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Migraine and Depression Connection: Risks, Causes, and Treatments

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Migraine and Depression Connection: Risks, Causes, and Treatments

Both migraine and depression can be treated with pharmacological and nonpharmacological treatments, such as:

  • Medication
  • Psychotherapy
  • Healthy lifestyle changes

Can Antidepressants Help With Migraine?

Antidepressants are one way to treat migraine and comorbid depression simultaneously.

Although it may seem unusual to treat migraine with medications designed to treat depression, it’s not uncommon to use off-label medications in migraine prevention. In fact, one antidepressant — amitriptyline (Elavil) — has been used in migraine treatment since the 1970s.

While there are several classes of antidepressant, these three types may be used to treat migraine and comorbid depression:

“SNRIs such as venlafaxine (Effexor) and duloxetine (Cymbalta) are a class of medication that are helpful for treating migraine, and they are also helpful for treating depression and anxiety,” says Minen.

When talking to your doctor, it’s important to let them know about any medications you take.

For example, triptans are a class of medications commonly used to treat acute migraine attacks. They work by mimicking the effects of serotonin, a chemical messenger involved in pain, mood, and other important bodily functions.

 Taking other drugs that increase serotonin — such as TCAs, SSRIs, and SNRIs — raise the risk of developing serotonin syndrome, a potentially life-threatening reaction.

What About Psychotherapy or Mindfulness to Help With Migraine and Depression?

“Cognitive behavioral therapy (CBT) has Grade A evidence for migraine prevention. It is also evidence-based treatment for depression,” says Minen. This type of therapy can help you recognize the relationship between your thoughts, feelings, and behaviors.

Mindfulness-based stress reduction (MBSR) can also be beneficial. “Mindfulness training may be helpful for people with migraine because it may shift pain appraisal (or pain perception),” says Rebecca Erwin Wells, MD, MPH, a professor of neurology and social sciences and health policy at Wake Forest University School of Medicine in Winston-Salem, North Carolina.

Dr. Wells was the lead author in a study published in JAMA Internal Medicine that tested the effectiveness of eight-week MBSR in people with migraine. According to the results of the study, Wells says MBSR “decreases headache-related disability and improves quality of life, self-efficacy, pain catastrophizing, and depression scores.”

Lifestyle Modifications Can Help Migraine and Depression

Both migraine and depression can be addressed with a holistic approach. Routine and consistency are especially important for migraine management, and it also provides structure and a sense of control.

Since migraine and depression share a bidirectional relationship improving the symptoms of one disorder can help the other.

Here are some lifestyle changes that help migraine and complement any behavioral or pharmacological interventions:

  • Eat a well-balanced diet.
  • Don’t skip meals.
  • Stay hydrated.
  • Incorporate movement or exercise into your routine.
  • Maintain proper sleep hygiene.
  • Manage stress.
  • Keep a headache diary to identify triggers.
  • Utilize relaxation techniques, such as biofeedback and progressive muscle relaxation.
  • Build social support, which could include family, friends, or support groups.

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