Understanding the relationship between migraine, depression and anxiety with Dawn Buse, PhD
AHS: What do we know about the relationship between depression and migraine?
DB: Depression and migraine share a common relationship, and one may actually come before the other. That may not mean that one causes the other, but it could be a predisposer. We know that people with migraine are about five times more likely to develop depression than someone without migraine. We also know that someone who has depression is about three times more likely to have migraine later in life than someone without depression.
AHS: What about anxiety and migraine? What’s the relationship there?
DB: Migraine is an unpredictable illness that impacts people’s lives in every dimension, making it common for people who have it to also experience anxiety. They don’t know when the next attack is coming, so of course there’s going to be anxiety over not only that, but what the headache will impact. Is it going to affect work or school? Is it going to affect an important family event or a vacation, or something even bigger? We find that about 20% of people with episodic migraine or migraine on 14 or fewer days a month, and between 30% and 50% of people with chronic migraine, also have anxiety. On top of that, even more people have symptoms of anxiety: The worry over when the will attack come, the feeling of helplessness or hopelessness about their ability to control their lives and make plans, and their feelings of frustration and rumination that come up when just thinking about the many ways migraine affects their life.
AHS: What are some of the misconceptions people have about migraine, depression and anxiety and how they interrelate?
DB: When we talk about migraine, depression and anxiety occurring together, we have to be very careful not to make patients feel like how they’re feeling is their fault. These things co-occur because they share underlying biologic and neurochemical mechanisms. There’s a reason why the nervous system and the brain have these conditions together, and it’s very logical that you’re going to feel sad, down and frustrated when you’re living with a chronic disease like migraine.