Do you live with migraine AND a mental health condition? You’re not alone!
Depression is one of the most common comorbidities of migraine, occurring up to 2.5 times more than in the general population. It occurs more frequently among those with chronic migraine and migraine with aura. Anxiety can also occur along with both depression and migraine. Anxiety disorders (especially generalised anxiety disorder (GAD), obsessive compulsive disorder (OCD) and panic disorder (PD), are 2-5 times more common in people with migraine than in the general population. The rate increases for chronic migraine.
People with anxiety disorders (especially panic attacks) and migraine tend to have increased migraine frequency, increased disability, higher risk of chronification and higher risk of medication overuse. The two conditions can have similar manifestations such as functional impairment, gastrointestinal (nausea), autonomic (dizziness), affective (fear) symptoms during attacks, plus the worry about further attacks.
What do mental health symptoms look and feel like?
If you experience any of the following symptoms, talk to your healthcare provider.
- A loss of interest in activities you would normally enjoy
- Withdrawal and disconnect from friends, family and social activities
- A new pattern of an inability to sleep, or sleeping too much
- A new feeling of fatigue that is seeming unrelated to your usual fatigue from migraine attacks
- Extreme mood changes of highs and lows
- Unexplained teariness and sadness
- Feelings of guilt, shame or worthlessness
- Feeling consistently overwhelmed, anxious or worried
- Experiencing panic attacks
- Feeling constantly on edge or agitated
- An increase in brain fog or lack of concentration
- Changes in libido
- Major changes to eating habits
- Inability to cope with everyday problems or minor stress
- Thoughts of self-harm
So what can we do to manage mental health and migraine? There are quite a number of things we can all do to help us manage our mental health just a little better and in doing so, it may just help our experience with migraine.
14 Tips for coping with migraine and mental health
1. Get to know yourself and your migraine
Getting to know your body, and understanding your migraine and the way it behaves (or misbehaves) can help you to know when things just don’t feel right. By keeping a diary, you can identify your migraine patterns and triggers. By doing so, you will soon be able to tell when something is wrong and it needs to be followed up by a healthcare professional. This includes emotions, moods and feelings.
2. Speak to your doctor about emotional health
We know that it is important to communicate with our doctors about our physical health and any worrying symptoms that may arise. However, it is equally as important to communicate about our emotional health.
3. Develop a support network
If you already have a strong support network, that’s a truly wonderful thing! Keep on working on it and offering your appreciation to those that support you. If you don’t have a strong support network, it is important that you connect with others that can offer you support. Family and friends are a good place to start. Reach out to them and be honest with what you need from them. Additionally, you can connect with others through support groups.
Migraine Australia has a large national support group, Migraine Australia Chat Group, where you can connect with others, ask questions and even make some new connections with people that just get it. Migraine Australia also has a large network of Migraine Warrior Support Groups spread right across Australia. You can find your local group here. https://www.migraine.org.au/warriornetwork
4. Acceptance of limitations and challenges
This one is a tough one and it really does take time and work. Your physical health has likely changed due to migraine and this is often very disruptive to how you live your life. Migraine is debilitating and can be difficult to manage due to the nature of this incurable disorder and its accompanying symptoms. It is likely that you have had to make adjustments in your home life, social life, work life, and relationships in order to better manage your migraine. Your migraine attacks present you with symptoms that place limitations on what you are now able to manage.
This can be both challenging and upsetting. It is common to experience grief for the life you lived before migraine. You may also experience grief about the life you thought you might live. In order to accept your limitations and challenges, you’ll need to be compassionate with yourself. You may need to get comfortable with asking for help. You will likely have to learn how to pace yourself and learn how to create new goals for yourself. Give yourself permission to be who you are. Your worth is not defined by the things that you do. You are enough, just as you are.
5. Define the things that bring your life meaning and purpose
Purpose can be obtained through connections to people. Family, friends, loved ones, and even through volunteering. (hint hint) Some people may seem meaning in their lives through religion or spirituality. What enriches your life? What do you value? Bring those areas more focus and attention.
6. Make exercise an important part of your life
Exercise is an essential part of both physical and emotional health. Exercise doesn’t have to be strenuous. The point of physical activity for overall wellbeing is to simply be active. Gentle exercise, such as walking or yoga, can help you ease tension, promote relaxation and increase those all-important happy hormones. Try and find something you actually enjoy. Something that you look forward to, or at least feel good about once you finish.
That said, exercising with migraine can be difficult. You will need to find what works for you and try not to push yourself beyond your current capabilities. Just doing what you are able to do is better than avoiding it all together. You can always increase your routine when you can and then reduce it again when you have to.
7. Find ways to improve your diet
We all know the importance of a balanced diet, avoiding our food triggers and staying hydrated. But how much effort do we really put into this area of our lives? For some, it’s easy. For others, it can be a real challenge. However, it is important for those living with migraine to make an effort to have more stability in their diet. Eating poorly can increase your risk of certain symptoms of both migraine and mental health symptoms. Eating well may help you to manage these symptoms. Eating habits and hydration can also affect your sleeping habits, and therefore, may have an impact on both your migraine and your mental health.
8. Seek counselling for mental health
Speaking to a counsellor or psychologist has been proven to be beneficial for many people who are experiencing difficulties with both their physical and emotional health. These professionals can provide you with support and guidance. They can also help you work through your thoughts and feelings. They can offer you guidance and tools to help you deal with stress.
So how do you start? Talk to your doctor about seeing a therapist on a care plan. A mental health treatment plan lets you claim up to 20 sessions with a mental health professional each calendar year. (Information accurate as of the 11th Dec 2021 via https://www.servicesaustralia.gov.au/mental-health-care-and-medicare?context=60092) To start with, your doctor will refer you for up to 6 sessions. You can then request more through your doctor if it is recommended that you do so. Health professionals set their own fees, so the care plan may only cover some of the cost.
What happens when you see your doctor about mental health?
Your doctor will need to make an assessment of the type of help you need. To do this, they wil need to ask you personal questions to understand your situation. It can often be hard to talk to a medical professional about mental health. If you feel comfortable, take someone you trust with you for support. Write down your concerns so that when it comes time to talking, you don’t forget about something you feel is important to mention. You can find more tips on how to talk to your doctor about mental health here Talking to your doctor (GP) about mental health | healthdirect
9. Take supportive medications and supplements if needed
Talking to your doctor about your mental health concerns will likely open the discussion of treatment with medications. Some people will require long-term medication to help them manage their mental health, and others may require temporary support with medication. Your doctor will assess your individual situation to determine the right path for you.
You may also want to consider supplements to support your brain and body.
Magnesium is thought to help with anxiety, sleep and muscle tension. It is suggested that magnesium supports the nervous system. Talk to your doctor about the right type of magnesium for your individual needs.
Vitamin D is important for the support of brain function and nerve health. Check with your doctor about a vitamin D deficiency.
Ashwagandha may help to reduce cortisol and help your body cope with stress.
As with any supplement, always check with your doctor before taking it. This is especially important for those that already take other medications.
10. Avoid or limit alcohol
Alcohol is a common trigger for many people living with migraine. Alcohol also has the potential to increase symptoms of depression and anxiety. You should speak with your doctor or a mental health professional if you find that you are relying on alcohol (or other substances) to help you feel better. They can help you find healthier and more effective ways to improve your overall mood and deal with stress.
11. Practice self-care
Self-care is all those little things you do to take care of yourself, physically and emotionally.
TYPES OF SELF-CARE
Emotional self-care can include addressing your internal negative self-talk, saying ‘no’ to things that cause you unnecessary stress or anxiety, putting boundaries in place, giving yourself permission to take a break, making time for social connections, doing things that help you relax.
Physical self-care is anything that helps you to nourish your body. This might include making sleep a priority, getting a massage, ensuring your hygiene needs are met, developing an exercise routine, eating well, hydrating your body, and taking care of your medical or dental health.
Spiritual self-care could be engaging in your religious connections, spending time outside in nature, or practising mindfulness activities like meditation, journaling or art therapy.
There is no ‘right way’ to practice self-care. The way in which your practice self-care will be dependent on your needs and will likely change over time. Self-care is about filling your cup so that you can be the healthiest version of yourself. It is not selfish to practice self-care. Self-care is you taking care of your physical and emotional needs.
12. Try relaxation and mindfulness techniques
Relaxation means different things to different people. For a lot of us, plopping down on the couch or in bed for a binge session of Netflix might seem ideal. Whilst this activity can help us relax, it doesn't activate your body’s natural relaxation response. This response is a state of deep rest for your mind and body. When your body experiences a deep state of rest, it can help to lower stress, may help slow your breathing and may also help to regulate your heart rate. So how do we achieve this state of relaxation? Different techniques work for different people. Here are some things to try…
- Breathwork and breathing exercises
- Tai Chi
- Flow arts
- Visual arts
- Progressive muscle relaxation
- Spend some quiet time in nature
Visit https://www.headspace.com/meditation/how-to-relax for more ideas on how to achieve that deep state of relaxation.
13. Get out of the house
It can be very tempting to look yourself up in the comfort of your own home and become a hermit. Getting out of the house might also be the last thing on your mind when you are in the middle of mirgaine attack. So choosing your timing is important. You don’t have to make an adventure out of it or place pressure on yourself to spend the entire day somewhere. Something as simple as finding a nice spot at a local park, visiting a local cafe or library, or even doing a little gentle gardening can be beneficial for both your physical and mental health. Getting out of the house will also bring you more opportunities to be distracted from your physical and emotional pain, and may present you with the opportunity to connect with others in a meaningful way.
14. Find joy in the little things
It is easy to be caught up in all the negative feelings you may have about your physical and mental health. However, that doesn’t mean that everything in your life is negative and stressful. Finding space to have gratitude for the little things that bring you joy or pleasant feelings deserve some of your attention. By focussing on these little things, you will ultimately be challenging all of those negative feelings and thoughts. It may be your connection to someone special or your children, it may be a hobby you have that has been a little neglected, it might be finding joy in creating something, it might be admiring your garden, discovering new music or a new book, it could even be spending quality time with pets. Anything that brings you happiness has meaning. Look for those little things in your daily life. After all, it’s the little things that often matter the most!
You can read more about mental health here https://www.migraine.org.au/mental_health
Beyond Blue https://www.beyondblue.org.au/
Black Dog Institute https://www.blackdoginstitute.org.au
ACT Mindfully https://www.actmindfully.com.au
Head to Health https://headtohealth.gov.au/
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