Author: Beth Sissons
People with migraine have an increased risk of depression. In addition, depression can also increase the risk of migraine. Although there is no clear explanation for the link between migraine and depression, they may share similar causes.
Genetic factors, changes in the brain, and alterations of chemicals in the body can play a part in both conditions. Migraine may also impact quality of life, which could negatively affect mental health.
This article looks at the link between migraine and depression, treatment options, and prevention tips.
Research has found that people with migraine are 2 to 10 times more likely to experience mood and anxiety disorders compared to those without migraine.
According to a 2022 article, people with migraine may be three to six times more likely to experience depression compared to people who do not experience severe headaches.
Experts are still unclear on the exact link between migraine and depression. However, both migraine and depression may share genetic risk factors. The American Migraine Foundation (AMF) notes that both conditions share a link to similar chemicals within the body, and hereditary and genetic factors may play a role.
Migraine can be debilitating for some people, and can negatively affect quality of life, which may lead to mental health problems.
Other people may also experience depression and anxiety, and later develop migraine. People with depression may have a higher risk of developing migraine.
Chronic pain conditions such as migraine can interfere with daily life and may have a negative impact on a person’s quality of life. People may experience sadness or frustration and may experience mental health conditions as a result.
Genetic factors and differences in the brain may also play a role in depression with migraine.
Research has found that there are differences in brain tissue in people with migraine and depression.
In people with both migraine and depression, researchers have found changes in certain areas of the brain, including reduced activity in the thalamus. The thalamus is a part of the brain that processes sensory information.
Both depression and migraine may share similar genetic factors. Changes to the serotonin transporter gene, which helps to regulate serotonin in the body, are linked to an increased risk of both depression and migraine occurrence.
Both conditions may also be caused by low levels of serotonin receptors. Serotonin is a neurotransmitter that helps to regulate mood, as well as many other bodily functions.
Certain medications for migraine may also cause side effects that impact mood. According to a 2021 case report, there may be a link between triptans, a class of drugs to treat migraine, and depression.
There have been reports of people with migraine experiencing depressive symptoms after starting sumatriptan, or abruptly stopping sumatriptan.
According to the AMF, people with migraine may be around five times more likely to experience depression compared to people without migraine.
Around 20% of people with episodic migraine may have depression, although this percentage may increase in relation to the number of migraine attacks people experience each month.
People with migraine may also experience anxiety. Around 20% of people with episodic migraine, and around 30–50% of people with chronic migraine, may have anxiety.
According to a 2020 review, around 80% of people with migraine may experience depression at some point in their lives.
Antidepressants are a treatment option for migraine and may also be an effective treatment for people with both migraine and depression.
According to a 2019 article, the following antidepressants may be beneficial:
- Serotonin-norepinephrine reuptake inhibitors (SNRIs): SNRIs such as venlafaxine and duloxetine may be the most effective treatment for people with migraine and depression.
- Tricyclic antidepressants (TCAs): If people experience insomnia, which may link to depression, TCAs may a suitable option due to their sedative effect. Amitriptyline may be the most effective antidepressant for preventing migraine, while nortriptyline may be a suitable alternative if people do not tolerate amitriptyline.
Selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine, may not be effective for most people with migraine.
It is important to note that SSRIs and SNRIs may interact with triptans. These medications affect serotonin receptors and serotonin levels.
Although unlikely, this may lead to excessive levels of serotonin in the body, causing serotonin syndrome which can be dangerous without treatment.
People must discuss with their doctor any possible risks or side effects of combining migraine medication with antidepressants.
People may find that certain therapies may help to prevent depression and mood disorders with migraine, such as:
- Cognitive behavioral therapy (CBT): CBT can help people to manage stress and alter thinking patterns that may contribute to depression.
- Relaxation techniques: Deep breathing, meditation, or guided visual imagery may help in preventing depression and anxiety, as well as reducing stress which can worsen migraine symptoms.
- Biofeedback: This measures nervous system activity and teaches people how to control responses in the body, such as releasing muscle tension due to mood changes.
- Sleep hygiene: People should try to maintain good sleep hygiene and get quality sleep each night.
- Physical activity: People should try to keep active and maintain a healthy lifestyle.
Isolation can also increase the risk of depression. Those with migraine may find it beneficial to remain as social as possible.
If people are unable to sustain enough long-term work to earn a livable income due to migraine, they may be eligible for Social Security Disability Insurance (SSDI).
People can apply for SSDI through the Social Security Administration. People will need to meet certain criteria, such as proving the level of impairment migraine causes and the duration of the condition.
If you know someone at immediate risk of self-harm, suicide, or hurting another person:
- Ask the tough question: “Are you considering suicide?”
- Listen to the person without judgment.
- Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
- Stay with the person until professional help arrives.
- Try to remove any weapons, medications, or other potentially harmful objects.
If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.
People can contact a doctor if they are experiencing migraine with depression. A doctor will be able to provide a diagnosis and suggest suitable treatment options.
People will need to contact a doctor if they have taken an antidepressant such as an SSRI or SNRI alongside a triptan medication and experience any of the following:
- unusual body movements, such as rigidity, muscle spasms, or twitching
- high body temperature
- increased heart rate
- change in blood pressure
- agitation or anxiety
The above symptoms may indicate serotonin syndrome, and people will need to seek medical help straight away for treatment
Migraine and depression can occur together. This may be due to changes in the brain and chemical messengers that can occur with both conditions.
The impact of migraine on quality of life may negatively affect mental health. There may also be a genetic or heredity link between both conditions. People with depression may also have an increased risk of developing migraine.
Treating either condition may lead to an improvement in the other. Certain antidepressants may help to effectively treat both migraine and depression, helping to manage symptoms, and improve quality of life.
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