Depression, Migraine's Unpleasant Cousin
Having frequent migraine attacks is depleting in every way imaginable – physically, emotionally, mentally, spiritually, even sexually – but when migraine’s unpleasant cousin, depression, comes to visit, migraine alone seems like an easy house guest. Hope, optimism, self-compassion, all necessary tools for coping with a constant migraine, are replaced with bleak despair, which never does anyone a favor.
I call depression migraine’s cousin because the two are comorbid disorders. While some people say that depression is to be expected in someone with frequent severe pain, the correlation is not as simple as being sad because you’re in pain. Although the exact pathophysiologies of migraine and depression are unknown, studies are investigating common genes between the disorders and it is hypothesized that migraine and depression have similar neurochemical abnormalities, share neuropathic mechanisms that cause limbic activation, and involve the same regions of the brain1.
Whatever the biological mechanisms are, the prevalence statistics are striking. Depression is three times more likely for people with migraine or severe headache disorders than in the general population1. People with migraine are 80% more likely to have a major depressive episode than those without migraine2. People who have had major depressive episodes are 40% more likely to develop migraine than those who haven’t experienced depression2.
Another migraine blogger once told me that she can handle chronic migraine just fine, it’s the depression that really weighs her down. At the time, when my migraine pain was hitting at least a level 7 every day, but I’d been depression-free for several years, I had trouble identifying with her. Not anymore.
Since depression has robbed me of the tools that help me through the daily slog of chronic migraine, eventually finding an effective migraine treatment seems as elusive as adopting a unicorn. The possibility of living a happy life despite migraine seems similarly unlikely. Rationally, I know this depression won’t last and that my positive outlook will return, but that day feels impossibly far away.
Can you tell when a migraine attack is coming?