Migraine Comorbidities: Mental Health Disorders
Migraine is comorbid with a range of mental health disorders such as anxiety, depression, bipolar disorder, PTSD, and many other mood disorders. According to one study, up to 47% of people with migraine have comorbid depression, and up to 58% have comorbid anxiety—both commonly occurring, especially among people with chronic migraine.[1] Researchers believe there may be some neurological connection between migraine and mental health disorders [2] and there is emerging evidence of genetic links between migraine, depression, and anxiety.[3]
A Two-Way Street
In addition to the neurological connection, the overlap between migraine and depression/anxiety is one that is very understandable. Chronic pain, the unpredictability of attacks, and challenges navigating the healthcare system all negatively impact life in so many ways. They can cause worry, sadness, hopelessness, fear, and frustration. Migraines are often isolating conditions that can create problems at work, school, home, and in society as a whole. People with migraine may have anxiety over the fear of their next attack, and their previous negative experiences may even cause post-traumatic stress disorder.
Mood changes can themselves be symptoms of a migraine attack, and increased anxiety, depression, feelings of restlessness, or worry are often warning signs that an attack is coming (read more about that here). To further complicate things, side effects of migraine medications can include depression and anxiety. It should not be a surprise that people with comorbid migraine and mental health disorders frequently experience worse symptoms and increased disability.[4]
While living with migraine has notable effects on mental health, this is also a two-way street. Stress caused by untreated mental health issues like anxiety can have a physical impact on the body over time and can trigger migraine attacks. In fact, headaches can often be an indicator of anxiety disorders.[5] Some mental health disorders prevent people from getting quality sleep, further putting them at risk for an increase in the frequency and/or severity of migraine attacks. In addition, living with comorbid migraine and mental health issues can make it difficult to maintain a healthy lifestyle, as it can be hard to find the energy and motivation needed to do things such as exercise or cook well-balanced meals.
Treatment
While treating mental health conditions is unlikely to eliminate migraine attacks, effective treatment can lower the risk of migraine progressing or becoming chronic, which in itself has a positive impact on mental health.[6] Fortunately, there are some treatment options that can be used for both mental health disorders (such as depression, anxiety, and bipolar disorder) and migraine. This may not only reduce the number of medications taken but also, as a consequence, reduce the risk of medication interactions and intolerable side effects. Some of the treatment options that are included in this list may include:
- Anti-anxiety, depression, and bipolar medications
- Maintaining a healthy lifestyle by prioritizing sleep
- Eating a well-balanced diet
- Getting regular exercise
- Meditation
- Cognitive behavioral therapy
- Biofeedback
- Acupuncture
If you live with migraine and also experience mental health issues, talk with your headache doctor. Work together to create a personalized treatment plan that is best for you. It can also be very helpful to connect with others who are going through a similar situation, and support groups such as Migraine Meanderings can be a “safe place” to find support, discover resources, and learn from others.