Migraine and Depression with Dr. Robert Shulman (audio)
This is an interview (audio only) from the National Headache Foundation featuring Dr. Robert Shulman. In the interview, Dr. Shulman gives an overview and also answers common questions.
This is an interview (audio only) from the National Headache Foundation featuring Dr. Robert Shulman. In the interview, Dr. Shulman gives an overview and also answers common questions.
We know that migraine and depression are comorbid – they often go together. But why? Does one cause the other? Do they cause each other? Or is there a shared factor causing both?
Migraine and Depression – a common combination |
Researchers in the Department of Neurology at the Leiden University Medical Centre in the Netherlands set out to see if there was a shared genetic factor. They found 360 migraine patients, carefully diagnosed. There were 209 that had migraine without aura, and 151 that had migraine with aura.
Then they measured heritability between migraine and depression in these patients.
Heritability is a complex measurement that tells us if genetic factors contribute to something. Without going into more detail, the researchers found that there was a connection between depression and both types of migraine.
But they still had to make some adjustments – some migraine patients are on antidepressants, for example.
But even after adjustments, it was obvious that genetic factors do contribute, at least in part, to the connection between depression and migraine. The connection is even stronger in migraine with aura.
This is further confirmation of the involvement of genetics in both migraine and depression, and the reality of a medical connection between the two (far beyond "You’re just depressed because of the pain" or "You just have migraine because you’re so pessimistic"!).
For more on the study, read Shared genetic factors in migraine and depression: evidence from a genetic isolate., published in January 2010. For more on heritability, check out this brief description.
It’s that time of month again – time for the Headache and Migraine Disease Blog Carnival! I’m not going to give a summary of some of the best posts like I often do. But I have scanned a few of them already and there are some really interesting ones.
Actually, more than half this month are not specifically about depression. But that’s fine because there is a great collection of topics that should start some discussion.
So I won’t do anything more this month except thank Diana for all the hard work she puts into promoting and usually hosting these blog carnivals. Great work Diana! 🙂 Feel free to stop by to thank her yourself if you find the carnival helpful.
Visit now – Migraines and Depression (and more)
A new study is expanding our understanding of the links between headaches, migraine and depression. The study was published in the January 9th edition of Neurology, on research led by Gretchen Tietjen, a neurologist at the Ohio’s University of Toledo Health Science Campus. In simple terms, the study found that women with chronic headache or migraine are more likely to be depressed. But look at some of these numbers:
I’m sorry, could you repeat that last one? 32x?! Now of course the debate is always – do the symptoms contribute to the depression, is the depression contributing to the symptoms, or is there a third cause that’s contributing to both (perhaps a combination of the three). But whatever approach you take, let’s just face facts – there’s a connection, especially when it comes to migraine (when you compare this study with others).
There comes a time to stop placing blame, ignoring the problem or putting down people who suffer from depression. According to this article on the depression study [link no longer available], the World Heath Organization predicts that by 2020 depression will be the world’s biggest killer after heart disease! Whether it means getting the help of friends or family, talking to your doctor, or just evaluating your life and assumptions about the world, action need to be taken, whether you know someone who has depression or you have it yourself. It’s not just an “imaginary” problem, and it can be disabling and deadly.
I’ve never mentioned this study, published in 2003, but it may help us clarify the relationship between headache, migraine and depression. Dr Naomi Breslau, of the Henry Ford Health System in Detroit, headed up a two year long study, which was published in the journal Neurology.
Dr Breslau and her team interviewed 1186 people – about 42% had migraine, 13% had severe headaches, and 45% had no history of headache or migraine. So the question was, who had suffered major depression?
We already know that there’s a link between migraine and depression, and this study confirmed it. 42% of migraine patients had experienced major depression sometime in their lives. But there were some interesting findings beyond that which caught my attention.
First, although a large percentage of the headache (non-migraine) sufferers had also suffered from depression, the numbers were far lower that with migraine – 36%. This seems to lend credence to the belief that there’s a biological factor here, it’s not just a psychological response to the suffering. Only 16% of the non-headache/migraine group had suffered from major depression.
It also may come as a surprise to some people that the numbers were so low. Not even half of the migraineurs had ever had major depression. Of those that did, it was not necessarily constant, just "some time in their lives". Although the link is clear, the belief that all migraineurs are depressed just doesn’t hold up.
Dr Breslau has studied migraine and depression for a number of years. In 1994 she published a study which confirmed her belief that migraine and depression were bidirectional – each one seemed to make the other worse. This study showed also that people who had major depression tended to get migraine attacks, even though they had never had one when first interviewed.
These are still only basic studies – much more needs to be done to understand exactly how this relationship works, and what can be done about it. Read more about the "Comorbidity of migraine and depression".