The Relationship Between Migraine and Mental Health

Migraine and mental health are intertwined—here’s how they affect each other.

Mental health and migraine have something in common—they’re both known as ‘invisible diseases.’ Both have stigma surrounding them that may lead to dismissal or discrimination from those who do not live with either or both. Thankfully, there are treatment options and support resources available to help those who live with migraine and mental health issues.

In September 2022, the American Migraine Foundation (AMF) hosted “The Relationship Between Migraine and Mental Health” webinar. Dr. Steven Baskin, Co-director of Behavioral Medicine Services at The New England Institute for Neurology and Headache in Stamford, CT, discussed the relationship between migraine and mental health and how both impact each other. Read on to catch up on the webinar’s highlights, including how mental health and migraine can be a vicious cycle, what treatment options to consider and more.

What is the connection between migraine and mental health?

To investigate the link between migraine and mental health, the AMF, with support from Biohaven Pharmaceuticals, distributed the Migraine and Mental Health Connection Survey.

In the survey, patients with migraine reported being diagnosed with an anxiety disorder (almost 60%), depression (50%) or PTSD (25%). This correlation suggests that migraine and mental illnesses may be associated with each other. Furthermore, 87% of participants with migraine and 94% of healthcare providers expressed that they believed mental health would greatly improve with better migraine control.

“Both patients and physicians in this survey realized that migraine and mental health really impact each other,” says Dr. Baskin. “There is a vicious cycle between migraine and mental health issues.”

Dr. Baskin also discussed stigma surrounding both migraine and mental health. Many patients are worried about sharing their mental health problems with headache specialists because of the stigma surrounding mental illnesses. It was also reported that physicians underestimate the number of their patients who live with mood and anxiety disorders.

The Psychiatric Comorbidities of Migraine

Migraine and psychiatric conditions are different diseases that can occur together greater than by chance. This is referred to as comorbidity. Some comorbidities include depression, anxiety, other pain disorders, obesity, asthma, sleep disorders, epilepsy, and certain cardiovascular and gastrointestinal disorders. Many psychiatric as well as other comorbidities may increase the probability of migraine increasing in frequency.

Stress and migraine are linked together in a vicious circle. While stress can trigger migraine, the uncertainty and unpredictability of migraine is the most common stressor felt by people living with migraine. High levels of stress may also increase the frequency of attacks.

While migraine and psychiatric disorders are separate diseases, they may share some similar mechanisms. These can include genetics, childhood trauma, hormonal fluctuations, neurotransmitter dysregulation and impaired regulation of the biology underlying the stress response.

Treatments for Migraine and Mental Health

There are several treatment options that can help with both migraine and mental health. Before undergoing any kind of treatment, make sure to talk to your doctor to determine the best treatment plan for you.

Some treatment options to consider include:

  • Gradually increase exercise and activities that bring satisfaction
  • Learn applied relaxation and diaphragmatic breathing
  • Cognitive behavioral treatment (CBT) for:
    • Insomnia
    • Regulating biological rhythms, such as sleep schedules and meal schedules
    • Improving self-reward and decreasing self-criticism
    • Counteracting catastrophizing, negative thinking and having a specific plan to manage acute attacks of migraine
    • Gradually beginning to do things that you have avoided because of migraine or anxiety
  • Mindfulness strategies to change your relationship with internal sensations
  • Good medication trials when indicated to manage migraine as well as psychiatric illness

Dr. Baskin also stressed the importance of self-advocacy when pursuing treatments. “Many people with migraine do not get effective treatment,” explains Dr. Baskin. “If you have a psychiatric issue, it’s very easy for somebody to say, ‘Well, this is psychiatric. This is why this person isn’t doing well.’ You need to be an advocate for yourself and realize that a lack of optimized acute care can progress migraine to higher frequency.” Recent research has also shown that people with psychiatric disorders respond well to preventive migraine medications and some show significant mood improvement.

Stay Relentless and Resilient

Everyone’s migraine is unique and may require different treatment(s). For some, finding the right treatment is a long and difficult process. Remember to be patient and persistent. With several treatment options available, it is possible to find the best treatment plan for you.

“People with migraine are amongst the most resilient people I have ever met,” says Dr. Baskin. “I am really proud to have worked with migraine patients over the years and they often helped show me ways to manage uncertain aspects of my own life.”

The American Migraine Foundation is committed to improving the lives of those living with this debilitating disease. To learn more about all of your migraine treatment options, visit the AMF Resource Library. For help finding a healthcare provider, check out our Find a Doctor tool. Together, we are as relentless as migraine.

Reviewed for accuracy by the American Migraine Foundation’s subject matter experts, headache specialists and medical advisers with deep knowledge and training in headache medicine. Click here to read about our editorial board members.