By Jana Bounds
It's understandable to think that there might be a connection between migraines and depression, especially since frequent migraines can cause social isolation and disrupt daily life. But did you know that migraines and depression are considered medically comorbid conditions?
Comorbidity means that two conditions are interrelated and can influence each other. In the case of migraines and depression, even though they are distinct conditions - migraines being a neurological disorder and depression a mood disorder - they are so connected that they can both have an impact on each other.
The American Migraine Foundation notes that migraine sufferers are at a higher risk of developing depression and anxiety. To support this belief, studies have shown that people with migraine are three times more likely to experience depression than those without the condition.
The Physiological Connection
Migraines and depression are two of the most common health conditions in the world and share similar pathways in the brain, the ones involved in mood regulation and pain perception overlap— so a shift in one area can alter the other, according to the narrative review.
As a result, changes to the neurotransmitters that are involved in the regulation of pain and mood, such as serotonin and dopamine can lead to an increased risk of developing both migraine and depression.
Where migraineurs are significantly more likely to develop depression, studies show those with depression “have a two-fold chance of developing migraines.” According to one study, nearly 80% of migraineurs are affected by depression at one time or another. Interestingly, there are also differences in brain tissue volumes among patients who have depression and migraines.
Additionally, there is a genetic element to both Major Depressive Disorder (MDD) and migraines, with certain genetic markers showing a 40-50% increase in the likelihood of developing them. Hormonal changes are often also viewed as a risk factor.
According to some reports, the development of migraines is often preceded by anxiety, and depression can accompany migraine episodes.
The Psychological Connection
In addition to physiological risk factors, there are other factors that are believed to increase the likelihood of developing both migraines and depression, including stress and a history of childhood trauma.
Both conditions can be debilitating for different reasons. Migraines are accompanied by severe pain, nausea, and sensitivity to light and sound, to the point that those who have them can find it difficult to carry out day-to-day activities. Depression can cause a loss of interest in activities, exhaustion and lethargy, difficulty sleeping, and suicidal thoughts—these symptoms also make it challenging to carry out daily activities.
Both can lead to social isolation, decreased quality of life, and a situation where the symptoms of one can exacerbate the symptoms of the other.
There is Hope
While there is no one-size-fits-all solution in treating comorbid conditions, there is still good news: treating one condition can have a positive impact on the other, which can reduce symptoms and improve overall quality of life.
Understanding the strong association between both migraines and depression is important for developing an effective treatment plan.
There are a number of online and in-person migraine support groups. Also, if you or someone you love is suffering from a mental health crisis, there is support. Mental health hotlines are free and confidential for anyone who needs someone to talk to: the National Suicide Prevention Lifeline (1-800-273-TALK) and Crisis Text Line (text HOME to 741741).
Additionally, Employee Assistance Programs are employer-sponsored programs that provide free and confidential counseling and support services to employees and their families.
It is also worth considering therapy.
One lifelong migraine sufferer, author Sarah Hackley, revealed the struggle in her book, “Finding Happiness with Migraines: a Do it Yourself Guide”:
“I tried medication after medication. Some barely worked, and others didn’t work at all. Almost all of them, however, had horrific side effects,” she wrote. “I experienced frightening fainting spells. I got hives. I experienced sudden, unexpected mood swings that left me feeling confused and disheartened. I couldn’t sleep. I slept too much. I forgot everyday details...”
Her quality of life suffered due to her migraines, but she acknowledges later in the book: “I no longer allow my illness to steal my joy or make me afraid to live my life.
“If we want to live a happy and joyful life with migraine, we must acknowledge and deal with the emotional realities of the disease.”
In Honor of Mental Health Awareness Month
Increasing awareness and understanding of the links between migraines and depression can help to improve diagnosis and treatment.
As we continue to prioritize mental health awareness and promote access to appropriate care, we can help those who are affected by migraines and depression to lead healthier, happier lives.
It's essential to seek professional help if you or someone you know is experiencing symptoms of either condition, since early intervention can be crucial.
Let's continue to work together to increase awareness, reduce stigma, and support those affected by migraines and depression.