Migraine and Suicide: Not What You Think
A health professional once told me,”I don’t know how you couldn’t be depressed, with all your headaches.” I think the statement was well intended, to remind me that there’s no shame in being depressed.
The truth is that not all migraine patients – even patients with chronic migraine – are depressed. Many are not. But that being said, there is a clear link between migraine and depression.
Surprisingly, researchers aren’t sure why. It’s not a clear-cut case of “pain=depression”. Instead, there seem to be underlying biological/genetic issues that make a person with depression more likely to have migraine, and vice versa.
A recent study on migraine and depression has confirmed some previous studies, but may come as a surprise to many.
The study focused on patients that were hospitalized – obviously a specific subgroup. And yes, patients with migraine were more likely to suffer from anxiety, depression, or PTSD. They were also more likely to have 2 or more co-morbid conditions – migraine usually doesn’t arrive alone.
And yes, patients with migraine were more than twice as likely to demonstrate suicide behaviour. Previous studies have found an increased risk in migraine patients, such as this meta study from 2009, and this study from Ethiopia.
So where’s the surprise? Well, the researchers went on to look at the risk for patients with migraine and anxiety, depression, or PTSD. Of course, you would expect suicide risk to skyrocket in patients with migraine + one of these conditions.
Except, it didn’t. It dropped. Patients without anxiety, depression, or PTSD were significantly more likely to demonstrate suicidal behaviour! The Ethiopian study found the same thing specifically with depression – when a migraine patient did not have depression, they were more likely to be suicidal.
Why? Does this mean that non-depressed people are more suicidal? Not necessarily.
The study explains:
Friedman and colleagues did not detect a link between specific psychiatric conditions and suicidal behavior among patients with migraine. They speculated this might be because patients with migraine with comorbid psychiatric disorders are receiving treatment that reduces their risk for suicidal behaviors.
Study Summary: Link Between Migraine and Suicidal Behaviors
It could also be that patients had not been diagnosed properly with depression (and hence weren’t receiving treatment), or that they failed to report these conditions.
This study and others should remind us of some important things. So let’s summarize:
- Migraine patients are not automatically depressed.
- Many are.
- Sometimes it’s hard to see the visible signs of depression, or suicidal thoughts.
We need to recognize, again, that migraine is serious. If someone you love is suffering from migraine, they may rarely mention it. But when they do, listen. Take it seriously. If appropriate, help them find treatment, and encourage them not to ignore it.
Read more about the study here: Study Summary: Link Between Migraine and Suicidal Behaviors