciate that the depression may not be connected and can be due to other issues but like everyone I am always trying to find answers and not feel enslaved to the CH's.

I seem to recall a study showing a strong correlation between anxiety and depression, and subsequent cluster episode onset.  You could google it or maybe Bob if he reads this has a citation/abstract.  For me, I think most of my episodes have been preceded by periods of high anxiety and stress (and in a couple instances, moderate depression).  Like you, my timings are variable too.

I dont however get depressed during an episode, not really.  I get down, annoyed, frustrated, exhausted, fed up and despondent...but not depressed/anxious.  It always comes AFTER a period of stress or anxiety or depression.  Almost similar to how relaxation, when in a cycle, triggers an attack.    

A few years ago when I had a 2-month bout of depression and anxiety, not being a fan of SSRIs I sought treatment in psychotherapy.  The tools I learned then (especially Acceptance and Commitment therapy and also Mindfulness) have helped me a great amount in dealing with the cycles.

I wonder myself what the connection may be i.e. in terms of serotonin (and there has been a few threads on the serotonin issue).  Something there, I reckon, maybe not for all of us but I would speculate that my own CHs are connected in some way to serotonin.  Maybe when there is too much of it or after a period of low levels and returning to normal.  Not to suggest that depression or more stress could cure us!...just another thing to add to the long list of research topics that probably nobody is ever going to fully research/resolve.  Before this recent episode, I had a period of anxiety again.  When it resolved itself (relatively quickly) I thought to myself "I wonder if I will get a CH episode now" and sure enough soon after, it came.  Maybe I was "due" anyway but it makes me wonder about a possible psychosomatic aspect.  Methinks I shouldn't think so much...

Stymie