According to the Centers for Disease Control and Prevention (CDC), over 15% of American adults have reported a migraine or severe headache in the previous three months—a statistic that has been stable for nearly twenty years. Medline Plus estimates that women are three times more likely than other folx to report migraines. Considering how migraines can impact one’s physical functioning, it’s also important to take a look at how this type of headache impacts mental health. This article explores the impact of migraines on mental health, how migraine treatment affects BIPOC communities, and why the failure to grasp the impact of migraines may contribute to its stigma. Ways to help manage the challenges brought about by migraines are also offered.

What Is a Migraine?

According to the Cleveland Clinic, migraines cause moderate to severe throbbing or pulsing headaches.

Migraines and Mental Health

In regard to the connection between mental health and migraines, a 2015 study defined a migraine as “a complex neurological disorder, characterized by episodic severe headache attacks, which substantially impairs a person’s functioning and diminishes quality of life.“ In turn, migraines contribute to a greater risk of mental health concerns and represent not only a physical impact on the lives of folx but on their mental health as well.

The Impact of Migraines

Considering the discomfort of a migraine, it is easy to imagine how dealing with migraines on a regular basis can negatively impact one’s well-being and experiences.

Mental and Physical Health Effects of Migraines

In a 2012 journal article, a systematic review of psychosocial difficulties related to migraines found that the most prevalent included:

Emotional problemsReduced vitalityPainIncreased disabilityDifficulties with work, mental and physical health, and social functioning

This research shows that migraines can affect folx in a variety of debilitating ways that may negatively impact one’s quality of life.

A 2015 study surveyed over 2,500 folx impacted by migraines and found that “stress resulting from frequent migraine headaches may contribute to the development of medical and psychological comorbidities and may be a part of a cyclical relationship wherein stress is both a cause and effect of the social and medical impairments brought about by migraine.“ In a 2017 symptom-based research study of 782 patients, anxiety was more strongly associated with an increase in migraine risk than depression. Difficulty managing worry and challenges with relaxation, as well as physical symptoms of depression were linked with the experience of migraines.
Given these connections, it is easy to see how worry over migraines can increase stress, which triggers them, and results in physical depressive challenges.

Migraines and Stigma

A 2013 study found that chronic migraines were associated with more stigma than epilepsy, given its impact on the ability to work and the need for rest. Although both conditions are often considered chronic and episodic, patients who experienced migraines dealt with greater negative impacts on their quality of life. In this way, given expectations of productivity in society, folx who experience migraines, and are therefore less able to work and require more rest may be further burdened by stigma.

Migraine Treatment in BIPOC Communities

A 2018 journal article shed light on the need for equity-based intersectional migraine treatment approaches to better serve BIPOC folx and others experiencing marginalization, based on the social determinants of health. Folx who have to confront oppression on a daily basis are likely to deal with more health concerns, yet they are often not included in migraine treatment studies, so they are less likely to benefit if their needs are not considered, which can be a vicious cycle.

Managing Migraine Challenges

Migraines lead to challenges in physical functioning and greatly impacts mental health. The stigma tied to migraines also brings negative consequences to those dealing with them. Therapy and education about migraines via advocacy work can help to mitigate these challenges.

Acceptance and Commitment Therapy

Acceptance and Commitment Therapy (ACT) has grown increasingly common since the 1980s, as it can provide benefits when folx are dealing with negative experiences that may be out of their control. ACT approaches promote a willingness to observe challenges while working towards coping with them through meaningful activity. A 2015 journal article highlighted how patients found it more difficult to cope when feeling isolated or depressed, which is why researchers support “acceptance-based coping of experiences that cannot be changed easily (e.g., migraine, pain) and encourages behavior change in areas that are personally meaningful and important (e.g., engagement with family).“

Behavioral Treatment

According to a 2018 study, behavioral treatment skills including stress management, sleep hygiene, and self-care can maximize the efficacy of medical interventions to assist patients to manage migraines. Consequently, folx may benefit from the same behavioral strategies to manage both migraines and mental health issues, which can often be interconnected. This research also demonstrated that “those who did not attend behavioral treatment were accessing other aspects of the health care system. The vast majority (more than 80%) had consulted with a primary care physician, over 40% had been to the ED [emergency department] for headaches, and over 40% had consulted with an ophthalmologist regarding the headaches.“ This data suggests that folx may face more barriers to access behavioral treatments in comparison to medical treatments to cope with their migraines, which is why those tend to be explored to a greater degree. For instance, if an individual cannot afford to take time off from a job and pay for counseling to work on coping skills like stress management as anxiety may often be a trigger for migraines, then they are unlikely to follow through with behavioral treatment recommendations. Instead, they are likely to search for medical solutions for their migraines such as making a trip to the emergency department.

Education and Advocacy

Without change on a societal level and supportive services to manage the emotional impacts of migraines on a personal level, folx who navigate both migraines and mental health challenges are likely to struggle. Considering the judgment that those who deal with migraines face, there is a need “to reduce stigma among the public through education, advocacy, and legal and policy interventions; at the organizational level, through training programs for clinicians; and at the intrapersonal level, through counseling, therapy, support, and empowerment programs.“ These efforts have already made strides to address earlier stigma regarding epilepsy, so similar efforts could provide benefits regarding migraines. When folx continue to be affected by migraines and mental health challenges at such high rates, it is crucial for the public to understand how debilitating these conditions can be, or those impacted will be subject to further stigma rather than the understanding and compassion that they deserve.

A Word From Verywell

While a migraine can be viewed through the lens of it being just a headache, those impacted often experience a variety of symptoms and comorbidities that extend far beyond that. Given how migraines are connected with mental health challenges in a variety of cyclical ways, it is easy to see the negative impact on quality of life for folx who deal with both issues. In this way, a better understanding of the debilitating reality of migraines and mental health could garner much-needed empathy for those impacted.