Depression’s Impact on Development of Chronic Migraine

According to a pain and neurology researcher presenting at the recent European Headache and Migraine Trust International Congress in London, depression among people with episodic migraine is an independent risk factor for development of chronic migraine.

Dr. Sait Ashina of the Albert Einstein College of Medicine reviewed data from the ground-breaking American Migraine Prevalence and Prevention (AMPP) Study to see whether there were any trends among people living with both depression and episodic migraine and the likelihood of transformation to chronic migraine. The AMPP Study is the largest study of migraine patients that has ever been undertaken.

According to data from the AMPP study, depressed migraineurs were 1.65 times more likely to progress to chronic migraine within the next year than migraine patients who were not depressed. The more severe the patient’s depression, the more likely the patient was to develop chronic migraine.

Even after adjusting for factors known to contribute to the development of chronic migraine, such as cutaneous allodynia, anxiety disorders, headache pain intensity, headache frequency, migraine symptom severity, medication overuse, body mass index, income and health insurance status, Dr. Ashina said the presence of depression was still a statistically significant factor in transformation to chronic migraine.

Dr. Ashina emphasized that depression worsens migraine, but migraine also worsens depression. The two have a very interconnected relationship. Management of one can often be helpful to management of the other. In fact, ignoring management of one of these conditions is detrimental to both.

In order to try to prevent episodic migraine from becoming chronic it is important that headache specialists screen their migraine patients for depression and get those patients who need it well rounded treatment. Medication, psychotherapy and exercise can all be helpful tools in the management of depression.

About 1/4 of patients with chronic migraine return to episodic status after developing chronic migraine each year. While this is good news for that 1/4 of patients, for the other 3/4, it is especially important for care providers to try everything possible to prevent the transformation in the first place.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.
View References
1. Silberstein, Stephen; Loder, Elizabeth; Diamond, Seymour; Reed, Michael L.; Bigal, Marcelo, E.; Lipton, Richard B.; AMPP Advisory Group. “Probable migraine in the United States: results of the American Migraine Prevalence and Prevention (AMPP) study.” Cephalalgia 2007 27:3;220-229. http://www.ncbi.nlm.nih.gov/pubmed/17263769. 2. Jancin, Bruce. ” Depression Can Be Migraine’s Tipping Point.” Clinical Psychiatry News. September 27, 2012. http://bit.ly/QFfDJG.

Comments

View Comments (7)
  • Julie
    6 years ago

    i should have known better, well in my warped perspective I thought it couldn’t happen to me that happens to other people, but the depression spiraled out of control and I caught myself thinking of suicidal thoughts. Thank God I was still rational enough to call my friend who immediately intervened and took me to get professional help and I allowed myself to be admitted to a depression unit. But you can’t fool yourself into thinking it can never happen to you. It can or to anyone you know or love. Depression once it gets a hold of you is sucks you in if you don’t know how to deal with it. Sorry to blubber on so.

  • Julie
    6 years ago

    But the pain of daily migraines, the depression, PTSD, Chronic Insomnia-it all got out of control and I could not deal with it on my own anymore and I was at the end of my rope and didn’t ask for help on my own earlier when I should have.

  • Julie
    6 years ago

    I can relate to that. That is why seeing a therapist has been so important for me. Puts it all in perspective and gives me better coping skills to handle it all much better. I’d be lost without my therapist. And my online support like you folks.

  • Diana-Lee author
    6 years ago

    Exactly! It helps so much.

  • Ellen Schnakenberg
    6 years ago

    This is such important information for patients and for their doctors to be aware of. Thank you so much for sharing it Diana!!!

  • Buffy
    6 years ago

    What if you where originally diagnose with chronic migraine and the later on diagnose with depression and anxiety. Does that still play a factor

  • Diana-Lee author
    6 years ago

    It’s hard to say, Buffy. It could be that you were living with depression and anxiety and only diagnosed later and that those conditions did play a role. Or it could be that other factors contributed to the transformation of your migraines from episodic to chronic.

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