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Mental Health

Migraine

04/15/2009

Question:

I have had migraines for over 35 years. They are not well controlled. I get at least 12 per month. I do take prophylactic treatment and have tried many different types of prophylactic treatments, but obviously the have not worked well, and are not currently working well. I am currently having a lot of trouble with the rescue meds wearing off. Over the past few years I have become increasingly upset and frustrated. I get moody as part of the migraine aura, but my general moodiness has increased as well. Do you have any suggestions of where to go? I feel like I am elapsing into some sort of mental condition, or have a comorbid mental condition (although I take an anti-depressant as a prophylactic,) especially because for years, especially as a teen my headaches were ignored and I was told it "was all in my head." I made my way through high school without any pain meds, although now I know that they existed, and it angers me that my parents never took me seriously enough to bother to relieve my pain. Even though I consciously know that migraines are a brain problem, I get so many, I lapse into that old belief of my youth that it`s my fault and "all in my head." Who do I talk to? I do tell my neurologist, and even switched neurologists, but I just feel like no one ever realizes that it`s pretty hard to carry out a normal life when my life now seems to center around my headaches.

Answer:

Our understanding and recognition of migraines have changed over the years, certainly during the timeframe that you have had them. There is an overlap between primary clinical depression and migraines, also. Some medications used to treat one condition can affect the other certainly.

From what you describe, it may be helpful to discuss with your neurologist the role of clinical depression and its impact on your migraines. You can also ask your neurologist if he or she has had fellowship training in migraines. If not, is your doctor aware of anyone in your area who could see you on consultation? Best of luck.

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Response by:

Ram Chandran  Kalyanam, MD Ram Chandran Kalyanam, MD
Clinical Assistant Professor of Psychiatry
College of Medicine
The Ohio State University