Prodrome – Depressed Mood

  • By Tammy Rome

    Many have expressed an interest in learning more about this symptom after the publication of Depression as a prodrome symptom. I don’t really have any answers, but would enjoy keeping the conversation going to see if we together we can figure out some good coping strategies and ways to recognize this symptom before it overwhelms us. Who’s in?

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  • By JanetH

    I’ve been having more migraines for about a month now. I suspect this is somehow related to menopause, as I’m also having increased hot flashes during the day and night. Along with it, I’ve struggled more with increased anxiety and depression. I’m glad to know that some others are out there with the same issue. I’m currently taking 1200 mg of Neurontin/day. Earlier this winter, when I was struggling awhile, the dr. upped it to 1400 for 2 weeks, then back down to 1200. I think the Neurontin keeps me functional, inasmuch as I can go to work (thank God, cuz I know a lot of folks can’t). But I’d like to think that life could be more enjoyable then work, tired, headache, repeat as needed. I also tend toward anxiety and obsessive thinking, so the mood issues have been tough. I tried two anti-depressants several years ago when I went through a divorce, and neither one seemed to fit well. I know there are others out there, but just reluctant after two fails, plus I’m on several meds for asthma and allergies. So, not trying to be John Wayne, but feel like I’ve given meds for depression a decent try. I drink moderately, try not to overdo caffeine or sugar, try to keep to mild exercise. That’s been tougher, as I have exercise-induced asthma, and now I have arthritis in my feet, so walking isn’t as pleasurable. This all gets discouraging, as I’m sure everyone knows.

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  • By Tamara

    i was just going towrite a question about this. I have depression constantly but cymbalta is keeping it under control 75% of the time (tried adding Wellbutrin and it helped but side effects too bad to continue). However the depression that hits before and during a meeting with a migraine completely knocked me off my feet, literally.

    I got one yesterday well I’m on the road doing one of my sales runs through the mountains and I literally had to pull over, stop (had already taken imitrex and dealt with minor symptoms for the last few hours). I wanted to drive rough the barrier and down some of the cliffs …. I stopped and was crying so hard I couldn’t breathe and ended up throwing up. The imitrex stopped most of the migraine so there was minimal pain, just the zapping and tingly symptoms with pressure. It took about 2 hours of sitting there to work through the symptoms enough I was mostly safe to drive, still cried non stop for the next two hours of driving.

    Anyone have any tips on how to treat this insane flare during migraines? I get 1-3 migraines a week and it is happening with each one. I’m afraid I won’t be able to stop myself one of these days. At this point nothing is working on lowering the amount of migraines themselves (and tried tons over the last year and a half), and of course if I’m over my 10 days allotted for pain meds the migraines last 3-6 days and the depression is horrible throughout.

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  • By JanetH

    OMG, Tamara. That sounds awful. On one hand, sounds like you shoudn’t be driving under those conditions. OTOH I know you have to make some money to live, eat, and get your migraine meds. Please be careful. I’m hoping the moderator Tammy will weigh in here, since from other posts she’s had, she has dealt with migraine a very long time. Suggestions, folks?

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  • By Tammy Rome

    Tamara and Janet –

    I’m just now seeing your posts. I do apologize for not seeing them sooner. Apparently the notification feature isn’t working well right now.

    It is quite common for migraine to worsen during perimenopause and continue to get worse until after menopause. Some patients, though, continue to get attacks long after menopause.

    Perimenopause can trigger its own form of depression due to rapidly declining hormones. While many migraineurs have difficulty with artificial hormone replacement, some have success with bioidentical hormones. That might be worth considering.

    RE: antidepressants
    There are way too many options to give up after only a few. It’s just like migraine preventive meds. You really have to keep trying to find the one that works. They don’t all work the same. There are basically 3 types of antidepressants: tricyclics, SSRIs, and SNRIs. I’ve used multiple versions of each type with varying degrees of success. Tricyclics are most successfully used as migraine preventives. The other two are not quite as successful, but do work for some. In my experience, SSRIs have been better for depression while SNRIs have been better for fibromyalgia. However, that’s just me. Everybody will respond differently.

    Also, studies have shown that Cognitive Behavior Therapy plus medication produces the best long-term results for depression. If you don’t have a good therapist who specializes in chronic pain, I’d recommend you find one. has a good health care provider search that may help.

    Tamara – That was smart of you to pull over and stop driving. It is never safe to drive with migraine, from prodrome all the way through the hangover. It’s a tough call when you have to work. That’s where working with a chronic pain behavioral therapist may be help you discover some ways to prevent those pre-meeting migraine attacks.

    Part of the success I’ve found is in recognizing this type of depression for what it is. Knowing that it will pass once the migraine is gone is helping me to avoid the fearful anxiety in response to symptoms. That helps to reassure me that my depression isn’t really getting worse — that it’s just temporary due to migraine. I’ve also started taking daily Naproxen and 5-HTP starting about 3 days before my cycle through the first 2-3 days of the cycle itself. That way I am less likely to get a migraine in the first place. The 5-HTP is helping to keep my serotonin levels a little higher so that they don’t drop so suddenly. Maybe this is something you could talk to your doctor about?

    I hope I answered all your questions. Please write back if I missed anything.


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