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Waiting For the Other Shoe to Drop: Migraine and Comorbid Conditions

Do any of you feel as though you are constantly waiting for the other shoe to drop? Do you live not only with migraine but also with multiple other health challenges? Does it sometimes feel as though your body is constantly betraying you and facing the future is scary? If so, you are not alone! Migraine is a challenging and complex neurological condition by itself, but sadly it also frequently brings with it a wide range of comorbid conditions which add to that challenge and complexity.

What is comorbidity?

So, what is meant by comorbidity? This term is used when two illnesses occur at a greater than coincidental rate than is seen in the general population. The indication is that at some level, somehow, the two conditions are actually related. Sometimes one condition can cause another, either directly or indirectly, and sometimes there are genetic or other factors at play. Understanding and addressing these conditions is essential to receiving optimal care for migraine, and with each new condition the treatment of migraine becomes more complex. Sometimes a treatment can help one condition while worsening another, sometimes a treatment can help more than one condition at a time. Sometimes different medications for various conditions can even increase the chance of new conditions when taken together. In addition, lack of effective treatment for one condition may aggravate another one.

The challenges of treatment

Obviously, having a holistic approach and looking at the bigger picture for treatment is ideal, but the reality is that dealing with comorbid conditions is a challenge! Most doctors simply don’t have the time to take long health histories or ask patients about other seemingly unrelated symptoms. Communication between different specialties can be challenging at best, resulting in each doctor only having part of the greater picture. Frequently as patients, we don’t tell our doctors everything that is going on; there is a tendency to focus on the “worst” symptoms and ignore the rest until they become too severe to ignore! There is a tendency to listen to that nagging feeling of having “too much wrong” with us to talk about more than one thing at a time. Sometimes we stay quiet simply because we are afraid that the other shoe is going to drop. No more bad news, thank you!!

So how do we move forward? A great place to start is realizing that if you live with more than one health challenge besides migraine then you are normal! It may not be a “normal” you’re happy about, but it is, sadly, the norm with migraine. The following are many of the more common comorbid conditions seen with migraine, and for convenience I’m dividing them up into psychological and non-psychological:

Psychological comorbid conditions

  • Depression
  • Anxiety
  • PTSD
  • Bipolar Disorder
  • Suicide
  • Sleep Disorders

Non-psychological comorbid conditions

You’re not alone!

If those lists seem long to you then you’re right, they are! They add to the complexity of migraine, an already little understood disease, and clearly amplify the desperate need for additional research. As new diagnoses are made in individuals, so the need for a multi-disciplinary approach becomes more and more essential in order to receive effective treatment and symptom management. And finally, it is crucial to be aware that the more comorbid conditions you have, the greater the disability experienced in different areas of life. That means the balancing act of taking care of yourself, making wise decisions, “pushing through” and learning to rest becomes much more challenging. Bearing all this in mind, it’s no great surprise that many of us go through life waiting for the other shoe to drop but remember…. you are not alone! There is a huge migraine community going on this journey with you!

Do you have any of these comorbid conditions? Which are the hardest for you to deal with? Do you find that they take turns flaring up with migraine, or does it all flare together? Are you ever free from pain?

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.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3008936/#idm139766036162096title
  • https://americanmigrainefoundation.org/resource-library/comorbidities-of-migraine/
  • https://headaches.org/resources/comorbidities-and-migraine/
  • https://www.ajmc.com/newsroom/chronic-migraine-associated-with-comorbidities-sleep-disorders
  • https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-019-0988-x

Comments

  • reasings
    7 days ago

    I additionally have sleep problems, not restless legs but more like periodic limb movement. My legs move non stop in my sleep.

  • reasings
    7 days ago

    Seems like it’s always something…

    Feel like a hypochondriac, but I am not

    When I have a good productive day, I inevitably feel terrible the next day..

    My co morbid conditions /diagnosis include…

    Cervicalia
    Small fiber neuropathy
    Neuropathy
    Occipital neuralgia
    Fibromyalgia
    Arthritis
    Tinnitus
    Congenital heart defect asd/pfo
    TIA
    Vertigo

  • kpdrsn
    1 month ago

    Also ADHD and other learning disabilities is comorbid as well as Autism.

  • Shoshana Lipson moderator author
    3 weeks ago

    Hi! Thank you for reminding me of that. There are so many comorbid conditions that the list seems endless. Hopefully one day soon researchers will discover how these are all linked! – Shoshana (Migraine.com team)

  • Vickieatlarge
    2 months ago

    My comment is more of a question. The list of comorbid conditions is divided into psychological and non-psychological. As a severe narcoleptic w/cataplexy, what I am wondering is why sleep disorders are listed under psychological conditions. For instance, how could narcolepsy, a neurological disorder, be listed as psychological ? How can a brain chemical that is missing from our brains be thought of as a psychological condition? Not only narcolepsy, but the same is true of other sleep disorders.

  • Shoshana Lipson moderator author
    1 month ago

    Hi! Thanks for your feedback – I think the division was more for convenience rather than to create hard and fast lines. The causes of sleep disorders are so varied, but in general, just because something is considered psychological that doesn’t mean it is not considered to do with a “brain chemical.”

    According to the DSM-V, pschychological disorders are those that involve significant changes in thinking, emotion and/or behavior. Distress and/or problems functioning in social, work or family activities. Sleep/wake disorders are included in this category by pschological organizations:)

    Hopefully that helps! Hugs – Shoshana (Migraine.com team)

  • JanetH
    2 months ago

    Migraine, asthma, IBS, anxiety/depression, tinnitus (though I thought that was part of migraine). My asthma over the years has gone from mild to moderate/severe, and I’m now on a biologic. Migraines suck, but if I had my druthers, I’d deal with them over the worsening asthma. There’s something about being able to breathe well that I enjoy, LOL.

  • Shoshana Lipson moderator author
    1 month ago

    So sorry that you are dealing with all these conditions and yes…. breathing is good!! Hugs – Shoshana (Migraine.com team)

  • Macbeck
    2 months ago

    Comorbidities? Combine that with a terrible family cardiac and diabetic histories. I’ve also come to realize I’ve had migraines since childhood. As a retired nurse I’m aware of my own health history and the treatments (medication and diet) as well as changing symptoms.
    Yup, I have a number of comorbidities, but I do my best to stay on top of it all.

  • Shoshana Lipson moderator author
    1 month ago

    So sorry you have several comorbidities – unfortunately you are not alone and it makes treatment so much more complex. Glad you are doing everything you can to stay on top of it all! Hugs – Shoshana (Migraine.com team)

  • ktloon
    2 months ago

    I have 5 of the comorbidities, but the one that seems to mess with me the most is the arthritis. I had a migraine induced stroke in 2002, so I can’t take triptans. If I take NSAIDS too frequently for arthritis relief I get breakthrough migraines from overuse(I’m on nightly suppression meds). It’s getting really hard to “pick one”.

  • Shoshana Lipson moderator author
    1 month ago

    Arthritis can be a tough one to deal with, and trying to treat one condition without aggravating the other can be challenging! I often find that I’m just picking the thing that hurts the most at the time but then regret it later when it flares the other up! Hugs – Shoshana (Migraine.com team)

  • bookseller
    2 months ago

    I can’t believe it, but I have 7!!! The hardest one to deal w/ is definitely the depression. When that hits a valley, I really struggle to function. I wonder if we took the time to write down our comorbid conditions, symptoms, what we take for it, prognosis, and care plan, it would help. Have copies for your docs when you go see them. Once you take the time to write it the first time, you’ll just have to make the changes from a visit. I think I’m going to try it. I too have chronic intractable migraine, I’d swing a dead cat around in a cemetery if I was told it would give me a day w/o pain. The paper seems at least better than that!

  • Shoshana Lipson moderator author
    1 month ago

    That is a lot of comorbidities but sadly not uncommon! Depression is a rough one to have and yes, all the suggestions you make are so true! Not all doctors have the time to see the bigger picture, but writing everything down can definitely help because it gives them a snapshot of what is going on. Hugs – Shoshana (Migraine.com team)

  • Nikita212
    2 months ago

    I can relate to having IBS, anxiety and depression, along with chronic migraine. I have also see a connection made with endometriosis, which I had for years until I had a hysterectomy. I would love to know what drives these comorbid conditions.

  • Shoshana Lipson moderator author
    1 month ago

    It would be great to know what drives all these comorbid conditions. I think the general sense right now is that a lot of it is genetic and there is research going on to try and figure it out! White lesions on the brain seem to be common with long-term migraine, but so far doctors say they don’t have any clinical significance! Hugs – Shoshana (Migraine.com team)

  • Nikita212
    2 months ago

    I also have several white matter lesions in the brain.

  • starjam1
    2 months ago

    I was diagnosed with migraines in my 20’s, now in my 40’s I was told my vertigo is caused by migraines.Vestibular migraines to be exact. So far the only drug that works causes stomach pain so I need drugs for this as well. And it doesn’t treat the vertigo! I have severe asthma and the meds can cause anxiety.. Life can be can challenging .. but pain free days make it worth while. The more we learn and share experiences..the greater the chance of healing

  • Shoshana Lipson moderator author
    1 month ago

    Thank you so much for sharing your thoughts and yes, the more we learn and share experiences the greater the chance of healing! Hugs – Shoshana (Migraine.com team)

  • CaDa
    2 months ago

    I am 76. I had severe motion sickness and headaches from being a child, migraine was diagnosed in my 30s and vertigo in my 50s. When I was 70 I was told that the vertigo I suffered terribly with for more than 20 years isn’t actually vertigo, it is caused by migraine and the condition is called vestibular migraine. I was also told that a another long list of symptoms I have (brain fog, aches and pains, dizziness, etc.) is from an anxiety disorder caused by living with a chronic illness most of my life. I am now convinced that the main cause of my severe and entrenched anxiety is a phobia routed in the fear of re-occurring vertigo. I also have a sleep disorder which I believe is an anxiety related symptom. Believe it or not I enjoy life most of the time. I have achieved this by practicing CBT and I meditate using Headspace every day.

  • Shoshana Lipson moderator author
    1 month ago

    I’m so glad that you are able to enjoy life most of the time despite dealing with all this, and yes, Cognitive Behavioral Therapy and Meditation are both really important tools for pain managment! Hugs – Shoshana (Migraine.com team)

  • Katie19
    2 months ago

    Oh yes comorbidity. I recently had an aura that I actually could correlate with my TSH level being .15 Low. My Dr. decreased my Levothyroxine dose to 0.88mcg. I have been on 0.1 for 28 years. This may not seem like any big deal but I was scheduled for a cardiac ablation that had to be canceled. I have been having SVT’s for the last ten years. The last one I had resulted in having to go to ER to get IV med to get my heart rhythm under control. It was 179 bpm for 1 hour and 35 mins. I was feeling faint and couldn’t walk. The SVT’s on many occasions seem to happen at the onset of a migraine episode. It presents with pain in both temples and throbbing. Because of this I was anxious to get procedure done. But because of the TSH level I have a two month wait to see if the change in Levo dose will be effective. I suspected for a long time that these SVT’s may be somehow connected to my migraines. Whether or not they are I talked to my Heart Dr. a couple of years ago about it. THen more recently I asked my neurologist what he thought. He said it could be a definite possibility but no one really knows for sure with migraines.

  • Shoshana Lipson moderator author
    1 month ago

    Migraine is such a complex disease and doctors/researchers are still figuring out all the links and connections to other conditions. I’m so sorry that you are dealing with all this and am glad you are a part of this community! Hugs – Shoshana (Migraine.com team)

  • Purvi
    2 months ago

    I have chronic migraine only finding relief when I’m on the Triptans along with undiagnised digestive issues, profuse vomiting and indigestion causing weaknesses and lack of energy but after reading the comments I feel I am better off. My prayers for those suffering

  • Shoshana Lipson moderator author
    1 month ago

    Thank you for sharing and glad that the triptans give you some relief! Hugs – Shoshana (Migraine.com team)

  • kellikens
    2 months ago

    I have chronic migraines as well as chronic pain from brain inflammation. Life is fairly miserable right now, as I hypertension constantly!

  • Shoshana Lipson moderator author
    1 month ago

    Chronic migraine can be really challenging and can make life rough. Please know that you are not alone, that there are so many of us who care, and that there is hope on the horizon! Hugs – Shoshana (Migraine.com team)

  • sarahblankenship
    2 months ago

    I have fibromyalgia and chronic intractable migraine, with depression and anxiety thrown in to keep things interesting. My neuro says that my comorbidities are what makes treatment harder, and we have to just keep trying. Then I lost my job and insurance (thanks migraine!) Sooo now I can’t afford my meds or doctors, and I’m enjoying an almost 6 month status migraine. To add to the fun, our weather has caused a massive fibro flare. I’m treating both with ibuprofen, bed rest, bad TV and liberal doses of worse jokes. I’ve had to learn to cope, and it’s been really hard.

  • Shoshana Lipson moderator author
    1 month ago

    Sounds so familiar to me and it definitely “keeps things interesting”! The more conditions the harder treatment can be but we do have to keep on trying! Never give up hope and know that you are not alone:) Hugs – Shoshana (Migraine.com team)

  • bookseller
    2 months ago

    I hope you are in the process of applying for SS Disability. I hated to do it, but there is no way I can work and my meds are so expensive. Be thorough on your application and don’t be surprised if you get turned down the first time. With disability, you are eligible for Medicare. Message me back if you have questions. BTW, Excederin or generic equivalent is better than ibuprofen especially if taken w/ hot caffeine like coffee. This is only if you can tolerate aspirin. Don’t take it if you can’t have aspirin and acetaminophen.

  • Purvi
    2 months ago

    Prayers for you

  • petmigraine
    2 months ago

    This hits home for me 🙁 unfortunately.. I’ve always had sketchy sleep patterns/insomnia. Then when I started having migraines, I thought it weird that IBS symptoms and lactose intolerance arrived as well. But, really; I didn’t think they were connected. I mean, migraine squeezing my brain isn’t anywhere close to cramps squeezing the tummy, right ? And not sleeping -for me, well that’s just normal. Then a few years down the road, arthritis kicked in. Doctors have confirmed they can all be related. It’s just a wild party my body chooses to host without a permit. The good news is, with all these ‘residents’, I’ll never be alone. ugh. This situation is one big reason why we tend to be at home mostly.. My hubby is very sympathetic and understanding. Lucky for me, he is happy at home with me, too 🙂

  • Shoshana Lipson moderator author
    1 month ago

    I’m glad you found this article helpful. Knowing that everything is somehow connected can be a huge help emotionally even if it doesn’t help with management of those conditions! It’s definitely one great big wild party that our bodies choose to host! Hugs – Shoshana (Migraine.com team)

  • ejcc
    2 months ago

    All the medications I’ve been on and all the medications I take now +2 brain stimulator‘s and I’m in a constant battle with my own body exhausted tired sick of fighting and two weeks ago I found out I’m allergic to probably the only two meds that keep me up right. All this fighting is extremely hard

  • Shoshana Lipson moderator author
    1 month ago

    The fighting and struggle to get effective treatment can be so exhausting. Please don’t give up – there is hope on the horizon and you are NOT alone! Hugs – Shoshana (Migraine.com team)

  • Idahokid
    2 months ago

    Thank you for this article….. For years I had the feeling that my issue with migraines, fibromyalgia, bipolar type 2 disorder, and multiple chemical sensitivity were all related. My new doctor was concerned about my daily use of Imitrex maybe becoming MOH. I went into a major anxiety attack and brought him articles on bipolar and fibromyalgia, plus, a newsletter from a neurologist saying triptans do not cause medication overuse headache. It’s crazy what we go through with the medical community. I’ve been taking Imitrex for 24 years, haven’t had any side effects even with taking it daily for the past several months. One day at a time, don’t loose your sense of humor, it’s great not to feel alone.

  • Shoshana Lipson moderator author
    1 month ago

    I’m glad you found this article helpful and yes we go through a lot! Like everything else some people have side effects from the different triptans and some do not – hopefully your doctor is partnering with you in making decisions? As you say, we just take one day at a time! Hugs – Shoshana (Migraine.com team)

  • weldmax
    2 months ago

    Chronic Vestibular Migraine….. that’s what the neurologist said. I asked if she’d been drinking. One helps the other Co exist….lovely neighbors intent on leaving bags of dog poo on my life highway. I feel the pre and post drones just like I feel my migraine…..they are real. I go through changes as the beast unlocks the cage, kills me with daggers, then lounges in the front yard in a rocking chair. I lean and can’t control my vertigo. I won’t be going on any roller coasters or grocery store buggies anytime soon…..I promise. It’s funny at times when I fall into a hallway…..I must be an eyeful. ……..add humor to your life and smile through the hell. Peace!!!

  • Shoshana Lipson moderator author
    2 months ago

    Love that you bring humor into your life like this!

  • ScherisAngel
    2 months ago

    I have had migraines since I was a child. As I’ve grown older they have increased in frequency and duration. I have 4 of these comorbid conditions which include depression, anxiety, PTSD and Celiac. I was also born with Spina Bifida (Tethered Cord Syndrome) but it was never bad enough to become obvious until my back pain became so severe about a year ago my doctor ordered an MRI which revealed the condition. I have since had to have back surgery to untether my spinal cord and am now having complications during my recovery. One of which is waking up with migraines every day. Since both conditions are neurological, it’s hard to dismiss them as unrelated, but I don’t know for sure. It’s very rare for me to have a day completely free of pain. Since the surgery I have also developed completely uncontrollable incontinence. I am only 41 years old so this is very frustrating and I’ve had to go on state disability. I just try my best to take things one day at a time.

  • Shoshana Lipson moderator author
    2 months ago

    I’m so sorry that you live with pain like this most days! Chronic pain and multiple conditions can be challenging to manage. So often all we can do is to take just one day at a time, like you say!

  • Author Alexis K
    2 months ago

    I have several of those conditions listed. I have TBI from 1986, too, which is linked to my migraines and seizures. I also have fibromyalgia, PTSD, depression, IBS, arthritis, anxiety, suicidal thoughts, hypertension, and sleep problems along with several conditions not listed. My migraines are chronic and intractive. I’ve had one for over 2 years straight–every single day–and 5-7 days per week for several years prior. They aren’t rebound, and they fluctuate from excruciating to tolerable but annoying. It’s debilitating for sure!

  • Shoshana Lipson moderator author
    1 month ago

    I’m so sorry that you are dealing with so much and that you have chronic intractable migraine. Please don’t give up hope – there is so much new on the horizon and we have a fabulous supportive community! Hugs – Shoshana (Migraine.com team)

  • DinaMay
    2 months ago

    Comorbidity is like my middle name – I was diagnosed with Systemic Lupus Eryth…(I cant remember how to spell it at the moment because I’m in the hangover stage of a migraine) about the same time as I was diagnosed with migraine. I also have psoriasis and/or eczema, plus asthma and some lesser autoimmune disorders. The medication I take for an asthma attack triggers a migraine, the med for lupus aggravates psoriasis, the med I formerly took for rosacea (one of those lesser disorders) aggravated lupus.

    The best way I’ve found to deal with comorbidities is, first, to educate myself. I read up on any new condition I’m diagnosed with so I have an idea of which symptoms fit into which category; I read the package insert that comes with medications, especially the part called contraindications (which means who should NOT take this med) and the list of possible side effects; and I prepare for my doctor visits ahead of time, making sure I have an updated medication list, plus a question or two. The more prepared I am before a doctor visit, the better the visit tends to go.

    All the prep gives me a sense of what I can expect. For example, I know that all my comorbities are chronic conditions, not the sort of thing that a few pills or an injection can cure. So I don’t go into the doctor’s office looking for a miracle. And I don’t demand the impossible, such as medication that has no side effects, or emotional support from the doctor.

    I have more bad days than I would like, but I focus on the good ones. When I’m feeling good I try to do something fun. When all these ills began, decades ago, the house would go to pot during my bad times. Then when I had a good day, I’d try to get caught up on all the things that I’d let slide. This was not a good idea because working that hard was likely the trigger that ended the good stretch and brought on more bad days. So alongside all my meds, I prescribe myself a dose of fun. I highly recommend a dose of fun to everyone. It gives a person something to look forward to and it has very nice side effects.

  • Shoshana Lipson moderator author
    2 months ago

    What you say is SO true! It’s really important to educate ourselves, especially when we live with mulitple conditions. Not only learning more about each condition, but also how taking a medication for one could potentially impact the other. Love how you end – a rx for fun!!!

  • LesaS
    2 months ago

    Chicken or the egg. I’ve been diagnosed with Chronic Intractable migraine as well as a few mood disorders. It’s a vicious cycle and they all feed on each other. Fortunately thanks to Thomas Jefferson Neurology, after 41 years of this insanity, I have found a protocol proving hopeful to both. I have been treatment resistant or “failed” soooo many meds over the years (many 2 or 3 times), I have a list 50 or 60 names long. Thank GOD for those who continue to research without giving up on this awful debilitating disease.

  • Shoshana Lipson moderator author
    1 month ago

    You’re so right – sometimes it’s hard to know which is the chicken and which is the egg. They all feed on each other and they all make treatment more complex. I’m glad you’ve found a protocol that helps you and are going to a great headache center! Hugs – Shoshana (Migraine.com team)

  • Author Alexis K
    2 months ago

    I’m glad you’ve found something that will help. My doctor tries hard, but like you, I’m resistant to everything so far.

  • bluesguy
    2 months ago

    Great article. I too deal with multiple (co-morbid) illnesses. The fight with migraines, and the persistent pain, malaise, and other symptoms is a huge challenge. For me, adding Depression, and chronic eye disorders makes my life that much more unmanageable. I don’t handle stress well. I am an absent partner, friend, brother, and son. All of this brings on significant guilt. I imagine that there are many others dealing with similar issues. I very much appreciate the support from migraine.com. We all must try our best to stay connected. Isolation is a dangerous trap that migraine can cause. Thank you so much for bringing these issues up for all of us to consider. Great article!

  • Shoshana Lipson moderator author
    2 months ago

    Thank you and yes, isolation is not a good path to go down at all but so hard to avoid often. This online community is fabulous, and can be a huge source not only of information but also strength, inspiration, and courage to face tomorrow!

  • glassmind
    2 months ago

    Thanks for bringing awareness to the conundrum of comorbidity.

    So very true. I’ve actually had more than one doctor say “we only have time to deal with one problem. Which is your biggest concern?” To which I reply “my biggest problem is that I have all these problems.” But then, of course, I have to prioritize and pick one or two for the doctor to address and offer treatment. Worse if if the doctor prioritizes and differs from my concerns.

    Example: doctor more concerned with missed yearly preventative medicine test than with the pain I was in office with that was keeping me from sleep, activity, and my family. I had to continually press to have it addressed. A few xrays later revealed a degenerated joint, a bone spur, and a compressed vertebrae disk. So, I got that dealt with, but the other conditions I need treatment for were deferred. Alas.

    Few practitioners have the literal time (20 min appt) much less patience to address comorbidity. More holistic practicioners availible would help.

    Good luck to and hugs for us all.

    Thanks again.

  • Shoshana Lipson moderator author
    2 months ago

    Love your comment, “my biggest problem is that I have all these problems.” This is so true! Sometimes it can be hard to just speak up with our doctors and then we tend to leave the appointments frustrated. Kudos to you to advocating for yourself!

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