• People diagnosed with migraine have a higher risk of developing depression and anxiety.
• Recognizing the symptoms of anxiety and depression is important to protect your mental health.
• You can help manage depression or anxiety through effective medical treatments and lifestyle changes.

For those diagnosed with chronic migraine, the physical effects of the condition can be all-consuming. But you may not be aware of the psychological impact of migraine on your mental health or that effective treatments exist that can improve your quality of life.

According to the National Institute of Mental Health, people with chronic conditions are more likely to develop symptoms of depression than those who aren’t chronically ill. This also works the other way around, with mental well-being affecting disease activity. People who experience depression are at an increased risk for developing certain chronic illnesses, compared to those who are not depressed.

Some people who experience migraine may postpone treating mental health conditions because they feel it might take their attention away from dealing with migraine attacks. However, the opposite is true. Treating mental health issues with therapy or appropriate medication can reduce stress and may improve physical migraine symptoms as well. Your health care provider can work together with mental health professionals, such as an expert in psychology or psychiatry, to ensure you stay both mentally and physically healthy.

Anxiety is also common for people with chronic conditions, particularly as they deal with the uncertainty of what might happen as a result of their disease. This can lead to other health issues. For instance, sleep issues, including insomnia and extreme oversleeping, have been associated with a lower quality of life in people who have chronic conditions.

“Anyone dealing with chronic illness of any kind can really come up against challenges, particularly when there is no cure, or there’s uncertainty in the progression of the illness,” said Dr. Sarah Gray, a clinical psychologist with Integrative Psychology in Arlington, Massachusetts, and a psychology instructor at Harvard Medical School.

Members of MyMigraineTeam often talk about the effects of migraine on their mental health. “I've been having headaches for a month already — I feel my head is too heavy for my neck,” said one member. “I don't know what to do, I've been anxious and depressed ever since that started.”

The Link Between Migraine and Your Mind

Scientists don’t fully understand the link between mental health and migraine. One study found that people with any anxiety or mood disorder were more likely to have had a migraine attack within the previous year.

There are several reasons why having a chronic health condition may put people at a higher risk of mental health difficulties, according to Mental Health America. For example, you might feel isolated after spending long periods of time at the doctor, or you’re not as mobile as you used to be. In addition, you may feel very worried about your health, you might experience inflammation in the long-term because of the stress, and you may be going through chemical and hormonal changes.

Watch migraine specialist Dr. Amaal Starling explain the connection between migraine and mental health.

In some cases, people with migraine may feel depressed or anxious because they aren’t getting the right medical care. One research team found that people who felt stigmatized by health care workers had a decreased quality of life, at least in part because they accessed health care services less frequently than people who did not anticipate a negative response from their doctors.

This situation can prevent some people from seeking care for their mental health conditions. “Unfortunately, sometimes there can still be a stigma around seeking help for mental health concerns,” Dr. Gray noted. “Thankfully, that's changing and continues to improve, but that can still exist.”

Recognizing Depression and Anxiety Symptoms

You may not recognize that you’re dealing with a mental health disorder, like depression or anxiety, because those feelings came on slowly over time, and you didn’t notice how strong they became. Or perhaps you’ve gotten so accustomed to feeling blue or stressed that you assumed this was just a way of life now. Recognizing when you have a condition that requires a professional evaluation is important.

“In my experience, and working with so many patients at different phases and stages, the type of stress that comes up early evolves over time,” Dr. Gray said. “Often, people along the way will find ways to cope, to draw on that inner strength that's there, and hopefully get linked in with a number of supports, but the stressors change over time. And that requires ongoing support.”

Symptoms of depression may include:

• Sadness
• Feelings of worthlessness or hopelessness
• Guilt
• Loss of interest in things or people you typically enjoy
• Changes in sleep, nutrition, or energy levels
• Difficulty with concentration or cognition
• Agitated or slow movements
• Suicidal thoughts

Common symptoms of anxiety can include:

• Nervousness or agitation
• Feeling a sense of upcoming doom
• Heart palpitations, rapid breathing, or sweating
• Trouble sleeping
• Gastrointestinal (digestive tract) issues
• Trouble focusing

If you’re experiencing these symptoms, talk to your health care team or contact a mental health provider for help.

Consider Lifestyle Adjustments

Your health care team can advise you about what types of treatment options you should pursue. In addition to the treatments your physician recommends, you can find ways of treating depression and anxiety with lifestyle changes and therapies that go beyond medication.

Dr. Gray recommends such tools as cognitive behavioral therapy and biofeedback for coping with the many unknowns inherent to having a chronic disease.

She also works directly with people to identify the specific stressors that may be troubling them. “For instance, if there's a family member who is bringing up some conflict and the patient finds it particularly difficult to navigate setting boundaries with a certain person, then we might work on concrete, specific tools to address any troublesome interactions there,” she said.

It’s essential that you remain on your treatment regimen for migraine attacks as you treat your mental health condition, while also pursuing lifestyle modifications. One 2020 study found that for older adults with multiple chronic conditions, maintenance behaviors — such as physical activity and treatment adherence — were the most critical components of self-care to combat depression. The researchers also noted, “Even mild [depression] symptoms can be associated with poor self-care maintenance.” This emphasizes how important it is for people with chronic conditions to be screened for depression of any severity.

Supportive Relationships

Make sure you have a supportive team around you, which can help when dealing with migraine symptoms. Another study found that people with certain chronic conditions reported family as the most important psychosocial resource. Social support can be a buffer for stress and just help you feel more connected.

Remember that your health condition may have an effect on every area of your life, Dr. Gray said. “Relationships, activities that one may enjoy — they may be impacted by the chronic illness and the symptoms,” she noted. “Your sense of self can be affected by the change in activities and relationships. So that in and of itself can really, validly lead to feelings of loss and worry.”

Modifiable Risk Factors and Mindfulness

Some risk factors for developing mental health issues — as well as for having chronic illnesses — are easier to change than others, according to the Centers for Disease Control and Prevention (CDC). Stressful life circumstances, a history of trauma, and a lack of social support may be out of an individual’s control. But diet, exercise, and drug use are among the “modifiable risk factors” the CDC identifies for reducing one’s risk of chronic disease.

You can also consider using mindfulness as part of your road to alleviating mental health issues.

“At its core, mindfulness is really approaching the present moment with openness, with curiosity, purposefully, and just being aware of what’s around you,” Dr. Gray said. “It takes a lot of practice, repetition, and time — it’s really important for people to know it doesn't just happen.”

Find Your Team

Through MyMigraineTeam, you can join an online social network for those living with migraine. In doing so, you will gain access to a social support group of people who are facing similar challenges and who understand what you are going through.

Are you experiencing mental health symptoms as well as migraine? How are you managing them? Share your ideas in the comments below, or start a new conversation on MyMigraineTeam.

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