If you live with depression, you could be at least twice as likely to experience chronic migraine.

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Throbbing pain. Sensitivity to light. Upset stomach. If you live with migraine, we don’t have to tell you how uncomfortable, distressing, or inconvenient it is.

You may also have an added layer: depression. In the middle of navigating a migraine attack, you may also feel symptoms of depression, such as:

  • low energy
  • exhaustion
  • hopelessness

So, what’s the connection between migraine and depression?

If this sounds like you, you’re not alone. Migraine and depression commonly happen at the same time, but support and hope exist for both.

Researchers have long been curious about the link between these two conditions, though they have yet to identify one single cause.

The link between migraine and depression may occur due to pain perception, environment and genetics, or personality.

Pain perception

Physical symptoms of depression can include:

  • difficulty sleeping
  • fatigue
  • changes in appetite

According to research from 2017, these symptoms are more common for people with migraine and contribute to the experience of a painful migraine attack.

In addition, research from 2021 suggests that emotions associated with chronic migraine include resentment, frustration, embarrassment, anxiety related to migraine pain, and depression. A 2020 study found that people with migraine might even feel a need to hide these emotions from others.

Environment and genetics

Other theories suggest that depression and migraine share a common environmental risk factor, or genetics that have been passed down, adds Dr. Lindsay Israel, a psychiatrist in Lake Worth, Florida.

A 2019 study points to differences in brain structure, neurotransmitters, or sex hormones as possible explanations for these comorbid conditions.

Personality

The link between depression and migraine may even have to do with your personality type.

One 2017 study suggests that those who score higher in the neuroticism trait appear to have an increased risk of having both migraine and depression.

In short, yes. Research suggests that having anxiety or depression can increase risk of also developing migraine, compared with other mental health conditions.

In fact, if you live with depression, you may be two to three times more likely to develop migraine than someone who doesn’t live with depression.

Depression, anxiety, and stress can often lead to stress-related headaches, which may turn into a migraine attack if they’re not treated in time, says Pareen Sehat, a registered clinical counselor in Vancouver, Canada.

People with chronic migraine often experience depression or other types of mood disorders due to the tough nature of the condition, says Sehat.

“They often live with stress, low productivity, and reduced quality of life. All these factors can lead to depression,” she says. “Chronic migraine can lead to depression if they are recurring and high in intensity.”

You may find that the severity of your migraine attacks can worsen depression symptoms, particularly if the pain and sensitivity make it more difficult for you to participate in activities that help you feel better, like spending time with loved ones.

Since experts have found that migraine may be linked to — and worsened by — stress, any mental health condition that has the potential to exhaust your mental energy can contribute to headaches and migraine, says Sehat.

“People living with generalized anxiety disorder, those who have difficulty with stress management, and those living with bipolar disorder are most commonly associated with migraine,” she adds.

For some, depression alongside migraine can make it hard to live your life in the way you want to. This is understandable, but there are resources that can help.

Medications

Antidepressants are most commonly prescribed for symptoms of depression, but they may also tackle migraine symptoms.

“Oral antidepressants, specifically SSRIs [selective serotonin reuptake inhibitors] like fluoxetine or sertraline, can treat both depression and prevent migraine [episodes] for some people,” says Israel.

“Also, older antidepressants such as the tricyclic antidepressants, like amitriptyline, have also been shown to help alleviate or prevent migraine,” she adds.

If your doctor prescribes you medication, it will take time to work. You can ask a doctor what to expect, but it can sometimes take up to 6 weeks to notice changes in your symptoms.

Therapy

Depression can increase your chances of migraine attacks, and migraine can trigger depressive episodes. So what can you do? According to Israel, treating depression can help treat migraine.

“Therapy such as cognitive behavioral therapy (CBT), which has been proven to be an important part of treatment for major depression, can also help secondarily to prevent migraine [episodes],” she says.

Therapy may also help you learn to:

  • identify migraine triggers
  • improve coping skills
  • mitigate stressors that can make migraine symptoms worse

Identifying your triggers

It can be beneficial to work with your primary care doctor or a neurologist to see if there are lifestyle factors that could be making your migraine attacks worse.

Some potential migraine triggers may include:

  • alcohol (tannins in red wine, specifically)
  • caffeine
  • chronic stress
  • dehydration
  • food sensitivities (such as chocolate, dairy, or gluten)
  • low blood sugar

Meditation

Mindfulness meditation may help both migraine and depression symptoms — not to mention its other benefits.

A trial in 2021 found that a mindfulness program created a “shift in pain appraisal.” Participants reportedly perceived their migraine attacks as less painful after practicing meditation for 36 weeks.

Studies on mindfulness meditation and depression may be equally promising. Research in 2020 found that participants living with depression reported reduced symptoms after three mindfulness intervention sessions and sustaining an at-home practice.

To get started at home, there are a plethora of guided meditations to choose from.

“I often recommend my patients listen to hypnotic meditation,” says Sehat. “Apart from how it sounds, it is highly effective in establishing a state of calm and consistency. It allows patients to feel in control and aware of their feelings.”

An estimated 12% to 16% of people may be living with migraine in Western countries. Worldwide, depression is estimated to affect 5% of adults.

There’s a significant overlap between migraine and depression, though the reason for this link is still largely unknown. It may be due to a combination of factors, including genetics and environmental causes.

Treating depression and migraine together may require more than type of intervention, says Israel.

“Be sure to talk to a mental health professional about your depression, in addition to your doctor or a neurologist about your migraine,” she says.

“It’s important that your doctors coordinate care with each other to prevent redundancy and negative interactions between different recommended treatments,” she adds.

While depression and migraine can both present challenges, you can get through them by taking it one moment at a time.

If you’re looking for support but don’t know where to start, you can visit Psych Central’s guide to mental health support. In addition, you can find a community like Migraine Healthline, or learn more on preventing migraine attacks here.