Migraine is very disabling, which takes a toll on mood which can lead to depression and anxiety.

As if living with the debilitating pain and other disturbing symptoms of chronic migraine wasn’t enough, combine it with a psychiatric disorder and quality of life drastically declines for many migraineurs. Comorbidity means two chronic diseases or conditions existing simultaneously in a patient.  Chronic migraine is often comorbid with psychiatric conditions such as depression, anxiety, post-traumatic stress disorder, personality disorders, and bipolar disorder. However, migraineurs have a reported 2- to 4-fold increase in lifetime risk of developing a major depressive disorder.

People with migraine may be at even higher risk of anxiety. A 2017 study found that, compared with those without migraine, individuals with migraine were 25 times more likely to feel nervous or anxious on a daily basis.  Also, people who experience migraine earlier in life are more likely to develop depression, and vice versa, over the course of their lifetime. Migraine sufferers who also experience depression should know the signs of both ailments since each might be at a higher risk for the other condition.




According to the DSM-IV, a manual used to diagnose mental disorders, depression occurs when you have at least five of the following nine symptoms at the same time:

  • a depressed mood during most of the day, particularly in the morning
  • fatigue or loss of energy almost every day
  • feelings of worthlessness or guilt almost every day
  • impaired concentration, indecisiveness
  • insomnia or hypersomnia (excessive sleeping) almost every day
  • markedly diminished interest or pleasure in almost all activities nearly every day
  • recurring thoughts of death or suicide (not just fearing death)
  • a sense of restlessness — known as psychomotor agitation — or being slowed down – retardation
  • significant weight loss or gain (a change of more than 5% of body weight in a month)


Migraine is a common, multifactorial, disabling, recurrent, hereditary neurovascular headache disorder. (2)

The frequency and intensity of migraines can vary among sufferers but commonly is characterized by

  • a throbbing headache often localized to one side of the head
  • intense head pain usually gradual in onset, then progressively more painful.
  • sometimes accompanied by a pronounced sensitivity to light and sound or nausea and vomiting.
  • a dull, deep and steady pain or throbbing and pulsating if severe
  • can occur any time of the day, though it often starts in the morning.
  • pain in the temples or behind one eye or ear, although any part of the head can be involved.
  • may be accompanied by a variety of sensory warning signs or symptoms, such as flashes of light, blind spots, temporary loss of vision, or tingling in your hand or face (MIGRAINE WITH AURA)
  • pain lasting a few hours or up to one or two days,
  • occurrence varies – once or twice a week, or only once or twice a year

It is suggested that migraines and depression are bidirectional, meaning that people who experience migraine earlier in life are more likely to develop depression, and vice versa, over the course of their lifetime.

Because of the migraine-depression connection, I wanted to bring up a topic I covered in an earlier MigreLief Blog Post – the danger migraineurs face when attempting to treat both depression and migraine headaches at the same time with prescription drugs.



Migraine sufferers should be aware of the dangers of combining some anti-depressants with prescription migraine medications.  Unfortunately, the mechanism of action of many antidepressants is to increase serotonin (a feel-good neurotransmitter) levels in the brain. Triptan drugs like Imitrex, which are used to reduce or end the pain of a migraine attack also work by stimulating serotonin receptors.

This combination of antidepressants and triptan migraine drugs, can lead to too much serotonin in the brain. This is not good and can result in a potentially life-threatening condition known as “serotonin syndrome.”

In some people, just the use of triptans drugs such as Imitrex or Zomig alone can result in unhealthy levels of serotonin, leading to serotonin syndrome. This risk increases substantially if these people are also taking an antidepressant like Pristiq or any other of several antidepressants known either as SSRI (selective serotonin reuptake inhibitors) or SNRI (serotonin-noradrenaline reuptake inhibitors).

The symptoms of “Serotonin Syndrome” are:

Rapid heart rate and high blood pressure
Agitation or restlessness
Dilated pupils
Loss of muscle control or twitching muscles
Heavy sweating

In severe cases of serotonin syndrome life-threatening symptoms can occur:

High Fever
Irregular heartbeat

Sad moods are not among the typical migraine triggers, but some migraineurs notice that they experience sad moods before migraines occur—especially premenstrual migraines. There appears to be increasing evidence that there are a number of links between migraine and depression. As researchers explore these links, findings may eventually lead to insights about the etiology—and potentially even treatment, of the two conditions. People with migraines and comorbid psychiatric or mood disorders often need treatments that address both conditions, as well as management of sleep, stress, nutrition and lifestyle issues.

If you and your physician decide to use a combination of anti-depressant and migraine drugs, you must be monitored very closely for any of these signs and symptoms of serotonin syndrome.  When it comes to migraine and depression, never underestimate the power of nutrition.  If you are not familiar with the MigreLief line of nutritional support for migraines sufferers for over 25 years, visit MigreLief.com for more information.

For positive mood support, consider an effective combination supplement containing the following ingredients: saffron, rhodiola, 5-hydroxytryptophan (5-HTP), and methyl-folate at the dosages proven effective in human clinical studies. Learn more.

Saffron is an impressive botanical known in traditional medicine and backed by growing science for its’ neuroprotective effect and mood balance.

Rhodiola has multiple science-backed benefits, including support for sufferers of mood imbalances and fatigue.

5-hydroxytryptophan (5-HTP) is a precursor to the neurotransmitter serotonin, an important “messenger” in the body needed for healthy nerve and brain function, as well as having a significant role in emotional mood and well-being.

Folate (methylfolate) is a naturally occurring B vitamin needed to sustain healthy levels of three important neurotransmitters in the body: serotonin, norepinephrine, and dopamine (known as the natural feel-good chemical in the brain). Serotonin helps regulate mood, occasional anxiety, and other functions, while norepinephrine helps mobilize the brain for action and can improve energy and attentiveness. Experts have suggested that supplementing with less than 1mg of folic acid can be useful in managing mood imbalances.

What else can you do?

There are also a few other effective lifestyle choices you can make to support a healthy, positive mood. Studies have shown that individuals who have no exercise in their lives are 44% more likely to experience low moods compared to those who get even 1 or 2 hours of exercise a week. And if that exercise is outdoors, all the better because sun exposure allows the body to produce vitamin D, which is great for your mood. Also known to be helpful are 20 minutes of meditation during the day, cognitive behavioral therapy, and diet changes—especially limiting sugar, alcohol, and gluten. And check any meds you are taking for potential side effects to make sure they are not contributing to how you are feeling.

To the Best of Health

Curt Hendrix, M.S., C.C.N., C.N.S.






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The MigreLief collection of supplements was created by Akeso Health Sciences to help migraine sufferers of all ages. AKESO formulates world class dietary supplements that provide nutritional support for the most common health issues that concern people most, such as migraines, headaches, joint health, stress & anxiety, memory, sleeplessness, ADHD, and more. Changing lives is the reasons we wake up every day passionate about the special products we provide to our customers. Helping you to get well and stay well is our bottom line.