Migraine and Mental Health

Written by: Teri Robert / Reviewed by: John-Claude Krusz, PhD, MD | January 2012

Migraine and Mental Health : Introduction

Effective Migraine management must include taking care of all of our health needs, including mental health needs.

Highlights

Depression
Social Anxiety Disorder
Post Traumatic Stress Disorder
Panic Disorder Overview
Agoraphobia Overview

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Migraine and mental health conditions are often comorbid, which means that we have them at the same time, but neither causes the other.

Research has repeatedly demonstrated Migraine and mental health conditions to be comorbid. Migraineurs are from 2.2 to 4.0 times more likely to have major depressive disorder. Some studies have suggested a bidirectional relationship between the two diseases with each increasing the risk for the onset of the other.

Hamelsky and Lipton concluded:

“These findings have important implications for clinical practice. Patients with migraine or depression should be evaluated for the other disorder. In addition, for patients with co-existing conditions, treatment choices that might improve both conditions should be considered.”¹

Progress in genetic research may offer an explanation of the relationship between Migraine and depression. Schur et. al. concluded:

“The comorbidity of depression and migraine headache may be due in part to shared genetic risk factors. Research should focus attention on shared pathways, thereby making progress on 2 disease fronts simultaneously and perhaps providing clinicians with unified treatment strategies.”²

Migraine and anxiety disorders have also been shown to be comorbid. In some studies, the relationship between Migraine and anxiety disorders was shown to be even more prevalent than the relationship between Migraine and depression.

With depression, the studies show a higher prevalence of depression among people with Migraine. The comorbidity with bipolar disorder is somewhat different. Studies have shown a higher prevalence of Migraine among people with bipolar disorder, not a higher prevalence of bipolar disorder among people with Migraine.

Low et. al. stated:

“This study confirms the higher prevalence of migraine among those with bipolar disorder compared to the general population. Migraine in patients with bipolar disorder is underdiagnosed and undertreated. Bipolar disorder with migraine is associated with differences in the clinical course of bipolar disorder, and may represent a subtype of bipolar disorder.”³

There is still much to be learned about Migraine, much research yet to be done. Given that Migraine is still not well understood, it’s difficult for the comorbidities with mental health conditions to be well understood, but progress is being made in the field. Still, there are two points that are consistently made by researchers studying the connections between Migraine and mental health conditions:

Migraine patients should be screened for mental health conditions and treated if necessary.
When patients have both Migraine and a mental health condition, treatments that can address both should be considered.

Even though Migraine and mental health conditions don’t cause each other, they can impact each other, and there are treatments that can be beneficial for both. Migraineurs should be screened for depression and other mental health conditions for better health and improved quality of life.

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^Resources:

^{1Hamelsky, Sandra W., PhD, MPH; Lipton, Richard B., MD. “Psychiatric Comorbidity of Migraine.” Headache 2006;46:1327-1333. doi: 10.1111/j.1526-4610.2006.00576.x.}
^{2Schur, Ellen A., MD, MS; Noonan, Carolyn, MS; Buchwald, Dedra, MD; Goldberg, Jack, PhD; Afari, Niloofar, PhD. “A Twin Study of Depression and Migraine: Evidence for a Shared Genetic Vulnerability.” Headache 2009;49:1493-1502. doi: 10.1111/j.1526-4610.2009.01425.x.}
^{3Low, Nandy C. P., MD; Du Fort, Guillaume Galbaud, MD, PhD; Cervantes, Pablo, MD. “Prevalence, Clinical Correlates, and Treatment of Migraine in Bipolar Disorder.” Headache 2003;43:940–949. doi: 10.1046/j.1526-4610.2003.03184.x}