Living with chronic migraine takes a toll on our physical and emotional health. Unfortunately, we tend to focus on our physical health, often ignoring our emotional needs. Chronic illness impacts our entire life, and it’s imperative that our emotional health is also a priority.
Living with chronic migraine takes a toll on our physical and emotional health. Unfortunately, we tend to focus on our physical health, often ignoring our emotional needs. Chronic illness impacts our entire life, and it’s imperative that our emotional health is also a priority. It is important to understand the connection that living with chronic disease can have on emotional well-being. People with migraine have a reported two-to-four-fold increase in lifetime risk of developing major depressive disorder.(1)
The stress of dealing with chronic illness creates understandable emotional impact and mental pressure. Having symptoms dismissed as “in your head” can lead to feeling frustrated and unheard. Not being believed can cause anger and disappointment. Coping with disabling pain and symptoms with ineffective medical care can lead to emotions of fear and sadness, leading to depression and anxiety. Living with chronic disease can create many losses, such as employment, relationships, financial instability, dreams and expectations. These losses can create grief and feelings of denial, guilt, anger and sadness.
Below is a “toolbox” of coping and resilience strategies. Feel free to use what works, leave what doesn’t and even add new tools.
Emotional Distress Tolerance
Activity - Find an activity you can do that requires thought and concentration.
Contributing - Do something that focuses on another person.
Comparisons - Put your situation in perspective by comparing it to a more painful or distressing time.
Emotions - Do something to create a new emotion that competes with your distressing emotion.
Pushing Away - Block a painful or upsetting situation from your mind by using techniques such as guided imagery.
Thoughts - Shift your thoughts to something neutral.
Sensations - Find a safe physical sensation to distract you from your distressing emotion.
Maintenance or Comfort Care
Challenge Negative Automatic Thoughts
Faith, religion and spirituality are important aspects of many people’s lives and can be utilized as a coping skill.
Affirm What Is Positive
Why add a mental health professional to your treatment team?
There is a fear in the chronic migraine community as in most chronic illness communities, that going to a mental health professional or receiving a referral to one, means that the physical illness is “all in their head” or a symptom of a mental health issue. This fear and stigma prevents people from caring for their emotional well-being. The need to add a mental health professional is important because living with chronic migraine takes a toll not only on physical health, but on mental health as well.
Reaching out to a mental health professional can help you learn new coping skills. Learning how to better communicate and advocate for your needs. A mental health professional can also be a great partner and advocate in your care.
There are many conditions that may be a focus of therapeutic attention related to living with chronic migraine, such as social exclusion or rejection, inaccessibility to health care, target of adverse discrimination, etc. There are also symptoms of clinical significance that may be assessed by your provider, such as a clinical depressive condition, trauma or stress-related condition.
Self-Assessment from the American Psychiatric Association
*The following assessment is not to take the place of a mental health assessment by a qualified mental health professional*
Five or more of the following symptoms have been present during the same two-week period; at least one symptom is depressed mood or loss of interest or pleasure. Symptoms cause clinically significant distress or impairment in social, occupational or other areas of functioning. The disturbance is not better accounted for by Adjustment Disorder with Depressive Symptoms in which the stressor is a general medical condition.
Note - Responses to a significant loss (i.e., serious medical illness or disability) may include feelings of intense sadness, rumination about the loss, insomnia, poor appetite, and weight loss which may resemble a depressive episode. Although such symptoms may be understandable or appropriate to a loss, the presence of a major depressive episode should be considered. This decision requires the exercise of clinical judgment.
* Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities. The anxiety or worry cause clinically significant distress or impairment in social, occupational or other areas of functioning. The person finds it difficult to control the worry. The anxiety or worry are associated with three or more of the following. The disturbance is not better accounted for by Adjustment Disorder with Anxiety in which the stressor is a general medical condition.
Warning signs of suicide include:
If you have been having suicidal ideation, please reach out for help from a trusted professional or crisis hotline.
1. Amoozegar F. Depression comorbidity in migraine. Int Rev Psychiatry. 2017;6:1-12.
2. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author.
Jeannette Rotondi, MSW, LSW, CCTP, CGCS