The Secondary Headaches · ICHD-3 · 12

Psychiatric disorder

The international classification rarely attributes headache directly to a psychiatric disorder. Depression and anxiety very often travel with migraine, but travelling together does not mean one caused the other. Calling it “just nerves” is wrong, and it delays treatment.

In practice

Ask about mood, sleep, and thoughts of self-harm in chronic headache, because the burden is real. If there is immediate psychiatric danger, that axis comes first. Otherwise continue the headache plan and add psychological care in parallel, rather than leaving the person between two clinics.

These pages are written for health professionals. They do not replace a history, examination, or clinical judgment. Treatment is decided for each patient individually.