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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.

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Migraine and Depression: Disturbing Research Findings

The link between migraine and depression is pretty well established, but some research findings are still disturbing. Such is the case for a large-scale study published in the journal Depression Treatment and Researcher in November 2013. The study, which included 67,000 Canadians, more than 6,000 of whom have migraine, found that depression and suicidal ideation were much higher among migraineurs than non-migraineurs.

A glance at the findings:

  • 8.4% of men with migraine were depressed at the time of the study, while only 3.4% of those without migraine were.
  • 12.4% of women with migraine were depressed, while 5.7% without migraine were.
  • Both men and women with migraine were more likely to have ever considered suicide seriously than those without migraine.
  • 15.6% of men with migraine had considered suicide serious versus 7.9% of men without migraine.
  • 17.6% of women with migraine had considered suicide serious versus¬†9.1% of women without migraine.
  • Migraineurs, male and female, younger than 30 had a six times higher risk of depression and four times higher odds of suicidal ideation than those 65 and older.
  • Suicidal ideation among those with migraine was also higher in those who were unmarried, had lower household income and/or greater physical limitations.

Reference: Fuller-Thomson, E., Schrumm, M., & Brennenstuhl, S. (2013). Migraine and despair: factors associated with depression and suicidal ideation among Canadian migraineurs in a population-based study. Depression research and treatment, 2013. (The full text of the article is available for free.)

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Suicide & Migraine: Thoughts From Someone Who’s Considered It

Another migraineur has taken her life. I have few details, but those I do have paint a heartbreakingly common picture: She wasn’t taken seriously by doctors and did not receive proper care despite being in massive pain. She’s the second person I know of who has taken her life because of migraine in the last two months. I have to wonder how many others have done the same, but their deaths haven’t made the migraine news circuit.

I could rail against the medical system that knows so little about migraine, the lack of funding for research into this disabling condition, the majority of society who thinks we’re faking migraines to get out of making dinner, the stigma of migraine, people who can’t open their minds enough to even consider migraine as a debilitating illness….

There are plenty of reasons to be angry, but right now I’m just sad. Sad for all the people who are so desperate in their struggle with chronic migraine to consider or attempt taking their lives. It is such a lonely, terrifying emotional place to be. I know because I’ve been there myself.

There are a few things I want everyone with chronic migraine to know:

You are not alone. Connect with migraineurs on a forum like Migrainepage.com or the one on Migraine.com. Forums are the best place to find people who who understand the toll of chronic migraine and can help you cope with it. Talking with people who understood this lonely and stigmatized illness helped me through my worst days.

There’s always hope, hope for better health and hope for learning to live well despite chronic illness. I tried more than 36 preventives before finally finding some effective ones. I still have migraine attacks most days, but the pain is so mild that it feels like an entirely different illness. I am not “cured,” but I am grateful for every single day. Mindfulness techniques were a tremendous help in coping while I was still mired in daily pain of level 7 and higher. Start with How to Be Sickby Toni Bernhard; if you want more, see my recommendations in Migraine & Mindfulness on Migraine.com.

If you aren’t getting adequate treatment or feel like your doctors are dismissive, see a headache specialist. General neurologists get mere hours of training in headache medicine; you have the best chance of finding someone who truly understands migraine and its impact by seeing a headache specialist. Find specialists on the Migraine Research Foundation’s list of doctors certified in headache medicine, the National Headache Foundation’s physician finder, or the American Council for Headache Education’s provider search.

A therapist is a necessary health care provider. Chronic illness is a drag and migraine has its own infuriating stigma. This is a hard life to live and no one should have to navigate it on their own, nor should any romantic relationship or friendship have to bear the weight of it alone. Ask your doctors for recommendations, ask for suggestions on forums, or check Psychology Today’s therapist finder.

If you are considering suicide, contact the National Suicide Prevention Lifeline at (800) 273-8255. Trained staff will receive your call and help you sort out what’s going on. Even if you’re not at immediate risk of suicide, they will help you create a safety plan to keep you safe in case you ever reach that point.

Hang in there. The bad spell will not last forever. It may not feel like it right now, but you will get a break.

I fear that advice is oozing cliches, but each one is abundantly true. Keep in mind they’re coming from someone has had such severe, unrelenting chronic migraine that death has sometimes seemed a better alternative. Someone who is thrilled to be alive and experiencing what every day has to bring, both good and bad, after finally finding helpful preventive medications.

As my husband once told me, life with chronic migraine is way harder than any life should be, but that doesn’t mean it’s not worth living.

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Migraine as Solitary Confinement, Controlling Lover

A non-migraineur who was close to the young woman who took her life a couple weeks ago, but didn’t know how much she was suffering, emailed me after reading my post and expressed regret that they hadn’t been able to help her. I tried to describe the isolation of chronic migraine, but capturing the experience was nearly impossible. I likened it to solitary confinement. I also explained that no matter how much the chronic migraineur may want to reach out or how hard someone tries to reach in, there’s an invisible, impenetrable barrier. While this seemed to help the person I was emailing with, it still seems an inadequate description of how much chronic migraine can distance a person from their loved ones.

When my migraine attacks were at their worst, Hart and I knew our relationship was suffering. We both wanted to improve our marriage, but I couldn’t work on it. It wasn’t that I didn’t want to, but that I simply could not. The very basics of keeping myself going took all my attention and energy. No matter how much I love my husband and wanted to nurture our relationship, I had to focus on myself.

At that time, Hart compared the role of migraine in our relationship to a difficult, demanding child. I think of it more as a controlling lover. We could have worked together on parenting a child, no matter how unruly the child or how much we disagreed. Though he could help with day-to-day life and getting me to appointments, migraine was still my “thing” and drove a wedge between us that I couldn’t see past. Migraine dictated what I did at every minute of every day. It was all that I thought about.

Solitary confinement and an affair with a controlling lover are the best ways I’ve come up with to illustrate the isolation of chronic migraine, but I know there have to be a million other ways to describe it. What’s your analogy?

Update: Just stumbled upon a post from 2007 where I asked about headache metaphors. Read the informative responses in the comments.

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Migraine Can Be Life-Threatening

A young woman who had chronic migraine “took her own life,” I told you Saturday. Originally, I wrote that she had “committed suicide,” but changed it after being told the mental health community prefers the phrasing “took his/her life” because “committing suicide” sounds like a crime. The corrected phrasing doesn’t sit right with me either because chronic migraine took her life as she knew it. She chose suicide over living with extreme disability and a severely diminished quality of life from an illness that few people take seriously.

The migraine community is deeply shaken by this young woman’s suicide. Those who knew her are crushed by the loss of a vibrant, warm-hearted, loving person who was only 22. And I believe that those who didn’t are haunted by the niggling thought, “It could have been me.” Even the chronic migraineurs who haven’t seriously considered suicide know the feeling of not wanting to live like this anymore. It is not that we want to die, but that the daily struggle of chronic migraine feels like it is too much to bear and the light at the end of the tunnel often seems nonexistent.

What causes some people to hang on and others to choose suicide is a mystery to me. I have been desperately searching for a way to help suicidal migraineurs. Perhaps the best I can offer is a variation on something Hart told me the last time I was suicidal: Life with chronic migraine is extraordinarily difficult, but that doesn’t mean it is worthless. That and a success story, as I found my first helpful preventive (after more than three dozen unsuccessful meds) two weeks after Hart reminded my of my life’s worth.

When I shared the news of this young woman’s death on my private Facebook page, a non-migraineur friend said that anyone who dies from suicide because of an illness should be considered as having died from that illness. I’d never thought of it that way before, but I absolutely agree. Migraine is not thought of as a life-threatening illness. This young woman’s suicide is a tragic reminder that it can be.

If you are considering suicide, please, please contact the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).