Migraines, Depression and Anxiety – What to look out for

depression anxiety

It’s estimated that around 20% of people who suffer from episodic migraines (migraines which take place on fourteen or fewer days per month) may also have depression. That percentage of sufferers goes up as the number of migraine days per month increases. In fact, suffering from migraines makes you five times more likely to suffer from depression than someone without migraines. However, on a more positive note, depression and migraines are so closely linked that some antidepressant medications, including some SNRIs, have successfully been used to prevent migraines. 

Anxiety is also a big problem for migraine sufferers. Between 30% and 50% of people with chronic migraines are thought to suffer with anxiety, and about 20% of episodic migraine sufferers. 

Unfortunately, depression and anxiety are bi-directionally co-morbid, so to suffer from one of these problems makes you far more likely to develop the other.

With such a prevalence of anxiety and depression among migraine sufferers it’s important to know what symptoms to look out for.

Common symptoms of depression include; a loss of interest in things which used to cause pleasure (hobbies, seeing friends etc), difficulty sleeping, feeling fatigued, difficulty concentrating, decreased sex drive, feeling sad and hopeless, and changes to eating habits – some people go off their food, while others may take to comfort-eating.

Common symptoms of anxiety can include; irritability, excessive fear, and worrying overly in normal life. Given that migraines are unpredictable and for some sufferers an attack can strike at any time, it’s not surprising that anxiety can become an issue.

Depression and anxiety are both treatable conditions – both by means of medication and also through therapies such as CBT, biofeedback, and other non-pharmaceutical treatments. If you suspect you may be suffering from either depression or anxiety, go to your doctor. There will definitely be things they can do to help.

Concussion? Your Migraines May Mean It’s Worse

concussion

Data from the prospective longitudinal Toronto Concussion Study has shown that migraine history predicted how severe a person’s concussions would be.

The study was conducted by Laura Langer, MSc, from the Toronto Rehabilitation Institute of University Health Network, and her colleagues. Langer and the other researchers found that concussion patients who had a lifetime history of migraines before their injury/accident had significantly more concussion symptoms and higher symptom severity scores than those people without a history of migraines.

The study looked at a total of 302 concussion patients, of whom 116 reported having a pre-injury history of migraines – although after their injury, 92% of all of the patients reported from suffering from headaches.

The patients were enrolled in the study within seven days of their head injury and concussion diagnosis from local referring emergency departments. Once enrolled, the patients completed questionnaires about their concussion symptoms and severity every week for the first eight weeks of the study, and then at week twelve and week sixteen of the study.

In the first week, 42% of the group who had a history of migraines said that they had “continuous” post-traumatic headaches, while only 16% of the patients who had no migraine history reported continuous post-traumatic headaches. The migraine-history group also had a tendency towards a slower recovery. At week sixteen 22% of the migraine-history group had still not recovered to the point of their pre-concussion migraine frequency baseline.

This study was one of the few studies which “have linked symptomatic recovery to pre-injury baselines”. The reason the study’s findings that migraine patients have more severe concussions is important because “it may flag that a patient is at risk for a prolonged recovery, which could influence treatment plan – lifestyle modifications, appropriate pharmacological treatment considerations, etc”.

Reducing Migraine Frequency with CBT

CBT

A new paper published in the eminent scientific journal Headache has found that four out of five migraine sufferers experienced fewer migraine headaches following CBT.

CBT is short for cognitive behavioural treatment. It’s one of the most widely taught and most readily available types of psychotherapy in the US, and is similarly popular with UK doctors and therapists. It can be used to treat a range of illnesses such as insomnia, depression, and irritable bowel syndrome, but has also been used to help migraine sufferers.

The practise of CBT is based on the concept that your thoughts, feelings, physical sensations and actions are all interconnected, and that by breaking bad thoughts and unhelpful behaviours the end negative result can be changed. As well as changing negative patterns to improve how people feel, CBT aims to break down overwhelming problems into smaller parts.

The new paper published in Headache detailed the results of a study in which eighteen adolescents with migraines were given eight weekly CBT sessions. Before the first CBT session, and after the final CBT session, the participants underwent MRI scans to assess the level of activity and connectivity in different areas of the brain through blood-oxygen-level-dependent contrast scans. After the CBT, the scans showed that there was a greater level of activity in the frontal regions associated with the cognitive regulation of pain, and in the amygdala which is the area of the brain which deals with stress and raw emotions.

At the start of the study, before the CBT, the participants suffered from an average of fifteen migraines per month. After the eight weeks of CBT, this has dropped to an average of ten migraines per month.

Not all migraine sufferers may find CBT helps them. Just as each migraine sufferer is unique and will have slightly different symptoms to another sufferer, the underlying cause of each migraine sufferer’s migraines will be different, and so the effective treatment will vary from person to person. All the same, given how many of the study participants CBT helped, and despite the fact that CBT does not stop migraine attacks completely, it could still be a helpful treatment route for some migraine sufferers to pursue.

The Difference Between Male and Female Migraine Triggers

migraine triggers

Migraines affect approximately one in every seven people around the world, but migraines do not affect both sexes equally. Migraines affect three-times as many women as men, and it is thought that this higher prevalence in women is largely hormonally-driven.

As well as affecting a greater proportion of women, migraines also manifest themselves differently based on sex, and this difference based on sex was the basis of an investigation which analysed data from a community-based study in Turkey involving 5323 subjects aged between 18 and 65. Of these subjects, 871 (640 women and 231 men) were diagnosed with definite migraine according to the International Classification of Headache Disorders.

Household information was determined using an electronic questionnaire, while face-to-face interviews with 33 trained general physicians allowed the investigators to gather data on the migraineurs’ characteristics, associated features and triggers of migraine based on sex.

The data revealed that stress (68.5%), wind (54.4%), hunger (54.2%), and lack of sleep (53%) were common migraine triggers across all migraine sufferers, regardless of their sex, but strong smells were more likely to trigger migraines for women, while sleeping too much was a more commonly reported trigger for men.

In terms of symptoms, female migraine sufferers tend to experience longer attacks, and they also have a greater frequency of nausea, vomiting, sensitivity and aversion to smells, and vertigo/dizziness when compared with male migraine sufferers.

The reason that identifying these sex-based differences matters, concluded the study authors is that by doing so, and through further investigations, medical practitioners and researchers “will be able to diagnose, treat, and estimate outcomes for both sexes more accurately”.

Parenting Tips For When You Have Migraines  

parenting tips

Being a parent is tough at the best of times, let alone when you’re in the grip of a migraine. How do you cope with looking after children when you’re finding it hard to even look after yourself?

If this nightmare scenario sounds familiar, these tips could really help you.

Know who you can call on

Asking for help is no bad thing. We all need help from time to time, and having a plan in place for when and if a migraine strikes is a key part of being ready.

Identify people who you can call on to help care for your children while you’re not well. It might be a partner, a parent, a trusted friend, or a close neighbour. It could be as little as cooking a meal when you’re not well, or coming over to watch the children while you wait for the pain to pass.

Talking over what you might need and how they can help before the actual migraine hits will makes things so much easier and less stressful when the attack comes.

Have easy dinners ready

Being able to get meals that you don’t have to spend lots of time preparing are a huge plus when you’re in the grip of a migraine attack. These might be home-cooked meals that you make and store in the freezer, or ready-meals, or even just having pre-prepared takeaway orders ready so you just need to click a few buttons to get dinner on the table.

Prepare activities in advance

Books and audiobooks are good activities to keep the children entertained and quiet when you have a migraine. So are puzzles and art kits. Having some new books or jigsaws stored away is a good pre-migraine preparation as they’ll have something new to focus on while you focus on feeling better.

Ask the children to help

Many children thrive when they’re given a little bit of responsibility. Asking them to help you by completing little tasks, and praising them highly when they do them, will help to make you all feel good.

Some things they won’t be able to help with, but there will definitely be some things they can do. For example, if you can’t do the washing up, ask them if they can and challenge them to do it as quietly as possible. That will turn it into a game and make it both fun and helpful!

 

Dyeing Your Hair When You Have Migraines

If you fancy changing up your look, dyeing your hair a different colour is an easy way to do it. Or, perhaps you’ve seen a few streaks of grey appearing which you’d rather weren’t there. There are many reasons why you might want to dye your hair, but unfortunately it’s not always as easy as picking a colour when you suffer from migraines; there are other things to consider.

dyeing hair

If you’re one of the many migraine sufferers for whom strong smells are a migraine trigger, then dyeing your hair is potentially a big problem. Many hair dyes come with a strong chemical smell, which can’t be counteracted even if you dye your hair in a large, well-ventilated room where all the windows are open.

If this is the case for you, but you’d still like to dye your hair, then opting for hair dyes which are scent-free and made from organic ingredients is your best bet. This isn’t a guarantee that you’ll be able to dye your hair without triggering a migraine, but it’s one thing you can do to try and reduce the likelihood.

It’s not just the smell of the hair dye which can trigger a migraine though. The process of pulling the dye through your hair can put strain on your hair, and in turn put stress on the scalp. This is especially true of applying all-over hair colour – where the hair has to be pulled taught in order to apply it to the roots. This pulling can be an added migraine trigger, alongside the stress your hair and scalp may be under while it’s twisted up as the dye takes its time to develop.

If you’re looking to dye your hair, but are worried about the migraine risk, then these tips may help you to do so with a smaller risk of triggering an attack:

  • If you’re dyeing at home, may sure that all the windows are open and the air is moving. Setting up a fan to help with the flow may help.
  • If you’re going to a salon to get your hair dyed, tell your stylist about your migraines before you go. This way they can help you to pick a time when the salon will be quieter (the fewer noisy hairdryers going the better!) and they may be able to do other things to help, such as turn the music down, and be extra gentle with your hair and scalp.
  • Remember to drink regularly throughout the process, and to eat something before you start. Dyeing hair is a long process, and low blood sugar and dehydration are two extra migraine triggers that you’ll want to, and can, avoid.
  • Consider your options – you may be able to have an all-over bleach-free dye applied without triggering a migraine attack, whereas a style involving multiple colours, bleaching and highlights may be too much for your body to tolerate.

Poor Sleep Affects Migraines Too

Anyone, whether they suffer from an illness or not, can feel pretty bad the day after a night of little sleep, but for migraine sufferers it can be the final trigger for a migraine attack. It’s not just the amount of sleep that can trigger a migraine though. Poor sleep quality may also indirectly increase headache frequency and severity in patients with migraine.

sleep

A study published in the Journal of Clinical Neurology earlier this year found that, as well as poor sleep quality leading to more headaches, it could also contribute to “alterations in the neuroendocrine stress response system and metabolic activity during sleep, resulting in impaired daytime function”.

The study authors concluded that “physicians should make efforts to improve the sleep quality in patients with primary headache disorders, since this would further improve the headache-related impact as well as the headache frequency and severity in migraine and tension-type headaches”.

A different study, which was also published this year but this time in the Journal of Medicine and Life, looked at the relationship between sleep disorders and migraine in children. The authors had noted that previous studies about migraines and sleep were usually only studies involving adults, and instead of quality of sleep, they focused primarily on sleep deprivation as a trigger for migraine attacks or the cessation of migraine attacks after sleep. This newly published study looked specifically at migraines in relation to sleep disorders and disordered sleep in children.

The study found that the odds of having a sleep disorder were 5.6 times higher in the migraine group than in the control group. However, it is worth noting that the study was a very small one, with only 34 participants between the ages of five and seventeen being involved.

Despite there being relatively few studies looking at sleep quality and migraines, it’s clear that it’s not just the amount of sleep which can have an impact on migraine frequency – migraine attacks can also be affected by whether the sleep which has been had has been deep and undisturbed.

Not all sleep is equal, and so, perhaps, working with a sleep specialist to improve the quality of sleep is something that migraine sufferers need to be offered as part of migraine treatment.

Migraines In Children – What To Look Out For

One in seven people, or 14.7% of the population, is thought to suffer from migraines, and in general migraines are considered to be a problem that adults suffer with, but children can also be affected.

children

Not many people know that migraines can occur in toddlers, and even in babies. According to some estimates, migraines occur in up to 3% of 3-7 year olds, up to 11% of 7-11 year olds, and up to 23% of children up to the age of 15. Since not many people think of migraines as something that children can get, and especially since the migraine symptoms for children are different to those for adults, it’s hardly surprising that so many children’s attacks go undiagnosed.

In adults, migraine symptoms often include; head pain on one side of the head, increased sensitivity to light and sound, feeling sick, seeing visual disturbances (e.g. flashing lights), and feeling dizzy. There are more symptoms, but these are some of the most common. However, the symptoms which children commonly suffer with are a bit different.

In children, head pain is still a common symptom, but the pain typically affects the forehead and temple areas or the whole head –rather than being on one side. Abdominal pain and vomiting is incredibly common. In fact, with some children it’s the main symptom and the headache pain may not be part of their migraine attack at all. Alice in Wonderland syndrome is another symptom to look out for. This is a neurological condition which causes a distorted sense of perception. A child may describe things that are close by as looking far away, and things that are far away looking close.

Migraine attacks are also shorter in duration for children. While adult migraine attacks can last between a few hours and a few days, attacks for children are much shorter – sometimes lasting less than an hour.

Studies suggest that nearly half of children with migraine never receive a diagnosis. This can result in less effective treatment of symptoms, anxiety about future attacks, a loss of confidence, and poor attendance at school.

Simply knowing that if a child says they feel sick, and they are retreating to a quiet and dark place (hiding under a blanket is a common one), that the cause could be a migraine, is the first step in helping a child to get the help and treatment they need. The next one is to book an appointment with a GP, paediatrician, or headache specialist.

How Yoga Could Halve Your Migraines  

If you suffer from migraines and have ever considered doing yoga, there’s now even more of a reason to try it.

yoga

A study published in the medical journal Neurology has shown how yoga could reduce the frequency, duration, and pain of migraine attacks. There has been research in the past which has supported the theory that yoga can help in alleviating migraines, but this latest study has suggested that practising yoga could reduce the number of migraines experienced per month by nearly half!

In the study, 114 people aged between 18 and 50 who all suffered from episodic migraines (4 to 14 headaches per month) were assigned into one of two groups. The first group only used medication to try and control their migraines. The second group used medication, but they also practised yoga. Both groups were given guidance on lifestyle changes they could make to help reduce their migraines – such as eating well, doing some exercise, and getting enough sleep.

The group who did yoga did an hour of yoga three days a week for the first month. Afterwards, for the final two months of the study, the group practised yoga for five days per week. The yoga included meditation, breathing exercises, and yoga poses.

At the end of the study, the group who had only been taking medication saw a 12% decrease in the number of headaches they had per month – their average of 7.7 headaches per month went down to 6.8 headaches per month. However, the group who had been doing yoga as well as taking medication went from an average of 9.1 headaches per month, down to 4.7 headaches per month – a 48% reduction in headaches.

Interestingly, the level of medication the yoga group took also went down significantly over the course of the study, with the average number of pills the yoga group took going down by 47%.

Yoga is often cited as a way to reduce stress, which is one major trigger for migraines, but there are also other theories as to why it helps reduce migraines.

It’s thought that yoga may change the autonomic nervous system, and consequently the interconnections with the trigeminal vascular system. Imaging studies have shown there has been a positive effect on the limbic system, pain matrix, and brain networks as a result of yoga. Additionally, yoga is said to improve sleep, physical fitness, and overall quality of life – more reasons why yoga may help to relieve migraines.

Although this recent study has its limitations due to its size, duration, and the data being self-reported, it does suggest that yoga is well worth trying as an additional way to reduce migraines.