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Migraine Mood Changes: Depression-Like Symptoms

migraine-mood-changesI was standing in the bedroom alone with my eyes closed, taking deep breaths. I didn’t know Hart had entered the room until he asked, “What’s up?” “I’m nervous about you leaving,” I said, and the tears I’d been keeping at bay burst forth.

Even though I don’t have an anxiety disorder, I have subclinical levels of anxiety in two situations: sleeping when I’m home alone all night and when Hart travels long distances. The Fourth of July brought both of those. During a migraine attack. It led to one of a handful of full-blown panic attacks I’ve ever experienced. It was horrible, but made a lot of sense in retrospect. For the few weeks prior to that night, migraine attacks were going straight for my mood.

I first noticed it during a migraine attack on Father’s Day. I had to stop looking at Facebook posts because they made me miss my dad too much. This isn’t abnormal in the realm of grief, but I also cried when I realized that the attack would keep Hart and me from enjoying our day’s plans. Even that’s an understandable reaction to the situation. Becoming racked with guilt when the precarious stack I’d built in the freezer caused Hart to drop a container is not normal. Instability in the freezer is a common occurrence in our household and it’s usually my fault. The container didn’t break and Hart wasn’t upset, but I felt like an utter failure. These are all indications of depression, but my mood returned to normal with that particularly intense migraine attack cleared.

Migraine attacks bring major mood changes for me maybe a dozen times a year. The experience is unpleasant and unpredictable, but never enduring. Until this summer. During many, but not all, of my migraine attacks over a three-week period, I cried at song lyrics that wouldn’t normally make me cry and was quick to anger in low-stakes situations, like not being able to find the pen I wanted to use. These are telltale symptoms of clinical depression for me. So much so that my doctor wanted me to start another antidepressant.

I held off on the meds for a week because it just didn’t feel right. It didn’t follow the pattern for depression. Then again, it didn’t follow the pattern for migraine mood changes, either. Still, I watched and waited. By the time that week was up, mood disturbances were no longer regularly part of my migraine attacks.

Migraine symptoms are so weird. (I swear I say that at least once a month.) They’re both predictable and unpredictable. I expect to have associated mood changes occasionally, but this is the first time I can recall three weeks during which many attacks were accompanied by depression-like symptoms. I’m wondering if the uptick was caused by a short-term change in my brain similar to what my doctor described when I suddenly became sensitive to Wellbutrin’s side effects:

The brain you have after a migraine attacks is not the same brain as you had before it. Any medication that acts on the central nervous system, like antidepressants, could interact with this new brain in a different way than before, causing an increase in side effects. My dose hadn’t changed, my brain had.

The changes to your brain after an attack are not permanent, so please don’t let this scare you. It’s more like a storm with high winds came through and there’s still dirt and debris in the street. The street sweeper will get to it eventually, but it may take some time.

This explanation makes intuitive sense. The Father’s Day migraine attack that kicked all this off was particularly intense and odd. My thinking was way off. Despite being drug-free, I was thinking as if I’d smoked marijuana. That’s never happened in quite this same way before. Perhaps the celery that triggered the attack was genetically modified to have a psychedelic effect.

Whatever the explanation, the problem seems to have subsided for now. My mood has been stable for about a month. I’m grateful for the increased empathy that came from my tiny glimpse of insight into what panic attacks can be like. And I will be grateful if I never have to experience one again.

 

(In case you’re curious, the grief I’ve been wrestling with this summer has been entirely independent of migraine attacks and migraine mood changes.)

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Sensitivity to Drug Side Effects Increased by Migraine Attack

Nine days of dizziness following four days of migraine. That’s what I’ve been up to these last two weeks.

The migraines made sense. We had rainstorms that week and I’d blown off my diet a couple times. The dizziness, however, was surprising. Wellbutrin has been to blame every time I’ve been dizzy in the last 16 months, but it didn’t make sense. I haven’t changed my dose in a few months months. I’d eaten plenty before taking it each time and hadn’t missed a dose. Maybe I accidentally took too much one day? I skipped a dose intentionally, took it at different times, took 300 mg instead of 450 mg. When the dizziness did lessen, the reprieve never lasted long. It was as if the migraine attack had made me more sensitive to Wellbutrin’s side effects.

It seemed unlikely that one migraine attack would change how I reacted to medication I’ve been on for more than a year, but my headache specialist told me he’s seen it happen with other patients. As he put it, the brain you have after a migraine attacks is not the same brain as you had before it. Any medication that acts on the central nervous system, like antidepressants, could interact with this new brain in a different way than before, causing an increase in side effects. My dose hadn’t changed, my brain had.

The changes to your brain after an attack are not permanent, so please don’t let this scare you. It’s more like a storm with high winds came through and there’s still dirt and debris in the street. The street sweeper will get to it eventually, but it may take some time. (I live in a place with haboobs and dramatic thunderstorms. You can liken it to a snowstorm if that’s more familiar.)

I’ve been taking 300 mg of Wellbutrin for the last week. Today I can look at the computer without feeling like my head is melting as if in a psychedelic video, but I still have to be careful to minimize the chance of side effects whenever I take a dose. My fingers are crossed that this part of the change to my brain lasts and that I can keep the depression at bay on this lower dose.

My naturopath/therapist believes that my depression is directly tied to migraine attacks. Since I started seeing her almost two years ago, every increase in depression has followed a long migraine attack that didn’t respond to acute medications. This fits with my headache specialist’s explanation. I haven’t waited to see if the depression abates without medication, but I wonder if it would. Not enough to find out, but I will ponder it.

My fingers are crossed that I have the internal mess from this latest storm cleaned up. Now it’s time to attend to everything I haven’t been able to attend to while weathering it. I’m going to read and approve a slew of comments now, but it will take me a while to respond to all of them.

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Checking In

Worried emails come in whenever I’m quiet for long, so here’s a brief update. My mood is pretty good and my migraines have been a bit better (though I have an ugly one right now). Wellbutrin is still making me dizzy when I work on the computer, so I’m not writing much. I’ve chugged a Tolerex with breakfast the last two days, which seems to have kept the dizziness at bay. My fingers are crossed that I’ll be fully functional again soon.

I’m now 38 and had a lovely, low-migraine birthday (though Hart had a migraine that day!). I decided to indulge in dinner out and homemade yellow cake with buttercream frosting. A migraine followed, but it was mild and worth it.

If you’re looking for new writing from me, Migraine.com is a good place to check. They have a backlog of articles from me that they publish as needed and usually post one new one from me each week. Here are some recently published posts:

I apologize for letting your comments languish; I hope to reply this week. And I hope to get at least one new post up this week. I hope you’re doing as well as possible!

 

 

 

 

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I’m Out of Cope Due to Depression

After posting Food and Migraine Frustrations: I’m All Out of Cope, I finally looked at all the pieces that were frustrating me (and how I was overreacting to everything and felt helpless) and realized they added up to depression. I was still waffling until the day I woke up and didn’t want to get out of bed. Then I knew it was time to increase my Wellbutrin.

I started feeling better almost immediately. It’s highly unlikely that the Wellbutrin made such a difference so fast, but recognizing what was happening and taking steps to change it was a big relief. I’m also seeing some improvement in my diet and pinpointing the foods (and possibly a supplement) that have been problematic. And one day out of every four is (usually) trigger-free.

Unfortunately, I’m not getting enough calories to support 300 mg of Wellbutrin without side effects. Like happened when I was on Tolerex in December, I get dizzy looking down or working at the computer. Once again, it’s keeping me from working much.

I’m still frustrated, but no longer feel helpless or overwhelmed. I’m taking each hour as it comes and trusting I’ll figure this out eventually. (That sounds so trite, but it’s totally true.) I’m not sure what “this” looks like, how long it will take or how many migraines a week (or day) it will mean. And that’s OK.

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Robin Williams

When I saw that Robin Williams had died, I was sad for the death of someone whose work had touched my life, but I did not cry. Then I saw it was suicide and — as twisted as this may sound — hoped it was to avoid the painful decline of a chronic illness. When I saw he’d been severely depressed, I stood in my kitchen and sobbed. Depression was that illness and he’d already experienced its painful decline.

I remember what it felt like when death seemed like my best option and am crying for everyone who feels the same way. That the world has lost someone who brought great joy to so many lives, that a woman lost her beloved husband, that children have lost their father to a cruel yet (usually) treatable illness is tremendously sad. That he is only one of the thousands of people who took their own lives today… I cannot find the words.

1-800-273-TALK. Put that number for the National Suicide Prevention Lifeline in your phone right now. Whether you need it for yourself someday or for someone you love, have it available and, more importantly, use it. If you have had suicidal thoughts in the past, please put together a suicide safety plan. (The link is to guidance in the context of migraine, but it is best to put a plan together with the help of a mental health professional. The National Suicide Prevention Lifeline can also help with a suicide safety plan.) I hope you’ll never need to use it, but planning ahead could literally save your life.

Take care of yourselves.