Migraine Disease and Depression Go Hand-in-Hand

I’ve had migraines since I was a kid. When I was 11 or 12, I started to get these awful headaches, but I didn’t know what they were. I started missing a lot of school because the only way I could get them to go away was to lie in a dark room. Noise and sounds bothered me.

It was frustrating, because it made it harder for me to be a kid — play on sports teams and socialize with my friends at school.

The headaches continued through high school and progressively got worse. I remember when I was 18, a senior in high school, driving to a funeral in South Texas with my family. I got a headache on the way down, but this headache was different. I was so nauseated I couldn’t open my eyes. I was writing in pain on the floor of the car, because I couldn’t sit up. When we got to the funeral, I couldn’t even get out of the car.

We started the long drive back to Dallas after the funeral, and the pain just intensified. I threw up, which I had never done before during a headache. Finally, when we reached Waco, my parents couldn’t take it anymore. They stopped at an emergency room, and we were immediately seen.

The ER doc said he knew instantly what it was — a migraine. I had never heard that word before. He retrieved a shot of Imitrex and gave me the injection. Within minutes, I felt so much better. No trace of a migraine or nausea, I couldn’t believe it.

As we were leaving, he told my mom to follow up with a neurologist.

I saw a neurologist and explained my symptoms and talked about how much school I was missing. The doctor, who was very sympathetic, diagnosed me with migraines and wrote me a prescription for that magical Imitrex in pill form.

The migraines would show up somewhat randomly, but I did manage to nail down some triggers:

  • Interrupted sleep or not enough sleep
  • Certain smells, like floral scents or cigarette smoke
  • Stress
  • My period
  • Drinking alcohol

Even when I avoided these triggers, the migraines still plagued me. When I went to college, I didn’t find sympathy when I missed class, except one professor whose wife was also a migraine sufferer.

I was missing so much class that I had to file paperwork with the campus’ Students with Disabilities office in order to be granted absence leniency. I still didn’t receive sympathy from my professors. I really wasn’t looking for sympathy, just understanding, but I never found it.

When I started my first job after college, my migraines were worse from all the stress I incurred. I called in a lot. I was embarrassed and felt guilty all the time, and some of my coworkers became resentful, even telling me so. Which now, I understand as part of the stigma of migraine. Boy, it’s hard living with one invisible, let alone two (migraine and depression).

People thought I was lazy, and my friends thought I was avoiding social activity with them. I couldn’t win, not that I’m looking for pity now. It was just frustrating at the time and even now, migraines are grossly misunderstood.

There’s an article in Practical Neurology that speaks about the stigma of migraine, going back to the 18th century.

“In the late 18th century, people with migraine were represented as privileged, self-absorbed individuals, who used their migraine as an excuse for shirking social duties and avoiding social responsibilities. By the 19th century, migraine was perceived as a weakness of women in the lower socio-economic classes. Physicians caring for patients with migraine were also ridiculed as out of touch, incompetent practitioners who encouraged their patients’ neurotic tendencies. A negative, feminized view of the person with migraine has persisted since, whether migraine was viewed as a psychological defect or as the result of an excitable, feminized brain.”

The article includes a 2016 survey by a medical insurance provider that found just 22 percent of employers deemed migraine to be a “serious enough reason for an employee to be absent from work,” lower than for any other reason, including depression, anxiety, stress, the flu, or the common cold. People with migraine must choose which parts of their lives to sacrifice, frequently prioritizing work over others (social, personal, leisure).

That’s so accurate — that migraine sufferers have to choose which parts of life they have to sacrifice.

Between the chronic pain and sacrifices that migraine suffers do make, it takes a toll on mental health. I started experiencing depression an anxiety after my headaches started, so I’m not sure which came first, but I do know that my depression symptoms were intensified by missing school and work, and the pressure and guilt I felt about it.

There is data that shows a connection between migraine and depression. People with migraine are about five times more likely to develop depression than someone without migraine, according to Dawn Buse, PhD, the director of behavioral medicine at the Montefiore Headache Center.

Ms. Buse says that about 20 percent of people with episodic migraine—headaches on 14 or fewer days per month—may also have depression, and that number goes up as the number of headache attack days per month increases. Similarly, about 20 percent of people with episodic migraine have anxiety, and between 30 percent and 50 percent of people with chronic migraine also have anxiety.

None of that is surprising to me.

Here are some stats on migraine in the U.S.:

  • Nearly 1 in 4 U.S. households includes someone with migraine
  • Amazingly, 12 percent of the population – including children – suffers from migraine
  • 18 percent of American women, 6 percent of men, and 10 percent of children experience migraines
  • Migraine is most common between the ages of 18 and 44

You can see that migraine is not a rare disease — 12 percent of the population is huge. I also found this interested:

  • Migraine is the sixth most disabling illness in the world
  • Every 10 seconds, someone in the U.S. goes to the emergency room complaining of head pain, and approximately 1.2 million visits are for acute migraine attacks
  • While most sufferers experience attacks once or twice a month, more than 4 million people have chronic daily migraine, with at least 15 migraine days per month
  • More than 90 percent of sufferers are unable to work or function normally during their migraine

Facts provided by the Migraine Research Foundation.

Just like with any other invisible illness, more attention needs to be paid to migraine — more understanding needs to be applied to migraine as well. You can help end the stigma of migraine by educating yourself and others about it.

Risk Factors for Migraine Sufferers

  • Family history. If you have a family member with migraines, then you have a good chance of developing them too
  • Age. Migraines can begin at any age, though the first often occurs during adolescence. Migraines tend to peak during your 30s, and gradually become less severe and less frequent in the following decades
  • Sex. Women are three times more likely to have migraines
  • Hormonal changes. For women who have migraines, headaches might begin just before or shortly after onset of menstruation. They might also change during pregnancy or menopause. Migraines generally improve after menopause

To learn more about migraine, visit the Migraine Research Foundation here.

My Mother

My mom is cut from a different cloth. Even from a young age, she has always done what she needed to do. At 19, her father died. She didn’t hesitate to help my Mema with the younger kids. She took a job right after high school so she could help pay bills. My mother had seven siblings but the two older siblings were married and were starting families, so she helped take care of the younger five. Still to this day she helps her siblings, financially or otherwise because that’s who she is – a caretaker.

Skipping years ahead, she got married and helped my dad and his brother open a business. She was the first employee and she excelled at it, even though it probably wasn’t her greatest passion. Still she learned everything about truck accessories for heavy duty trucks and continued to work that job for years. After some personnel issues, my mom and dad decided to open a second store, this one with my older brother at the helm. It too was a success and it still didn’t bother her talking shop about truck bumpers, wheels and other accessories. Like I said, she always did what she needed to do.

I can’t speak for my brother but I’m sure he would agree – she would do anything for us. In middle school when I developed migraines, that at times were uncontrollable and debilitating, she became my advocate. She navigated a new world of medicine and therapies and triggers. Fragrances were a trigger so she stopped wearing perfume and bought special soaps.

Years later I finally told her I had depression – bad depression. This was not her field of expertise and although she was probably really scared, she learned the ropes and how to help me calm down during a depressive episode.

When I had kids my depression worsened. Some days I couldn’t find my way out of the overwhelming sadness. I would often want to harm myself. My mom, who had never experienced mental illness herself, dug deeper and supported me the best way she knew how. It must’ve broken her heart when I became suicidal and needed intensive intervention. I stayed at a psychiatric treatment center for 6 long weeks. But she was there, helping take care of my children, visiting me and encouraging me once again.

As I’ve now stabilized, I think about the calls I made to her crying, suicidal. Her love, strength and endurance has never wavered and she just listened, not knowing how to help her daughter stop being suicidal. I firmly believe she was meant to be my mom, to help someone who struggled daily with invisible demons. Someone who wasn’t cut from that seemingly magical cloth. But I have learned from her, too. My bouts with depression have taught me strength, most importantly, compassion. My mom has been my advocate, leading me to be an advocate for those who suffer from depression and anxiety. Maybe to those who haven’t had support and are afraid of speaking out because of the stigma surrounding mental illness. Maybe I’m more like my mom than I think. At least I’d like to think so.

Blah

I haven’t written in a couple days and I don’t really feel like writing today. Yesterday, I had my first Spravato treatment, which I’ll get to later, and since then I haven’t felt right. I have a major migraine and I feel really depressed. So far not impressed with Spravato.

Anyway, that’s it for now.

Migrainepalooza

Remember when I said my migraines were nearly non-existent a couple of blogs ago? Well, this week they came back with a vengeance. Usually I would go get a ketamine infusion, which keeps them at bay, but guess what? The ketamine clinic here – the only one in town – has closed. The closest clinic is two hours away.

Photo by Public Domain Pictures on Pexels.com

Now what exacerbates my migraines is really anything but since I’m doing TMS and it feels like a woodpecker pecking the shit out of my head, it tends to make things worse. Good times.

This week I had to go to my neurologist for two injections. When my migraines get very bad and my abortive meds aren’t working I go to my doc and he gives me an injection of Nubain and some nausea meds. It worked for a little bit Tuesday but then the migraine was back in full force Thursday. I also had a less intense one on Friday but didn’t end up going back to the doc.

During the week I missed a board meeting, play date, didn’t get any chores done, barely saw my kids because they were either at after care at school or with my mother-in-law. And of course that all depressed me because 1. I felt like crap and 2. I felt useless because all I could do was lie down and take a massive amount of drugs that didn’t help.

My husband, who has picked up the slack for me this week, has decided to drive me to San Antonio for a ketamine infusion. Maybe he realized my job was too hard on top of his because I suggested getting an infusion before I started TMS to avoid this whole situation. Men, they never listen.

Last week I also talked about how good I was feeling and then I went a little downhill but with migraines three to four days a week it cant help but depress you. Chronic pain will do that to you, like I discussed in this blog.

I’ve now completed 10 TMS treatments and they say you’re supposed to feel a real difference by treatment 14 or so. I’m really hoping the ketamine will help my migraines, the TMS will start working better and then I can get my ass in gear. I do have two 5Ks coming up in the next four months and I haven’t exactly been running, unless it’s to the fridge for a Diet Coke (I needed the caffeine this week)….which I’m supposed to quit.

I’ll blog after my ketamine treatment and give an update on my TMS treatments next week. Wish my luck.

For more information on ketamine for chronic pain, go here.