Migraines and Mental Health

Although researchers have not discovered a singular link that accounts for the close relationship between migraines, anxiety, and depression, there’s no denying that a connection exists between disabling headaches and mental health disorders.

People who suffer from migraines are between two to five times more likely to have these mental health conditions than patients without migraines, regardless of age or gender. Consider the following:

  • About 25% of people with migraines have depression.
  • About 50% to 60% have anxiety.
  • People diagnosed with depressive disorders are at three times higher risk of developing migraines than those without depression.

Some people develop these mental health symptoms after living with migraines for years. Others develop them before the onset of migraine attacks.

People with chronic migraine (headache attacks that occur on 15 or more days a month) are about five times more likely to develop depression than someone without migraines. Dawn Buse, Ph.D., an associate professor in the Department of Neurology at Albert Einstein College of Medicine in New York, told the American Migraine Foundation:

“It’s very logical when you’re living with a chronic disease like migraines, which is affecting your life in such a big way, that you’re going to feel sad, and down, and frustrated about how it’s affecting your life.”

Migraines do not have to be chronic for people to suffer from depression or anxiety. Of those who suffer from episodic migraine (headaches on 14 or fewer days per month) about 20% may have depression and/or anxiety. Not surprising, that number increases as the number of headache attack days per month increases.

Importance of treating all conditions

As with most comorbid physical and mental health conditions, treating one disorder without addressing the other is typically ineffective. The American Migraine Foundation explains that treating mental health conditions and migraines simultaneously is important for the following reasons:

  • Migraine patients with depression or anxiety have higher medical costs.
  • They are at increased risk for suicide.
  • They have higher levels of disability than migraine patients without depression or anxiety.
  • Headache treatments don’t work as well when the depression or anxiety is not also being treated.
  • Untreated patients are less likely to follow medicine or behavior treatment plans.
  • They also show less response to headache medications and are more likely to relapse.

Treatment options for people with migraines and mental health conditions

One of the brain chemicals involved in all of these conditions is serotonin. For many people, treatment with certain antidepressants, such as selective norepinephrine reuptake inhibitors (SNRI), are often effective in preventing migraines. Others find a combination of antidepressants and migraine medications to be the best solution.

Non-pharmacological therapies, such as cognitive behavioral therapy (CBT), can be effective in preventing migraine, depression, and anxiety. It can also reduce the severity or length of a migraine attack. CBT helps people better manage stress and change the ways they think and act that may be contributing to feelings of anxiety and depression.

Many people find the most successful way to treat depression, anxiety, and headaches to be a combination of medication and behavioral therapy.

Biofeedback, yoga, meditation, and other relaxation techniques can help reduce the stress that can trigger all three conditions. Calming the nervous system is very helpful.

Maintaining an active lifestyle and resisting the urge to isolate that’s so common with a chronic illness, is beneficial for anyone with a mood disorder or migraines. The American Migraine Foundations notes, “Sufferers may have to cancel, leave early, or move to a darkened room for a time, disrupting plans, but this should not keep them from going ahead with activities as often as possible.”

If you or a loved one is having headaches that interfere substantially with your work or daily activities, it might be time to see a headache specialist. This is a doctor — sometimes a neurologist — who has focused their professional training specifically on the treatment of headaches and can help diagnose patients with unusual or complicated headache symptoms.

For more information on The Will Erwin Headache Research Center click here.

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