Comorbidity refers to the statistical relationship of two distinct diseases in the same person at a degree higher than is likely by chance. Some findings published in February 2017 by the Headache & Migraine Policy Forum revealed up to 90 percent of patients with chronic migraine have a comorbid condition. The problem with having an overlapping or comorbid condition is that each condition must be treated, not just the migraine. So if you have anxiety or depression and migraine, the anxiety or depression must be treated as well as the migraine. The treatment for anxiety or depression may improve the migraine symptoms — or worsening anxiety or depression may cause the migraine to worsen. If you have a comorbid condition with migraine, it’s important to learn how you can regain control of your overall health.
1. Chronic Pain Disorders
According to a review published in the journal Frontiers in Neurology, several chronic pain disorders are reported to be connected with migraine; previous research noted fibromyalgia in particular, a chronic pain condition with diffuse muscle pain and tenderness at trigger points on the body. In fact, more women than men report migraine with fibromyalgia. Interestingly, people with fibromyalgia have a higher prevalence of insomnia and irritable bowel syndrome (IBS), both migraine comorbidities, and report more mental stress.
2. Depression and Anxiety
In the Frontiers in Neurology paper, researchers found mental health disorders, including depression, anxiety disorder, bipolar disorder, and suicidal thoughts, frequently overlap with migraine. According to Meredith Barad, MD, a board-certified neurologist and director of the orofacial pain program at Stanford University in California, “If you take all migraine patients, the health conditions that have the biggest overlap are depression and anxiety. Treating the comorbidity may help with coping, and frequency and severity of the migraine.”
3. Irritable Bowel Syndrome (IBS)
IBS, a functional disorder of the GI tract with symptoms of chronic abdominal pain or discomfort, shares similar risk factors with migraine, according to a national database study published in April 2017 in the journal Medicine. Both commonly affect females and younger adults. Research published in September 2016 in the World Journal of Gastroenterology revealed that this comorbidity could be associated with conditions of smooth muscle dysfunction.
4. Sleep Disorders
Sleep disorders are related to more frequent and severe migraine, according to a study published in July 2018 in the journal Headache. While insomnia is the most common sleep disorder with migraine, others include snoring and obstructive sleep apnea, restless legs, and circadian rhythm disorders. Here’s how to regain control:
Get an Accurate Diagnosis
Whether you have anxiety, depression, IBS, or a sleep disorder with migraine, it’s important to see your primary care physician or a specialist to get an accurate diagnosis. Your doctor will discuss your health history, do a physical exam, and order lab tests and scans, if warranted, before making the diagnosis.
Get a Clear Treatment Plan
Some patients with migraine may benefit from one prescription medication for both conditions, such as with anxiety and depression. Others may need medication for each separate condition. Talk about the pros and cons of preventive and treatment medication, and trust your doctor to know what’s right for your body.
Manage Your Lifestyle
It’s important to know that migraines don’t like change. “Lifestyle reassures your brain that everything is okay,” says Robert Cowan, MD, professor of neurology and chief of the division of headache medicine at Stanford University in California. “Eat meals the same time, go to bed the same time, exercise regularly, and be consistent,” says Dr. Cowan. ”These are the things that set the patterns for the brain so it knows what’s coming: sleep, eat, wake up, exercise.”
Maintain a Regular Sleep Schedule
Dr. Barad recommends waking up at the same time and going to bed at the same time. “Migraine’s brain is particularly sensitive to change — weather, sleep cycle, sickness. Keep your lifestyle consistent and lead a scheduled lifestyle to avoid problems,” says Barad.
Limit Caffeine, Alcohol, and Other Nonprescription Medication
Barad tells her patients to “Minimize caffeine and sugar. Minimize processed foods in your diet, and avoid chemical triggers like MSG and nitrites, which may trigger migraine in some people.”
Live Your Life
Above all, live your life to the fullest. “It’s important to get away from this linear association with migraine,” Cowan says. “Take a holistic approach. Take precautions but live your life.”
