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Traumatic Brain Injury, Headaches and Depression. How are They Related?

Coping with a Traumatic Brain Injury: Headache and Depression
After a mild traumatic brain injury, the most common symptom people experience is headache.  Besides headache, the most common diagnosis after a mild traumatic brain injury (TBI) is depression.  Following treatment for TBI, a patient with a poor outcome is usually saddled with either headaches, depression, or both.

One study on the link between headache and mild TBI found that 54% of individuals experienced new or worsened headaches within seven days of the injury, and 58% of individuals reported headaches one year after the injury.  Overall, this study found that—of the participants involved—91% of patients experienced headaches after mild TBI, whereas only 18% of the population in that area experience headache.

Depression is also a frequent occurrence following mild TBI.  Previous studies have noted that 26% to 53% of patients experience depression in the first year following mild to severe TBI, whereas only 6.7% to 8.2% of the population experiences depression in a normal 12-month period.

Headache and depression have long been shown to be related.  In studies of major depressive disorder, headache is the most common pain-related symptom.  Additionally, for people with depression, the severity of depression is greater for those who also have headache.

In this study, 11% of participants experienced comorbidity (simultaneously experiencing headache and depression) at the time of hospitalization after injury.  After one year, comorbidity among the participants increased to 25%.

To make matters worse, results of these participants demonstrate that while there was no significant relationship between headache and depression at time of hospitalization, after one year, the association grew so that participant with headaches were now over five times as likely to have depression as well.  This demonstrates that there is a greater risk for depression and headache one year after injury rather than immediately after injury. 

Headache, unlike other pain-related symptoms, has been shown to worsen over the 12-month period.  For example, a person with a broken bone expects to feel less pain as time moves forward.  But in this scenario, people with mild TBI cannot expect this improvement; they might expect to worsen within 12 months.

This trend is believed to be a reason for why the number of cases of depression increased in participants within the 12-month period.   As well as increasing in case number, the severity of depression also increased for those who noted depression at the time of injury.

Written by Laura Keeble: Researcher at Simone Friedman SLS

Lucas, S., Smith, B. M., Temkin, N., Bell, K. R., Dikmen, S., & Hoffman, J. M. (2016). Comorbidity of Headache and Depression After Mild Traumatic Brain Injury. Headache: The Journal of Head and Face Pain, 56(2), 323-330. Retrieved March 9, 2016.


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