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Good News & Bad News in Last Couple Weeks

Bad news: The migraines have reached a level 8 or 9 nearly every day. Being on the computer has been a huge trigger.

Good news: Although the pain levels have been high every day, I was only laid flat one day. I’ve gotten out by myself several weekdays each week, seeing a therapist and a physical therapist, going to the grocery store and even doing some retail therapy (Buffalo Exchange opened nearby in October!).

Hart and I have gone out at least one day each of the last three weekends, visiting the aquarium, the natural history museum and the science museum. We’ve gotten coffee, crepes and hamburgers. Maxalt, a triptan, has been working for me lately, and I’ve taken it for nearly all these excursions. Even then, I usually wind up taking Midrin, naproxen and sometimes Zofran. (I’m careful to not overuse any of them.) The benefits to my spirits are worth taking meds.

Exercise is becoming a more regular part of my days. I try to walk a couple miles a day, whether on the treadmill or while out and about. Today I jogged on the treadmill for a minute! A yoga therapist has come over for a few private sessions. I’ve learned an excellent restorative pose and a modified sun salutation practice. Moving my body is blissful and my body feels better when I move it.

In my outings, I’ve spent some time in Davis Square, a neighborhood that feels homey. (It’s where Buffalo Exchange is.) Getting excited about a place here is reducing the homesickness a bit, though knowing that Seattle has been in bloom for a month is troublesome.

Tomorrow I head to Phoenix for a week. My sister and I are meeting to help our mom prepare the house to sell in the fall. I’m eager to bask in 70 degree weather while wearing summer clothes. Going through storage sheds and closets should be fun, too – an archaeological dig of sorts.

So the news is mostly good. I still have awful hours every day, but I feel more like I’m living life than I have in years.

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Asking for Help & Beginning to Heal

Since stubbornness is one of my most prominent traits, I long thought sheer tenacity could snuff out the migraines. If not through willing them away (a useless endeavor), then by relentless pursuit of treatment. Instead, I have spent the last two years feeling like the migraines and accompanying depression had conquered me. Being obstinate wasn’t enough. Only by asking for help has my despair transformed to hope.

“I can do it myself” is probably my most oft-uttered sentence. When it comes to my health, I can’t. Sequestering myself only made it worse. The isolation wasn’t intentional. It started a decade ago with me thinking that talking about my ailment would automatically make me a complainer. It ended in November with me reaching out to my friends, screaming and crying and holding their hands as I fought through the worst migraines I’ve ever had.

Letting people know (and see) how bad the migraines truly are and the havoc they wreak on my entire nervous system lightened my heart. The severity of my depression since Hart and I moved to Boston is more than I wish to revisit. It is far from gone, but I can now see a way out.

People often tell me I’m brave for dealing with illness as well as I do. Asking for help took more courage than anything else I’ve faced. I was convinced I had let everyone in my life down. That canceled plans and unreturned phone calls (and emails and text messages…) made them love me less. Completely untrue.

If you are in a similar place of hopelessness, please, please reach out to the people you love. They love you whether or not you are sick. The rewards of asking for help make the necessary vulnerability worth it.

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Migraine Linked to Depression, Anxiety and Other Mental Disorders

People with migraine are likely to have mood disorders, like major depression, anxiety and panic attacks. This is according to a new study, which supports findings of previous studies that have also shown the coexistence, or comorbidity, of migraine and these disorders.

From the current study’s press release (emphasis mine):

Mood Disorders, Migraines Might Be Connected

Migraine headaches can precede the onset of mental disorders, according to a growing body of knowledge that includes a new study in the January-February 2009 issue of General Hospital Psychiatry.

Together, migraine and mental disorders cause more impairment than alone,” said lead study author Gregory Ratcliffe. “Patients who have one condition should be assessed for the other so they can be treated holistically. Although it is important to know that both are present, treating one will have an effect on the other.”

Ratcliffe is with the department of psychiatry at the University of Manitoba in Canada. He and his colleagues analyzed data on 4,181 participants in the German National Health Interview and Examination Survey. Migraines were diagnosed by a physician and trained interviewers evaluated participants for mental disorders.

Researchers found that 11 percent of participants had migraines. Participants had a variety of disorders: major depression, general anxiety disorder, dysthymia, bipolar disorder, panic attacks, panic disorder, substance abuse disorders, agoraphobia and simple phobia.

The authors considered two theories that might explain the relationship between migraine and mental disorders. The first theory is that a common factor influences both conditions, such as low activity of enzymes that deactivate certain chemical messages sent to the brain. They also considered a causal relationship: This study and others found that anxiety often precedes migraine, which often precedes depression.

Frederick Taylor, M.D., director of the Park Nicollet Headache Clinic in St. Louis Park, Minn., said that migraine co-morbidities — depression, anxiety and other disorders — affect 83 percent of migraineurs and explain 65 percent of their inability to function in life, more than the pain itself.

My bouts of depression show this is true for me. It is also true for other headache bloggers, like Diana from Somebody Heal Me. How about you?

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Maybe Migraine Isn’t Always to Blame: Adventures in Hyperthyroidism

Since last summer, I’ve lost 15 pounds, eaten anything I’ve wanted without gaining weight, had night sweats, and have been even more intolerant to heat than usual. Nausea went from a rare problem to occasionally more debilitating than the head pain. It has barely abated in the last week.

As symptoms I assumed were migraine (nausea, nearly blacking out, fatigue) and depression (anxiety, restlessness, fatigue) added up, I had to wonder if something else was going on. Suspicious that my endocrine or metabolic systems were the culprit, yesterday I finally had the second follow-up appointment for the lump found on my thyroid in 2006.

With his wild gray curls, enormous smile and a Jerry Garcia tie, the endocrinologist won me over immediately. He listened to me carefully, felt my thyroid and sent me to the lab. In his words, had he been a betting man he’d put money on hyperthyroidism. Two vials of my blood will be tested for thyroid dysfunction and a host of metabolic disorders, including diabetes. The results should be available today or tomorrow.

I have to admit that I have my fingers crossed. I was about to write “I never thought I could be so happy being told I probably have hyperthyroidism.” Truth is, I’m thrilled every time there’s a clue something relatively easy to manage could be exacerbating my migraines.

I’m trying to control the nausea as much as possible as I wait for the news. Antiemetics have stopped the vomiting and I can keep down saltines and ginger ale. I’ve even managed some chicken soup. (Don’t worry, I’ll call my doctor if this continues.)

Baseball season started this week and I’m digging Netflix on demand, so I’m fairly well entertained. Sadly, working on the computer is still making me feel worse, so I’m not blogging, reading news, visiting the online support group and forum, or answering e-mail. In fact, 30 minutes on my computer is taking a toll.

I wrote this Wednesday morning and felt too sick to post it. Last night I drugged myself up and was able to eat real food. I feel better now than I have all week; I’d better get off the computer before I make myself sick again!

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Discovering I’m Depressed in Four Short Paragraphs

Multiple times a day I wonder if how I feel at a given moment is depression- or migraine-related. I keep concluding that I’m not, but I’m asking myself more than ever and have to wonder if that’s a sign that I am clinically depressed.

Background
I was first diagnosed with depression when I was about 15. I took Prozac for a couple months then didn’t take anything until I was in college. I’ve been on antidepressants more often than not in the last 10 years. They usually keep things under control, but I’ve had multiple backslides. These are major falls off the mountain not small slips.

I’ve been taking Wellbutrin and Cymbalta for three years and added Lamictal six months after starting the first two. I check in with my psychiatrist (whom I love) every three to six months and we play around with meds as necessary. In Octoberwe increased my Lamictal dose from 200 mg to 300 mg. It didn’t seem to be working so we went back to 200 mg on March 8. As I write this, I’m thinking that maybe it was working. . . .

What’s Going on Now
I’ve been hiding out all winter, but didn’t start feeling sorry for myself until recently. Except for the weekend thing (which really don’t feel like depression), I haven’t cried much. I have felt overwhelmed, tired and just generally blah for the last couple weeks. Not to mention that my e-mail inbox is nearly overflowing and even the shortest blog posts are taking me hours to write. I was blaming it on migraine, but the signs are adding up.

That Was Easy: I Am Depressed!
As I write, I’ve become almost positive I’m depressed. Having online depression screening tests rating my symptoms as moderate to severe is a pretty good clue too.

What’s Next?
It takes me a long time to find a cocktail of meds that’s effective. Once I do, drugs have always been quite helpful for me until I hit a backslide. I’ve considered therapy off and on. Trying to find a good therapist is such a pain. In fact, I’ve never found one I liked. Also, three standing appointments each week is my limit.

When I mentioned my mindfulness-based wellness class and meditation, my psychiatrist pulled a related book out of his bag: The Mindful Way Through Depression. One of the authors, Jon Kabat-Zinn, also wrote the book we’re using for class, Full Catastrophe Living. I read a fair amount of both before reading started triggering nausea and dizziness last week.

I really like what the depression book has to say. Particularly about the role of negative thoughts or self-talk in perpetuating depression. I seriously didn’t realize that other people don’t do that all the time. It has been normal for me for years, perhaps forever.

After Hart suggested that I beat myself up every time I let myself down, I’ve become much more aware of my thoughts. I’ve already progressed in noticing — and halting — the negative things I tell myself. There’s a lot of room for improvement, but it feels good to know I’ve already started what I’m trying to do.

Ironically, inability to concentrate is one of my major symptoms. It also makes learning to meditate highly frustrating. The meditation class I’m taking has taught me to not get upset with myself for “not doing it right.” I’m not as wound up about it as I normally would be and am even sticking with a daily practice.

For now I’m hanging in there. I’m trying to not be so hard on myself. I’m even giving myself permission to watch movies when I need to escape. I also stopped writing this mid-post so I could call my psychiatrist. I hope he’ll adjust my meds over the phone, but will make an appointment if I need to.

When I sat at my computer this morning, I had no idea all this would come gushing out. In fact I started out to write a short forum post about differentiating between depression and migraine symptoms. Amazing how helpful “talking” it through is.

What’s your experience with depression? Please share it in the comments below.