When describing migraines, patients often focus on the physical symptoms — the pounding headache, the debilitating nausea, and the searing sensitivity to light. However, migraine is not merely a physical ailment. Chronic migraine sufferers often suffer mentally, as well as physically. The condition can affect your lifestyle, your goals, and your relationships, and it can have a profound impact on your mental health. Your mental health can also impact the frequency and severity of your migraines.
The Relationship Between Migraine and Mental Health
Chronic migraines and depression often go hand-in-hand. In fact, migraine sufferers are, over their lifetime, between two and four times more likely than people without migraines to develop major depressive disorder. Migraine patients are also at an increased risk of anxiety. About 50% of migraine sufferers have anxiety. For some patients, the anxiety comes first, followed by the onset of migraines, and for other patients, anxiety develops after a period of chronic migraines.
Researchers are not certain exactly how chronic migraines, depression, and anxiety are related. Does depression cause or increase the risk of chronic migraine? Do migraines lead to depression? Most feel that the relationship works both ways. Migraines contribute to depression or anxiety, and these mental health disorders make migraines worse.
Serotonin — A Likely Link
Serotonin is a neurotransmitter that is active in the brain. It is known to affect your mood, and it also plays a role in the constriction and dilation of blood vessels. (Constricted blood vessels are a hallmark feature of migraines.)
Although low serotonin levels may not directly cause migraines, many patients who suffer from migraines do have low serotonin. A deficiency of serotonin can also lead to anxiety, depression, and other mental health ailments that often coincide with chronic migraine. Elevated levels of serotonin can also lead to migraine and serotonin syndrome — a collection of symptoms including anxiety, flushing, confusion, and changes in heart rate.
Serotonin may not be the link between migraine and mental health disorders, but it is almost certainly a link for many of my patients.
Migraines, Lifestyle, and Mental Health
Migraines and mental health disorders are also connected by the effects that chronic migraines have on your lifestyle. Migraines affect almost every aspect of your life, from the way you interact with your family to your performance at work. As your social life and progress towards your goals start to slip, your risk of mental health disorders, like depression, increases.
Relationships and Family Life
In a 2014 study, 78% of migraine sufferers reported that migraines caused problems with their live-in relationships. This is not surprising at all. When you’re bed-ridden with a pounding headache and nausea several days a week, you miss family dinners, don’t have the energy or time to chat with loved ones about their day, and don’t have the stamina to spend much time playing with your kids. These changes are not great for your mental health, either. Feeling alone or like you’re not able to be a partner or parent in the way you like may lead to worsening depression symptoms.
Exercise helps ease the symptoms of depression and anxiety. But when you’re in bed with a migraine, going to the gym, or even taking a walk around the block for that matter, is not on your list of priorities! Many of my migraine patients have given up physical activities they love over the years, and that has not been good for their mental health. Depression also has a way of keeping you sedentary, so you end up in this unfortunate, never-ending loop. Getting your migraines under control with effective treatment can be a good first step towards easing mental health symptoms and becoming more active again.
Work and Career
Sometimes struggles at work can be the mediator between migraine and poor mental health. Chronic migraine can cause work performance to suffer. You may be passed up for promotions, unable to work in the field you once loved, or even let go from jobs due to illness. This can lead to feelings of worthlessness and a lack of self-esteem, which can feed into depression and mental illness. Treating your migraines can be the first step towards getting your career back on track, which can help improve your mental health.
The relationship between migraines and mental health is complex, and more research is needed to fully understand it. What I do know is this: chronic migraine impacts your lifestyle in numerous ways, and those lifestyle changes are not good for you, mentally. If you are ready to improve your lifestyle and mental health, it’s time to take an aggressive, evidence-based approach towards migraine treatment. Book your first 30-minute consultation, and I’ll meet with you, virtually, within 48-72 hours.