Headache-migraine or stress related or both?

[BLHARRIS60]

Environment: My friend has attempted reconciling marriage as spouse does not want to continue.  Not a bad atmosphere but not a marriage either, as it caused tension in her life.  In addition, she had been trying to get a job for several months but can't get a foot in any door.

Symptoms: depression-like symptoms which included melancholy, not wanting to get motivated in the morning throughout the day and headaches (that started roughly 20 months ago when the marital problems began) between the eyes above the nose that caused her to go face down into the couch and sleep for 2-3 hours(by choice, because of the headache, she just couldn't do anything but sleep) anytime during the day.  When she woke up from her nap, her headache would be almost gone but she was extremely disoriented, not knowing what time it was or sometimes even the day.  Alot of times, a stressful moment happened prior to the headaches.

She went to her doctor, who prescribed 20 mgs. of Paxil per day, for her anxiety attacks/depressive state.  The BOOMING headaches have stopped.  She is a lot calmer now than prior to taking Paxil and more rational, too.  However, my concerns are these:

Will the headaches come back after she withdraws from Paxil (which the doctor recommended her to stay on for a year)?  Can migraines (if that's what these headaches were) be caused by stress?  Can depression cause these whopping headaches she experienced?

[CCF-Neuro-M.D.-JT]

I don't think that anyone can say for sure whether or not your friend's headaches will return when the Paxil is discontinued by her doc. However, given that antidepressants are used in migraine prevention (although typically other drugs such as Elavil are used), it's quite possible that the Paxil has some kind of protective effect against the headaches. But another very important factor regarding headaches is the mental state of the patient. Certainly, emotional stress is a big player in the occurrence, severity and frequency of headaches. So if the Paxil is helping her cope with the depression, then it could follow that the headaches are better from the control of her emotional distress. Finally, I would have to know more clinical history before diagnosing these as migraines as they could represent tension headaches.



Spinoza, a famous Dutch philosopher, once said that pain is localized sorrow. Best of luck to you and your friend.

[muffin man]

i have just recovered from a bad cold or allergy and had to take 2 weeks off work due to constant sneezing and servere nose blowing.I was constantly blocked up.

Now i have recovered i am suffering with a constant neck pain/ache on my left side.I am under a little stress at present due to financial problems but believe this pain is not due to stress as i have dealt with stress before.I think i may have pulled a muscle or possibly have a sinusitis problem .Anyone with any advice.