The Link Between Chronic Migraine and Depression?

Migraine Disorder is a neurological disorder with an even greater impact on the quality of life than asthma, diabetes, and arthritis. It is more disabling than depression and anxiety disorders.1 One-half -50%- of migraineurs also experience MOH (Medication Overuse Headache).

This means that this group of individuals use acute medications to treat migraines more than 10 times per month2. Also, another study conducted in France showed that 14% of migraineurs have tension-type headaches which are considered the most common type of headache are.

Moreover, Migraineurs 3 times more likely to have depression4  and 6 times more likely to suffer from anxiety disorders5 compared to healthy controls. It’s important to highlight that the finding of depression and anxiety disorders in patients with primary headaches is a global phenomenon.6.

Recently, the evidence linking chronic migraine to depression is increasing. Chronic migraines are headaches at least 15 days per month for more than 3 months.7  The underlying pathophysiology of migraine is related to genetics and environmental factors which act on the serotoninergic system, mainly through serotonergic 1A receptor.

Also, serotonin systems may play an important role in Migraine’ associated symptoms such as anxiety and depression too8. The same neurotransmitter also has a key role in depressive disorders, 10.

Moreover, headache frequency can be considered an independent predictor of Major Depressive Disorder (MDD)11, and every increase in headache frequency increases the risk of suicide attempts12. For that matter, preventive treatments that reduce headache frequency and severity, such as migraine surgery and prophylactic drugs, should be monitored for their effects on mood symptoms too.13

Depression and migraines:

you should know that an occasional migraine is often triggered by a psychiatric disorder. People with depression or anxiety are more likely to experience migraines, as depression and anxiety frequently precede the onset of a migraine attack. While there is no conclusive evidence regarding whether psychiatric disorders can cause migraines, it has been found that both depression and anxiety may be an influencing factor in developing a migraine at some time during one’s life.

Migraine emotional symptoms:

In almost one-third of people with depression or anxiety, a migraine may also occur. In many cases, migraines are an indicator that a psychiatric disorder is present. Depression can be accompanied by hypervigilance and irritability, sleep problems, difficulty making decisions, and withdrawal from social situations.

Other symptoms of depression include feelings of emptiness or hopelessness as well as thoughts of suicide. Anxiety often includes physical symptoms such as nausea or vomiting as well as an accompanying fear of having another attack. People who suffer from chronic pain syndromes such as fibromyalgia often have both conditions at the same time because their brains release similar chemicals in response to pain stimuli.

Migraine headaches cannot be cured without treating the underlying causes, such as stress and anxiety; however, they can be controlled with medication and lifestyle changes.

Migraine treatment is centered around identifying and eliminating triggers (such as skipping meals, overindulging in alcohol, or staying out too late), eating healthful foods (including adequate amounts of lean protein), cutting down on caffeine intake, and getting at least eight hours of sleep every night.

Migraine symptoms:

While a migraine attack itself lasts from about four to seventy-two hours, symptoms that occur before the attack may last from several days to weeks. These symptoms are known as “prodrome” symptoms because often foreshadow an upcoming attack.

Many people who have migraines experience one more of the following prodrome symptoms days or weeks before an attack:

• Fatigue, tiredness, lethargy.

• Mood swings, irritability.

• Food cravings (especially for chocolate).

• Feeling bloated or having digestive problems, especially after eating sugary foods.

• Constipation.

• Excessive need to urinate.

• Abdominal discomfort, including abdominal pain and nausea/vomiting.

Some people may only experience the prodrome symptoms of fatigue and food craving while others have more musculoskeletal or gastrointestinal symptoms preceding an attack – often without any mood changes at all. Each individual’s pattern is unique which means that everyone needs to discover their migraine triggers to be able to effectively prevent future migraine attacks.

Frequency of migraines:

Trying to identify your migraine patterns can help you avoid future attacks by knowing when to take action. Most often, the prodrome symptoms of irritability and fatigue begin a few days before a migraine attack.

In some cases, a person may also experience food cravings for salty foods or carbohydrates as well as mood changes such as crying spells or feelings of anger or anxiety that have no apparent triggers. The first sign that a migraine attack is coming on maybe dull, throbbing temples followed by nausea and vomiting later in the day. Women are more likely than men to experience food cravings during their migraine attacks while men are more likely to become easily agitated or angry.

Migraine frequency:

A person may experience one migraine every other week or as many as eight migraines in a single day – once every few months. The average migraineur (someone who suffers from frequent migraines) has four to six attacks per month, with about 15 percent of people having two or more migraine days per week.

Most people find that their headaches initially worsen during the first five years after onset before becoming less severe and more manageable over time. However, some individuals have very little symptom relief throughout their lifetime, although improvements can still be made by determining personal migraine triggers.

It is normal for someone who experiences sporadic migraines to see an increase in headache frequency just before menstruation. Many women have significantly worse migraines during their period and before ovulation.

Others may notice a pattern between stressful events in their life and a subsequent migraine attack. If you experience a dramatic increase – or decrease – of your regular migraine pattern, trying to identify possible triggers can help you manage your pain better by making the necessary lifestyle changes that will prevent future attacks from occurring.


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