Migraines, headaches, and mental health conditions are often comorbid, which means that they occur simultaneously, but neither causes the other. Hopefully, at some point in the future, we'll have a better understanding of comorbid conditions, but for now, we need to be aware of the possibility of the conditions and do our best to care for ourselves.

Sunday is World Mental Health Day (WMHD), so this is a fitting time to speak to this issue. The theme for WMHD for 2010 is:

Mental Health and Chronic Physical Illnesses

The Need for Continued and Integrated Care

This introduction from the World Federation for Mental Health is an excellent summary of the theme and the need for better care:

Quite often, physical and mental health disorders go hand in hand. Research shows that persons with severe or chronic physical illnesses often have a co-existing mental health problem. At the same time, persons with severe mental illnesses or substance abuse disorders have physical health problems that remain undetected or untreated. This situation, combined with the reality that there is still stigma associated with mental illness and that most persons first seek help through their GP, has resulted in an emphasis on the need for better integration between mental health and physical care, especially for better mental health and substance abuse screening and treatment in a primary care setting.

The World Federation for Mental Health, a 62-year-old international advocacy organization with consultative status to the United Nations, has developed and promoted the idea and celebration of World Mental Health Day. Last year - in 2009 - the focus was on integration of mental health treatment and services with primary care. The major theme was how to improve the capabilities of the primary care system to detect and treat mental illnesses.

This year we extend and elaborate the notion of "integration of care" by focusing on the connection and relationship of mental health disorders and chronic illnesses. As the World Health Organization has noted: Four chronic illnesses - cardiovascular, diabetes, cancer and respiratory illnesses - are responsible for 60 percent of the world's deaths.

Our understanding of the relationship between these chronic illnesses and mental illness has increased dramatically in the last two decades. We now know that persons with these chronic illnesses have much higher rates of depression and anxiety than the general population. Major depression among persons experiencing chronic medical conditions increases the burden of their physical illness and somatic symptoms, causes an increase in functional impairment, and increases medical costs. The presence of mental illness with long-term illnesses impairs self-care and adherence to treatment regimens and causes increased mortality.

The bottom line is that mental illnesses occur with chronic mental conditions in many patients, causing significant role impairment, work loss and work cutback. They also worsen prognosis for heart disease, stroke, diabetes, HIV/AIDS, cancer and other chronic illnesses. Many factors point to reasons that mental illnesses are not adequately addressed in this context. Consumer, provider and system factors all contribute to poor quality of care. Consumers and family members may not recognize or correctly identify symptoms or may be reluctant to seek care. The providers may not have the right training, equipment or support to provide appropriate interventions. Systems may have constraints and limitations related to financing and the availability of and access to mental health treatment.

Yet, effective treatments for mental illnesses exist. We have appropriate interventions to address these problems, reducing the burden on people's lives and the economic and social burden on society. The tragedy is that they are not being implemented. Much needs to be done. Consumers and family members need to have a better understanding of symptoms and possible treatment. Providers and physicians need to have better training and support. Medical schools need to incorporate integrated treatment of mental illnesses more explicitly. Health care financing systems need to recognize that the treatment of mental health illnesses can reduce costs. And, clearly, more research is needed.

The agenda is obvious. Our hope is that these materials developed by the World Federation for Mental Health will boost these efforts.

Vijay Ganju, Secretary General/CEO World Federation for Mental Health

In observance of WMHD, please take a few minutes to consider your own mental health in addition to your physical health. Both impact our wellness and our quality of life. Both deserve recognition, attention, and appropriate treatment. If you think you may have a mental health condition in addition to your Migraines or headaches, now's the perfect time to make an appointment to discuss the issue with your doctor. If you're already being treated for a comorbid mental health conditions, please take a few minutes to think about how you're feeling. If your treatment isn't working or isn't working as well as it once was, again, this is the perfect time to make an appointment with your doctor.

On the World Health Organizations' web site, I saw a statement that says it all: "No health without mental health." We're not one-dimensional beings. To be truly healthy, we need to take care of our mental health in addition to our physical health.


"Mental Health and Chronic Physical Illnesses." The World Federation for Mental Health. 2010.

Medical review by John Claude Krusz, PhD, MD

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