If you live with migraine, you know how much they can disrupt your life. So it might not surprise you to learn that some mental health conditions, including depression, anxiety, and bipolar disorder, affect people with migraine more than twice as often as others.
If you have chronic migraine, defined as having headaches on 15 or more days each month for at least 3 months, your risk is even higher. For example, people with chronic migraine are about five times more likely to get depression than those without migraine.
What's the Link Between Chronic Migraine and Mental Health?
Experts aren’t sure what the exact connection is. Sometimes people with migraine develop anxiety or depression. For others, the mental health condition comes first. All three conditions are more likely to affect you if someone else in your family also has them. And migraine and depression affect similar chemicals in your brain.
There are also plenty of practical reasons chronic migraine can affect you emotionally. Wondering when your next attack will come can cause anxiety. Over time, living with that constant worry could lead to depression.
Chronic pain itself is stressful to both your mind and body. Long-term stress can disrupt the balance of hormones and chemicals in your brain and nervous system, affecting your moods. In turn, stress may make migraine worse.
Further, headaches that often interrupt your work, home, and social life can make you feel isolated and affect your mental health. And the stigma of chronic migraine can harm your self-esteem.
If you have chronic migraine:
- Pay attention to your mental state.
- Do what you can to reduce stress and anxiety.
- Know when to seek professional help.
How to Take Care of Your Mental Health
Certain healthy habits help protect your emotional well-being. As a bonus, many of them also may help you have fewer or less intense headaches.
Stay connected to friends and family. Migraine gets in the way of being social. But the support of others is a key part of good mental health. Research has shown that strong connections with family and friends lower your chance of both depression and anxiety. One study found that out of 100 things that can affect your mental health, social connection offered the best protection against depression.
Make sleep a priority. Not only does getting enough sleep help you avoid migraine, but it's also critical to your emotional health. Your best bet is to stick to a consistent sleep routine. Go to bed and wake up at the same time each day. Give yourself time to wind down before you go to bed. And avoid caffeine or alcohol for at least 4 hours before bedtime.
Move your body every day. Exercise helps stave off headaches while it improves your mental outlook. And it doesn’t have to be intense. A 30-minute walk can boost your mood in a big way. If that feels like too much, start with shorter sessions of movement throughout your day.
Practice relaxation techniques to reduce stress. This is another tactic that can help control migraine while benefitting your mental health. Try mindfulness exercises, meditation, or mind-body practices like yoga or tai chi.
Is It Time to Get Help?
When you have chronic migraine, it can be hard to know whether what you're feeling is a rational response to pain or a mental health concern. If you have any of these symptoms, check in with your doctor or a mental health professional:
- A constant feeling of worry
- Feeling revved up or on edge
- Having a hard time falling or staying asleep
- Sleeping more than usual
- Trouble concentrating
- A frequent feeling of sadness or dread
- Avoiding things that make you feel worried
- Irritability or rage
- Feeling tired all the time
- Not enjoying things that you normally like to do
- Changes in your eating habits or loss of appetite
- Feeling worthless
Even if you're not having these symptoms, it's a good idea to check in with a doctor or mental health care provider anytime you don’t feel like yourself or when your emotions interfere with your daily life.
Talk to someone right away if you feel that life is not worth living or you are thinking about ending your life. Call the helpline of the National Alliance on Mental Illness at 800-950-NAMI (6264) or the National Suicide Prevention Lifeline at 800-273-8255 (or text HOME to 741741).
Which Treatments Can Help?
If you have a mental health condition, it's important to treat it as well as your migraine. In addition to improving your mental health, this can help your headache treatments work better and make you more likely to follow your migraine treatment plan.
There are several effective treatments for anxiety and depression, some of which also work to ease migraine. Your doctor may recommend one or a combination, such as therapy and medication.
- Psychotherapy. There are many kinds of psychotherapy. One of the most effective types for anxiety is cognitive behavioral therapy. It helps you learn to change the way you behave and think and develop coping skills to lower stress, anxiety and depression. CBT can also help to prevent migraine or shorten attacks.
- Medication. Some antidepressants that work on the brain chemical serotonin (called selective norepinephrine reuptake inhibitors or SNRIs) can treat migraine, depression, and anxiety. Other medications treat just depression while you continue with other treatments for migraine.
- Biofeedback. In a biofeedback session, body functions like your heart rate and pulse are monitored and shown to you on a screen. This helps you learn to calm the stress response in your body -- for example, by relaxing your muscles. Research has shown that biofeedback can help you manage migraine, too.
Photo Credit: Rowan Jordan / Getty Images
British Medical Journal: "Migraine and Its Psychiatric Comorbidities."
American Migraine Foundation: “The Link Between Migraine, Depression and Anxiety.”
The Will Erwin Headache Research Foundation: “Migraines and Mental Health.”
National Institute of Mental Health: “Caring for Your Mental Health.”
Pain: “Enhanced mindfulness-based stress reduction in episodic migraine: a randomized clinical trial with magnetic resonance imaging outcomes.”
Sleep Health Foundation: “Caffeine, Food, Alcohol, Smoking and Sleep.”
Mayo Clinic: “Biofeedback.”
The Journal of Headache and Pain: “Understanding the nature of psychiatric comorbidity in migraine: a systematic review focused on interactions and treatment implications.”
The American Journal of Psychiatry: “An Exposure-Wide and Mendellian Randomization Approach to Identifying Modifiable Factors for the Prevention of Depression.”
American Psychological Association: “What is Biofeedback Therapy?”
Mayo Clinic: “Anxiety Disorders," “Biofeedback.”
Cleveland Clinic Journal of Medicine: "SEEDS for success: Lifestyle management in migraine."