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Migraines and Depression: Can Treating One Help the Other?
Kyleigh Roessner RN-BSN
One of the worst aspects of migraines is that they can strike at any time. Whether you're heading to the beach with your family, taking an important test, or trying to get through a shift at work, a migraine is a sure way to derail your plans. If you experience debilitating migraine headaches, you are certainly not alone. Migraines are among the most common health conditions, and affect around 1 out of 7 adults, according to Migraine Trust.
Migraines and Depression: Is There a Link?
One highly researched aspect of migraine is its relationship to depression. According to the Anxiety and Depression Association of America, roughly 40 percent of people with anxiety and depression also experience migraines. This suggests that if depression is effectively treated, migraines may also subside or become less frequent.
The causal relationship between these conditions is not entirely clear, but it may be due to a shared genetic cause, environmental exposure, neurochemical activity within the brain, or a combination of these factors. According to
Psychiatry Advisor, imaging studies have demonstrated that the same structures in the brain, specifically the structures responsible for mood, motivation, and affect, are affected in both depression and migraine.
Aggravating Factors
Migraines and depression in combination can cause a variety of negative effects. For people who have several debilitating migraines each month, not knowing when they will suddenly have to take a day off from work or be unable to participate in a family event can cause sadness, anxiety, and a feeling of lack of control.
A well-known migraine prevention strategy is to follow a routine of good migraine hygiene every day. Going to bed at the same time each day, taking medications at set intervals, and managing stress are all components of good migraine hygiene. If you have depression, however, you might not feel motivated to get up and cook a healthy breakfast for yourself regularly, or you might forget to take your medications or suffer from a bout of insomnia, which could trigger migraines.
We know that treating depression is important for migraine sufferers. Antidepressants and talk therapy are usually the first line of treatment for depression. That said, they don't work for everyone. In fact, roughly one-third of people with depression don't find relief even after trying two medications. If you fall into this category, consider Transcranial Magnetic Stimulation (TMS) therapy. TMS uses gentle magnetic pulses to activate specific brain regions involved in mood and emotion regulation
Is TMS a Good Option for Migraine Sufferers?
Headaches (not migraines) can be a side effect of the TMS therapy, which can make people with frequent migraines worry about getting TMS. An experienced TMS provider can change the sequence and treatment plan to prevent TMS from causing undue pain or discomfort. If your migraines cause you to frequently miss school or work, it can also seem like TMS therapy isn’t an option because it requires coming into the office five days a week for six to nine weeks. Rest assured that it’s fine if you need to skip a day or two of TMS treatment here or there to accommodate your migraine days. We’ll work with you.
Danielle, a patient at Greenbrook TMS, shared details about her treatment experience and the responsiveness of Greenbrook staff in adapting her sequence to prevent migraines: "For my first session at Greenbrook TMS, I wasn't nervous. . . . The only thing I was taken aback by is that I have chronic migraines and the intensity of the pulses was a little too high. The staff immediately noticed I flinched, so the doctor and techs went down on the intensity, and we went more slowly building up, so it wasn't scary. Within two or three sessions, I was relaxed during the whole procedure, no problem at all. I felt like, I'm doing this and it's going to get better."
If you are one of the millions of Americans who experience depression and migraines, consider scheduling a
no-cost consultation to learn whether TMS might be right for you.
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Starting any medical treatment for the first time can leave you with questions, especially if you’re looking forward to the benefits it may bring. It’s no different when you’re preparing for your nasal esketamine treatment. Your previous mental health treatments may have consisted solely of taking antidepressants at home or visiting a therapist’s office for cognitive behavioral therapy (CBT), so nasal esketamine is probably a new treatment experience for you. If you're wondering what it's like to start nasal esketamine and get ready for your first session, keep reading. Getting Started with the Nasal Esketamine Treatment As with any new treatment, you’ll first talk to your primary care provider or psychiatrist about whether nasal esketamine is a good fit for you. Alternatively, you can schedule your esketamine nasal spray consultation with a treatment center (such as Greenbrook) that has certification by the FDA’s Risk Evaluation and Mitigation Strategy (REMS). At Greenbrook's REMS-certified nasal esketamine treatment centers, our Greenbrook-affiliated psychiatrists and psychiatric nurse practitioners will review your medical history and also conduct our own assessment to help determine whether nasal esketamine treatment is right for you. Certain conditions, including blood vessel disease and a history of psychosis, may make treatment a risk for you. Make sure you discuss all previous and present conditions with your doctor or nasal esketamine provider before beginning treatment. If the medication is deemed a good fit, you’ll receive your prescription from the Greenbrook-affiliated provider. Your Greenbrook Care Team will put together a personalized care plan for the weeks and months to follow. Keep in mind that you will need to take a standard (oral) antidepressant along with your nasal esketamine treatment. There are two important regulations to note when it comes to preparing for treatment: Each treatment is followed by a mandatory two-hour observation period. This means you will need to plan to stay at the center for at least two hours following your self-administration of the esketamine nasal spray. You cannot drive during the rest of the day after treatment and must arrange for transportation. These regulations are mandatory. It may be helpful to sit down and plan out several weeks’ worth of transportation once you know your treatment schedule. In addition, if you’re wondering what to bring for the treatment, we recommend entertainment such as an audiobook or playlist of favorite songs and a pair of headphones. You may want them during the two-hour observation period. What to Expect During Nasal Esketamine Treatment On the day of treatment, you’ll need to stop eating any food two hours before your appointment and stop drinking all fluids 30 minutes before you come in. Your Greenbrook Care Team will confirm that you are prepared for the two-hour observation period and that you have a ride home. You’ll get the opportunity to practice using a “trainer sprayer” that mimics the real nasal esketamine sprayer but does not release any medication. The Care Team will encourage you to use the restroom and set up your preferred environment in your private treatment bay or room. Some patients like reduced lighting, for example, while others don’t request light adjustments. You’ll complete a depression scale before each treatment session. Your Greenbrook provider will confirm that the dose kit is yours, show you how to administer it, and then hand it to you. Each sprayer contained 28mg of Spravato esketamine nasal spray. Patients usually start with two sprayers (56mg) and soon increase to 84mg (three sprayers) per treatment. But, your dosage maybe vary. Should you be left with a metallic taste by the spray, the Care Team will offer suckers to help make the flavor dissipate. After your dose, you’ll be encouraged to lie back in your comfortable recliner. While most patients enjoy a quiet setting, Greenbrook is prepared to accommodate patients with a more animated reaction to the medication. You may feel sleepy, dizzy, mildly dissociated, and/or nauseated during treatment. Greenbrook's Care Team is readily available if you need assistance. How to Prepare for after your Nasal Esketamine Treatment Most side effects begin to wane in the second hour of observation, but if you’re wondering, “Is it safe to drive immediately after nasal esketamine treatment?” the answer is a resounding no. In addition to the mandatory ride home, you will need to block off time to rest and let side effects fully dissipate. This extended rest period is especially important in the first weeks of treatment when you’ll have treatment twice a week. Do not drive or operate machinery of any kind until the day after treatment. Just take it easy, relax, and take care of yourself. If you’re unsure what activities you can do or should avoid during this time, talk to your Care Team for more information. While side effects tend to dissipate completely after a good night’s sleep, many nasal esketamine patients begin feeling relief from depression symptoms within hours of their treatment. Other Tips in Preparing for Your Nasal Esketamine Treatment At Greenbrook, we make every effort to schedule your treatment in the afternoons or whenever it is most convenient for you. We encourage you to see each treatment session as an opportunity to relax and take care of your mental health. If you have any questions or concerns, talk to your doctor or the Greenbrook Care Team. At Greenbrook, we’ll help you feel at ease when preparing for each treatment session. Schedule A Free Consultation To get started with nasal esketamine, schedule your free consultation today.
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