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Depression And Migraine: The Effect of Depression


  • How Does Depression Affect Headaches?

Depression and migraine might be one of those "other" migraine headache causes. So often we are looking for just one thing that causes headaches when in reality it is a combination of many factors.

The most frequent cause of headaches in general is stress.

Quite frankly, until you are able to recognize and accept this, you might not have much success in getting these headaches under control. The effects of lifestyle on headaches cannot be underestimated.

Depression and anxiety can greatly affect your headache profile and are recognized by all national headache experts as a migraine trigger.

Now wait!! Before you dismiss the idea, up to 85% of all chronic pain sufferers have depression and/or anxiety to SOME degree. Many people, including medical providers, are unaware of this statistic. The reason for this is the serotonin receptors in the brain. There are subsets of these receptors and they control migraine, anxiety, depression ...and nausea. Sound familiar?

It's almost like the chicken and the egg..which came first? Depression and migraine impact each other..the more pain, the more depressed you feel and then that makes the pain worse. If you have a headache, doesn't crying or being upset make it worse? This is the anxiety fueling the headache.

Along the same vein, if you have headaches or migraines on a regular basis, are missing school, work and family outings, you are bound to feel a bit depressed.

Depression is also highly associated with fibromyalgia symptoms and with irritable bowel syndrome symptoms.

depression chronic pain Too many times this is one of the most difficult concepts for my patients to get their minds to accept..that they may have some degree of depression which makes the pain more chronic and more severe. Artwork is by Christa Barnell who in my opinion has perfectly captured chronic pain. You can visit her site and see her award winning art work at www.christagallery.com.

Don't be too hard on yourself! As I mentioned, the receptors and pathways for headache are similar and sometime the same as anxiety receptors in the brain. Without getting in to a medical lecture, when they are all firing off..you have a headache and are anxious. One basically fuels the other.

  • Treatment Depression And Migraine

Just like treating the headache itself, it is important to realize that treating mood is multi-factorial.

Counseling with a good psychologist is invaluable. The rule of thumb when getting counseling is to give it at least three visits to see if you and the counselor "mesh" so to speak. Not all patient/provider relationships are perfect.

Counseling will allow you to dump some of the stress, in addition to learning how to develop good coping skills for future life stressors. Try too, to develop a good social structure. Even if you can't participate in activities that your friends may do (sports), you can still invite people to your place for a get together once a month or so.

Regular human social contact is a form of support and can help stave off depression. From Real-depression-help.com comes the following fact: In fact, more than 6 million women experience depression each year in the USA.

  • Medication For Mood

Please to not disregard the recommendation to take medication for mood in the presence of depression and migraine, especially when mood problems are one of your migraine triggers.

So many people make this mistake and think there is something wrong with them if they accept the fact that they are anxious or depressed. Even MILD depression can make headaches worse.Many of today's medications can treat BOTH mood and headaches.

SSRI's: This group of drugs are seratonin re-uptake inhibitors (what??). Seratonin is one of your brain's natural "happy drugs", but is taken up by nerve endings and recycled, so to speak.

By slowing this process, you have more of it in the way you need it and feel happier.

Side effects include weight gain, odd dreaming, mild episodic vertigo and rarely some of them can cause headaches to be worse.

Zoloft, Lexapro, Celexa, Prozac and Paxil are all in this class. Paxil and Lexapro are excellent if you have more anxiety. If you are over the age of 60, you may need to start at a lower dose than normal.

TCA'S: Tricyclic antidepressants (TCA) are an older class of drugs that are NOT first line for depression. I mention them here because we use them in the treatment of headaches. For more information about the benefits of TCA's in a headache profile, read about headaches and Elavil.

CYMBALTA: I wanted to mention this drug as many people are asking about it in relation to different types of headaches and as a medication for fibromyalgia.

Cymbalta is a drug that functions with two effects. Part of the drug is an SSRI but most of the drug functions on another pathway called norepinephrine. (What? Here she goes again!)

Anyway..the end result is another brain chemical is boosted and you feel happier. It also has and effect of calming pain in some patients with fibromyalgia and diabetic neuropathy.

Unlike most of the SSRI's, this drug has a faster effect and my patients have said they feel better in about a week or so. Only Lexapro, in my experience, works as fast. Remember, depression and migraine can be treated effectively at the same time. When you get one under control, the other may come under better control.

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