On Having Migraines and Being Mad

A Reuters story caught my eye this morning. The headline was Migraine often associated with psychiatric disorders and the brief summary told me that a Canadian team of researchers had done a study that indeed linked migraines to various mental health problems. Because I do get migraine headaches that can sometimes be quite severe, I decided to take a look at the article mentioned by the Reuters story and went to the journal Headache: The Journal of Head and Face Pain — that name is hilarious and ominous at the same time.

I learned a new word or two from the article, “migraineurs” for instance. There’s also “comorbidity,” which is defined as “greater than coincidental association of two conditions in the same individual.” Without going into the details, this is what the study came up with:

The key findings of this study are: (1) Migraine is more than twice more common in females than in males, and is most common in those aged 25-44 years and in those of lower income. (2) Migraine is associated with MDD [major depressive disorder], bipolar disorder, panic disorder, and social phobia, all occurring twice as often in those with migraine compared with those without it. However, migraine is not associated with drug, alcohol, or substance dependence. (3) The higher prevalence of mental health disorders in migraineurs is not accounted for by sociodemographic variables. However, psychiatric disorders are less common in those over 65 years, in those who are in a relationship, and in those of higher income whether migraine is present or not. (4) Antidepressant and antiepileptic drug use is generally highest in those with migraine and a mental health disorder, intermediate in those with a mental health condition but without migraine, and lowest in those with migraine alone or neither condition. (5) Health-related outcomes are poorer in those with both migraines and a psychiatric disorder than in those with either condition alone.

So there’s depression, bipolar disorder, panic disorder, and social phobia. I don’t think I’ve been that severely affected by any of these, but I can certainly see how it would be possible to even have some of these as symptoms from migraine attacks. My own migraine is the common kind: no aura, hypersensitivity to light, sound, and smells, nausea, and of course a splitting headache. The headache goes away with painkillers, the other symptoms not so much, and I am completely useless for twelve or so hours if the attack is severe. The next day is spent in a pleasant haze of pain-free euphoria which can actually be quite nice. I’ve spoken with people with much worse migraines, so I can’t complain too much, but it does have on an effect on the way I go about my daily business.

Another weird article I picked up when I searched the Reuters site was a piece titled Headaches linked to painful skin sensations. Cutaneous allodynia is a fancy term for this sort of sensitivity to touch and it seems to mesh well with other kinds of hypersensitivity that occur with migraines. Bipolarity and depression are much more severe things and I wouldn’t dream of talking about them as symptoms of migraine. However, it’s not a big leap from these hypersensitiveness symptoms to panic attacks and social phobias. Imagine going out and confronting a world that has been turned up to eleven and trying not to panic in that cacophonous confusion. Add to this what we might call semantic noise — people talking, signs, newsstands and headlines, traffic lights, etc. — and there is a good chance that all this becomes overwhelming. You are like a raw nerve walking the streets and it seems to make sense to escape as fast as you can. It’s not madness, it’s the reasonable thing to do.

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