HEADACHE AND COMORBID CONDITIONS
What is a comorbid condition? Comorbid means
a disease or condition which exists alongside another primary
disease or condition, and has a greater than chance association between
the two conditions. In other words, it‘s too frequent to be a coincidence.
Most of the comorbidities discussed here apply to migraine; however, we are beginning to learn
about some which also pertain to chronic daily headache.
Depression
One of the most significant comorbid conditions associated with migraine is depression. This particular relationship is one that is
considered bidirectional—it works both ways. What that means is that if you have a tendency toward depression, you are more
likely to develop migraine headaches, but also if you are a migraine headache sufferer, you are more likely to become depressed.
Careful population-based statistical studies have been done, and it does not look simply as if migraine headaches make you
depressed, although that might seem a logical conclusion. It is not that simple.
Based on one of these large studies, a person is 2.9 times more likely to develop depression if they are a migraine sufferer, and a
person is 3.8 times more likely to develop migraine if depressed.
Depression did not affect the frequency of migraine attacks, or the progression of migraine-related disability over time.
Depression occurs in more than 80% of chronic daily headache sufferers. The comorbid depression often improves if the daily pain
pattern can be broken, and an episodic pain pattern can be re-established.
Bipolar Disorder
There is a well-known association between bipolar disorders and migraine headaches, but until recently, this had not been formally
studied. A small series of psychiatric patients (62) admitted to the hospital was assessed for migraine. 48% of the women and 39%
of the men had migraine. The prevalence was highest in those individuals who had bipolar disorder type II at 77%, and those had
more migraine attacks as well. As always—larger studies are needed.
Anxiety and Panic Disorders
Anxiety disorder has been reported as being twice as prevalent in migraine sufferers, while panic disorder has been reported as
occurring six times as often. Like depression, these are also bidirectional relationships. If you have panic disorder first, you are twice
as likely to develop migraine. You are also twice as likely to develop severe headache that does not meet migraine diagnostic criteria.
One of the most significant comorbid conditions associated with migraine is depression. This particular relationship is one that is
considered bidirectional—it works both ways. What that means is that if you have a tendency toward depression, you are more
likely to develop migraine headaches, but also if you are a migraine headache sufferer, you are more likely to become depressed.
Careful population-based statistical studies have been done, and it does not look simply as if migraine headaches make you
depressed, although that might seem a logical conclusion. It is not that simple.
Based on one of these large studies, a person is 2.9 times more likely to develop depression if they are a migraine sufferer, and a
person is 3.8 times more likely to develop migraine if depressed.
Depression did not affect the frequency of migraine attacks, or the progression of migraine-related disability over time.
Depression occurs in more than 80% of chronic daily headache sufferers. The comorbid depression often improves if the daily pain
pattern can be broken, and an episodic pain pattern can be re-established.
Bipolar Disorder
There is a well-known association between bipolar disorders and migraine headaches, but until recently, this had not been formally
studied. A small series of psychiatric patients (62) admitted to the hospital was assessed for migraine. 48% of the women and 39%
of the men had migraine. The prevalence was highest in those individuals who had bipolar disorder type II at 77%, and those had
more migraine attacks as well. As always—larger studies are needed.
Anxiety and Panic Disorders
Anxiety disorder has been reported as being twice as prevalent in migraine sufferers, while panic disorder has been reported as
occurring six times as often. Like depression, these are also bidirectional relationships. If you have panic disorder first, you are twice
as likely to develop migraine. You are also twice as likely to develop severe headache that does not meet migraine diagnostic criteria.
Copyright 2006 HEADquarters Migraine Management Inc. All Rights Reserved