The Mystery of Migraine
There’s more work to be done when figuring out the exact causes of migraine headache, but as research starts gaining ground (see our previous post on a recent meta-analysis of migraine causes), an interesting link is surfacing; the relationship between migraine and anxiety disorder is more than mere coincidence.
Migraine and Anxiety Disorder
On the surface, it does seem the persistence of debilitating headaches – especially if unpredictable – would affect one’s calmness and stress. But the connection goes deeper than that. According to one study, the triggers of a condition like migraine do not only pertain to migraine. In many instances, they also point to an underlying anxiety disorder as well.
Before we get into what the scientists say about this connection, however, it’s important to clarify what is meant by words such as “nervousness,” “worry,” “anxious,” as a temporary feeling, and “anxiety” as a diagnosed condition.
Anxiousness vs. Anxiety Disorder
Everyone goes through periods where they feel worried or anxious. This is, of course, normal, and perhaps even instinctual, as some have speculated. Anxiousness is our bodies’ way of alerting us to danger. Being diagnosed with an “anxiety,” disorder, however, is very different. When a person deals with this condition, everyday worries that are not dangerous nor life-threatening take on increased, often artificial magnitude. For some, they can cause an anxiety attack, where the feelings of danger do not match the situation.
There are many kinds of anxiety disorder. The most prevalent are:
- Generalized Anxiety Disorder (GAD): Those diagnosed with GAD are characterized with an ongoing sense of fear. For people suffering from GAD, the smallest tasks—picking up laundry, going to the grocery store, or coming into work, for example—could be mentally taxing since their generalized sense of anxiety can occur in the most mundane events.
- Social Anxiety Disorder (SAD, or Social Phobia): Those with social phobia find social events and interactions a great cause for anxiety. People suffering from SAD often avoid social functions entirely. Since the fear of judgment is what many with SAD are anxious about, the potential for shame, fear, and risk of embarrassment become too overwhelming to shake. It’s not worth the risk.
- Panic Disorder (PD): When many in the general population think of anxiety disorders, they most likely see those who suffer from consistent PD. Panic attacks, which many who have experienced them describe them, is an acute sense of pain and danger. The pain may be so intense some think they’re experiencing a heart attack.
Panic attacks are unpredictable when they occur, and often one may not know what triggers one. The irrational part of the brain in a panic attack overtakes the reasonable side. This can distort the reality of the situation in a dramatic way. A person who experiences one for the first time may feel at the mercy of their bodies and that their life is being threatened. And though panic attacks don’t last long—usually only a couple minutes—patients often fear the next one. The utter terror, the shortness of breath or hyperventilation, and the rapid heart rate are seriously scary.
Links between migraine and anxiety disorder have been reported as early as 1994. Dr. Jennifer Devlen, a researcher at the University of Manchester, found that “approximately 50%” of those with migraine have other anxiety disorders. This finding, based on data from 697 migraine sufferers, was then confirmed through follow-up research. Today it’s accepted that anywhere from 50% to 60% of those with migraine deal with anxiety disorder as well.
Following the findings in Dr. Devlen’s study, a team lead by Dr. Borcu Goksan Yavuz of the Department of Psychology at Istanbul, Turkey’s Arcibadem University School of Medicine adds an importance aspect of the connection: that of sensory sensitivity. Sensory sensitivity is the extent in which people feel pain through a magnification of outside stimuli, such as car horns, dripping faucets, etc.
Dr. Yavuz argues sensory sensitivity may be a chief contributor to the link. He writes “our findings showed significant correlations between somatic amplification and level of anxiety and stress.” The researchers added that migraine sufferers with additional anxiety disorders often experience a lower quality of life and poorer health outcomes. Anxiety, often a crippling disorder, significantly affects one’s personal health management. The extent to which a patient keeps up with their medical health declines significantly.
A third study was conducted in Zurich, Switzerland. This study provided further evidence between the commonality of anxiety and migraine. Dr. Kathleen Merikangas, the study’s lead researcher, called it a “syndromic relationship” rather than “discrete manifestations” -i.e., the relationship is more than mere coincidence or outliers – of the two conditions. Employing a “longitudinal” approach (that is, data that’s been taken from the same participants over a greater period of time) the team found that, in most cases, anxiety disorders often precede migraine.
What Do We Make of This?
What’s happening here? What could be causing such elevated rates of anxiety disorders in those with migraine? The answer to that is still being determined. Given how complicated the brain is, exact causes of migraine have yet to be completely localized. It will take some time before we have a full understanding.
Medicine is Moving Forward
What does seem clear, however, is the importance of medical practitioners providing multi-faceted treatment to those with both conditions. Patients are actively urged to be mindful of what they’re experiencing. If an onset occurs, reporting any unusual periods of anxiety or depression can be extremely helpful information.
Those suffering from migraine need want their life back. There’s no doubt dedicated medical professionals can help, so seek them out. As research continues, treatments and care are getting better. That means a better quality of life is possible.
The team at Migraine Centers of America make the extra effort to respond to those in pain with both effective treatment, and empathetic support.
Give them a call at 855-300-6822.
- Devlen, Jennifer. ‘Anxiety and Depression in Migraine’. J R Soc Med 87, no. 6 (June 1994): 338–41. Accessed November 13, 2016. doi:10.1177/014107689408700613. http://jrs.sagepub.com/content/87/6/338.abstract.
- Smitherman, Todd A. and Steven M. Baskin. ‘Depression and Anxiety in Migraine Patients: American Migraine Foundation’. 2016. Accessed November 14, 2016. https://americanmigrainefoundation.org/depression-and-anxiety-in-migraine-patients/.
- Yavuz, Borcu Goksan, Elif Ilgaz Aydinlar, Pinar Pinar Dikmen, and Cem Incesu. ‘Association between Somatic Amplification, Anxiety, Depression, Stress and Migraine’. The Journal of Headache and Pain 14, no. 1 (June 25, 2013): 53. Accessed November 13, 2016. doi:10.1186/1129-2377-14-53. https://thejournalofheadacheandpain.springeropen.com/articles/10.1186/1129-2377-14-53.
- Merikangas, Kathleen R., James R. Merikangas, and Jules Angst. ‘Headache Syndromes and Psychiatric Disorders: Association and Familial Transmission’. Journal of Psychiatric Research 27, no. 2 (1993): 197–210. Accessed November 14, 2016. http://www.journalofpsychiatricresearch.com/article/0022-3956(93)90008-P/abstract.