Migraine and Depression – Increased Suicide and Mood Disorder Risks
Many migraineurs have faced some level of depression at one time or another in the course of their disease. This may range from a minor case of the blues due to the changes in lifestyle experienced because of migraines to major depressive disorder. We also know that mood disorders, such as anxiety, are also frequently found among migraineurs. The question remains whether or not migraineurs with depression are at increased risk for suicidal ideation (thoughts about suicide) or other psychiatric disorders. A research poster presented at the American Headache Society’s annual scientific meeting in June, 2014 explored this issue.
“To assess if an affirmative answer to the question “have you ever been diagnosed with depression?” identifies increased risk for current psychiatric disorders in young women with migraine.”
- Women between the ages of 18 and 50 were divided into two groups based upon a self-report of a prior depression diagnosis.
- Diagnosis of migraine was made by a headache specialist using the ICHD-II criteria (This has since been updated and replaced by the ICHD-3.)
- All participants were given an electronic questionnaire that included an assessment of
- Depression using the PHQ-9 Depression Screener
- Anxiety using the Beck Anxiety Index
- Abuse using the Childhood Trauma Questionnaire
- Medical Conditions
- All participants were interviewed using the face-to-face M.I.N.I. International Psychiatric Interview.
- Migraineurs in the group with a previous diagnosis of depression were of roughly the same age as those without a previous depression diagnosis. (Mean=42 and 39 respectively.)
- Those who had been diagnosed with depression had more headache days per month than those without depression. (16 days v 10 days)
- Those who had been diagnosed with depression scored higher on both the PHQ-9 Depression Screener and the Beck Anxiety Index
- Those who had been diagnosed with depression were more likely to screen positive for
- Major depressive disorder – 52% versus 2%
- Dysthymia (mild but chronic form of depression) – 25% versus 0%
- Panic Disorder – 12% versus 0%
- Obsessive compulsive disorder – 15% versus 1%
- Current agoraphobia (fear of being in public places) – 28% versus 10%
- Post traumatic stress disorder (PTSD) – 11% versus 2%
- Migraineurs with a prior depression diagnosis scored higher for suicidality.
- 26% (versus 4%) for low suicide risk
- 9% (versus 2%) for medium suicide risk
- 10% (versus 1%) for high suicide risk
- “No increased prevalence of substance abuse, psychotic episodes or eating disorders in the group reporting prior diagnosis of depression.”
“In young female migraineurs, a previous diagnosis of depression may serve as a robust marker for increased risk for current mood and anxiety disorders, as well as for increased risk of suicide. This population warrants further psychiatric screening and possibly evaluation by mental health professionals.”
From My Perspective:
While there is a diagnostic difference between a case of the blues and a biochemical depression, depression in any form is a very real and difficult experience for anyone. When this condition is comorbid (occurs in conjunction with) with migraine, it is important that doctors, patients, and family members be aware that even a history of depression can predispose the migraineur for anxiety and suicidal ideation. This does not mean that if you are a migraineur with depression, you will experience another mood disorder or thoughts of suicide; nor does it mean that migraines cause depression or mood disorders. However, it does alert us to the fact that we may be more susceptible to the conditions identified in this studied and that we need to seek medical and therapeutic support if we find ourselves experiencing them. These are not markers of a weak or unstable person, but of one who is experiencing commonly associated comorbid conditions. Learning to identify the presence of these issues and accepting them as “normal” and treatable goes a long way in helping us to get the help that we need to deal with related symptoms.
Tietjen,G.; Batizy,L. "Depression Diagnosis is Associated with Heightened Risk of Other Psychiatric Disorders and of Suicide in Female Migraineurs Screened with the M.I.N.I. International Neuropsychiatric Interview." Poster Presentation. 56th Annual Scientific Meeting; American Headache Society. Los Angeles. June, 2014.
Wishing you health, hope & happiness,
Reviewed by David Watson, MD.
© Cyndi Jordan, 2014, • Last updated September 30, 2014.