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First of all, you don't seem to have oxygen. A proper oxygen setup will reduce your abort time very substantially, without medical side effects. Knowing you can abort most attacks within 10-15 minutes might help with the anxiety, too. Any neurologist who doesn't prescribe oxygen is not an expert. The idea that if you don't treat your episodic CH properly it will become chronic is, I believe, completely ridiculous. Talk about making you anxious! That just seems like a very uninformed thing for the doctor to have said. Lithium is recommended to be prescribed only for chronic cluster headache, because of the side effects and because it has been shown to cause significant rebound attacks when you stop taking it. The article, "Treatment of Cluster Headache," on this page would be worth reading for you, I think: https://clusterbusters.org/medical-research-reports-studies-case-reports-links/ I know of a person who had CH and also anxiety and was prescribed lithium. I don't remember the dosage. While I'm sure that lithium helps many people with psychological conditions, for this person it seemed to have no effect on the CH and it seemed to make her more anxious just to know that she was taking lithium, if that makes sense. Triptan pills are usually not effective for CH, because they take too long to work. Maybe your attacks would end in 30-45 minutes without it. A sensible doctor would prescribe at least the oral spray, and probably the injections. Not everyone thinks that triptans are a good idea, but if you have oxygen you could use the triptan for breakout attacks that aren't helped by the O2. The only way the pills seem to help people, as I underswtand it, is if they know what time their attacks usually come and take the pill an hour or so before that. That's what I am remembering. Many people find that taking melatonin at night helps with attacks. Since as I understand it melatonin is a prescription drug in some countries, you might not be able to get it. If you can -- start at 9mg/night and work up from there. Please consider the D3 regimen described here. It might be kind of daunting to read the information even though your English is excellent, but the basic ingredients are listed in a table and that's most of what you need to know. Because it is so effective at preventing cycles or at least reducing how bad things are during a cycle, I think it has reduced many people's anxiety about their cycles. https://clusterbusters.org/forums/topic/1308-d3-regimen/ With all of that said (suggesting that treating your CH more effectively is likely to reduce your anxiety), anxiety and fear are things that many people with CH experience. And, yes, also depression. It has effects that are very understandably like what we call here PTSD -- post-traumatic stress disorder. Others might talk about how they cope, but I will say again that there are basic things you can do to make the experience less terrible. Some people find that psilocybin ("magic mushrooms") has had a very positive effect related to their emotional symptoms (and it also actually treats CH). You would have to decide whether you want to go that way. I'm not recommending it for you; just passing along the information.