It's “in the head”, of course, but not in the psychological sense of the expression.
Migraine is a neurological disease that does not result from a specific mental state.
This does not mean that there is no link: migraine and psyche are intertwined in a certain number of patients.
Psychiatrists and neurologists agree on the term “comorbidities”, also valid for tension headaches.
“
Stress
is frequently associated with migraine attacks,
recalls Dr. Françoise Radat, a psychiatrist in Bordeaux who formerly worked at the chronic pain treatment center at the Bordeaux University Hospital.
Ask a patient what triggered their seizure
;
chances are he is quoting something that happened recently.
»
Anxiety and depression also make migraines worse.
"
This has been very well documented in studies of large cohorts ,
"
she says.
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Several hypotheses are formulated to explain these associations.
The brain of a migraine sufferer adapts less easily to change, of whatever nature: hormonal, food, sleep or even emotional.
It is therefore logical that stress is a triggering factor, in the same way as taking certain foods or hormones.
As for anxiety, it alters the quality of sleep, which is known to be an aggravating factor in migraine.
It can also amplify the negative experience of migraine.
In addition, frequent and severe attacks that require interrupting activities several days a month can lead to anxiety.
"
On the neurochemical level, it is not excluded that the area of the brain involved in the triggering of seizures, the hypothalamus, is also involved in certain depressions
”
, specifies Dr. Anne Donnet, neurologist at the center for evaluation and treatment of pain from La Timone hospital in Marseille.
“Non-drug therapies”
One thing is certain, these ambiguous links complicate support.
“
Some patients attribute their migraine solely to stress, at the risk of missing out on effective medical care,”
says Françoise Radat.
Conversely, others knowing that they are anxious or depressed do not bring up the subject in neurology consultation for fear that the discussion will focus on these psychic disorders and not on the migraine pain which is the main complaint.
Patients divide problems according to medical specialties and that's a shame, because the body is a system and we need all the information for appropriate care.
Managing stress, anxiety and/or depression has been shown to have a positive impact on the course of migraine.
»
In the event of frequent migraines, it is therefore appropriate to ask the question of one's mental health, to question the way in which one takes care of oneself.
“
In consultation, we systematically assess the risk of anxiety and depression,
confirms Anne Donnet.
And we often offer non-drug therapies such as relaxation, sophrology or meditation.
This reduces anxiety and also modulates pain sensation, independent of psychic disorders ,
”
she explains.
And if the evocation of psychic difficulties ends up invading the consultation, then the question of recourse to a psychiatrist or a psychologist arises.
