The aim of the study is to investigate the relationship between the intensity of tension-type headache and the level of anxiety and depression in patients before and after osteopathic manipulative therapy (OMT), in order to assess the psycho-emotional component of the clinical response and the feasibility of including osteopathic therapy in the complex treatment of tension-type headache. Materials and methods. We examined and treated 96 patients aged (43.0±10.2) years. The intensity of headache was determined by VAS, anxiety and depression — by HADS. An analysis was performed to determine the significance and strength of the relationship, the direction of association, and the prognostic value of the components. Results. OMT was performed according to an individually developed complex for each patient. Statistical analysis before treatment revealed a statistically significant moderate association between headache intensity and anxiety/depression. After OMT, there was a decrease in both headache intensity and anxiety and depression caused by it. The association of headache and anxiety after treatment was statistically significant, although there was no trend between the increase in pain and anxiety after treatment. However, the association of pain with depression remained significant with moderate strength of association. There was a statistically significant reduction in headache intensity (p<0.001) and anxiety (p=0.005) and depression (p=0.016) as a response to OMT. Conclusion. The level of depression depends more on the severity of pain than anxiety. The presence of clinically manifested anxiety and depression is often associated with more severe pain. According to the analysis, it was determined that OMT is quite successful in reducing both the intensity of headache and the level of anxiety/depression. However, in patients with clinically severe anxiety and depression, additional therapeutic measures and examinations are needed to identify the causes of severe mental disorders.