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Suicide and Chronic Migraine

A lovely young woman with chronic migraine whom I met in an online forum has just taken her own life. She had a smile that could light up the world. And she was in tremendous pain for which she saw no end.

Though I didn’t know her well, this young woman’s death has hit me hard. I am sad for her family and friends, and my heart breaks to know how many other chronic migraineurs have felt similarly desperate.

I think of all the people whose episodic migraine attacks have slowly morphed into chronic migraine. So many of us try countless treatments before finding any relief. Our migraines worsen year after year while we try medications with sometimes unbearable side effects. When you’re mired in that much pain, both physical and emotional, you cannot conceive of a life without migraines that continue to escalate in frequency, severity, and duration, destroying what little quality of life you have left. (I know, I have been there.)

Combine having to face each day when your life is in ruins because of migraine with a society that does not understand how ravaging migraine can be. Migraineurs are regularly told that “it’s all in your head” or “it’s only a headache.” We are called weak or fakers. People tell us all we have to do is think positively and our migraine attacks will go away. There is so little sympathy or empathy for those struggling with migraine.

June is Migraine and Headache Awareness Month. I’ve been caught up in my own life and haven’t been on top of spreading facts or writing blog posts. This young woman’s tragic death has reminded me just how vital it is that we raise awareness about this devastating illness.

Too many people suffer horribly from migraine. Too few people know the tremendous damage it can cause. How many more bright, shining stars must the world lose before people begin to understand the cost of chronic migraine?

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Chronic Migraine’s Isolation and Emotional Torment

When the worst migraine I’ve had in months coincided with an overnight visit from a friend, I was overwhelmed by how incredibly alone I felt, even when surrounded by friends. In The Isolation of Chronic Migraine, a post I wrote about that night for Migraine.com, I said:

The isolation gave me a sense of physical emptiness. It was as if I wasn’t even there — like my essence (or soul, if you please) was missing. Like I was in this experience of migraine entirely alone and not even the people closest to me could touch me physically or emotionally. (Read the whole post here.)

My friend visited last Thursday. Although I haven’t felt isolated like I did that night again since then, the memory of when my migraine attacks were at their worst has continued to haunt me. In those days, I felt disconnected all the time. Like the constant companion of severe chronic migraine wrapped me in a layer of insulation that kept anyone else from reaching me. No one, not my friends, family, or even my husband, could get through it.

Much of this time was when I lived in Seattle. In my bedroom there, the closet took up one long wall, but the doors were a regular closet door width. This left a nook that was difficult to access. I used to lie in bed and fantasize about curling up in that tight space, where I could be comforted by the darkness and the enclosure. I don’t think I ever did it — it seemed a desperate move, like doing so would mean I was millimeters away a psych ward — but I do remember sitting on the floor in the tiny spot between the bedside table and the wall. Even there, migraine wouldn’t leave me, and the sense that I was disappearing from the world was magnified by the knowledge that I took up so little physical space.

Thankfully, those days are behind me. I say this not only because I’m on some preventives that reduce the severity of the migraine attacks, but because I don’t think I will be able to disconnect like that again. Since those days, I’ve allowed my friends to be around me when I’m in a bad migraine attack. I’ve let other people see what it can be like and have spoken about it more openly. I used to close off as soon as someone asked me about migraine, as if acknowledging it would make it more real. Now I answer questions readily and have described the experience to non-migraineurs. I have written about those times and how close I was to suicide.

Then again, it is easy to say I won’t get to that point again on a day I’m feeling better. Last Thursday night was scary both for the emotions I felt and how reminiscent they were of worse days. I am far more connected than I was a few years ago, but, truthfully, I’m still detached. I haven’t returned to calling friends and family for no reason and am nowhere close to being as social as I once was. I’m not in massive pain all the time, but I still have a migraine nearly every day. I’m physically and mentally exhausted much of the time. My emotional and physical strength are stretched taut in  support of myself; my ability to care for others comes in small, unpredictable bursts.

Even the most sympathetic, empathic friends and family cannot understand what it is like to live inside chronic migraine. Despite all the explaining and writing I have done, I still cannot capture the bleakness and alienation I have felt. The physical sensations of chronic migraine are horrendous, but the emotional torment may be even worse.

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2012: A Year of Remarkable Personal Migraine Progress

Exactly one year ago tomorrow, I had a massive breakdown. Sobbing, I proclaimed that I wanted out of this life. I didn’t want to fight anymore; I didn’t want to live with chronic migraine any longer. I even wished for cancer so that I could choose to not treat it, thus dying without technically committing suicide.

Today, my head pain is at a level 4, which is the highest the pain has gotten in a week. In the past four months, the pain usually topped out at a 5, occasionally a 6. Still far from comfortable, that’s way better than daily pain that hits a level 7 or 8, where I was last January. I don’t know how these pain ratings appear to anyone outside my body, but to me, pain reduction of even a single number is cause for celebration.

In the 11 years that chronic migraine has been the focus of my life, last year was the first in which I made significant progress in reducing the severity of attacks. I tried more than three dozen medications in that time and countless other Western and alternative treatments and diets, none of which had any effect. To see any progress is amazing to me; to now be at a place where I expect even more improvement than I currently have experienced is astonishing.

Though you’ve read about my progress through the year, here’s a summary of what’s working for me:

Magnesium: Although I had been on magnesium before with no success, I noticed an improvement  increasing the dose to 700 mg. After trying IV infusions to see if they would be more effective (they weren’t), I ultimately pushed my daily oral dose to 1,000 mg.

Cyproheptadine: The starting dose of 4 mg was enough for me to feel a bit better. Each 4 mg increase brought additional relief until I hit 16 mg, which didn’t seem to be any better than 12 mg. I’m back at 12 mg, though will probably try increasing it again, to be sure that I wasn’t just having a bad week the first time I tried 16 mg.

Diet: It has been a year since I started an extreme version of a traditional migraine elimination diet. Until a month ago, the diet was horribly frustrating. It seemed like both nothing and everything I ate were triggers. I wondered if there were other aspects of foods that I was unaware of that could be triggers. Then a reader mentioned that she feels better when she avoids foods with histamine. This started major research and an even more drastic diet to cut out amines and salicylate.

The initial improvement started to look like a fluke as the migraine attack severity returned to previous levels. A week ago, I switched from ground dark turkey meat to skinless chicken breast as my main protein source and the migraine severity dropped to a level 4. I’m still tweaking the diet and waiting to see a nutritionist. It will be a long process as I test out foods I’ve been avoiding, but I really think histamine and salicylate content in foods and body/beauty products is a major component of my debilitating migraine attacks.

I have so much more to tell you! There’s a detailed post about the diet coming later this week. First I needed to write this overview to remind myself of the massive improvements that 2012 brought. Sure, I still feel worn out and discouraged at times, but every little bit of progress shows me that chronic migraine is necessarily not a life sentence. A year ago, I was convinced I’d never escape that prison.

I was basically the prototype of chronic intractable migraine. (In a bizarre sort of way, that sounds like bragging.) Ten years with no improvement. Countless doctors, naturopaths and all manner of traditional and alternative health care providers have given up on me. I had given up on me. If I can see improvement, so can you. The struggle may be long and arduous, but there is always, always hope. Hang in there.

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My Story of Chronic Migraine & Suicidal Thoughts

Since reading the brave post about migraine and suicide that Kelly from Fly With Hope shared last year, I’ve been trying to gather the courage to share my own experiences with suicidal thoughts and migraine. I finally did so today in a post on Migraine.com entitled Migraine and Suicidal Thoughts: One Migraineur’s Story.

If you are experiencing similar despair, I hope it helps to know that you are not alone. Please don’t keep your pain, fear and sadness to yourself. If you don’t feel you can talk to someone you know, contact the National Suicide Prevention Lifeline at (800) 273-TALK.

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Antidepressants and Pregnancy, Bone Loss, Personalized Drugs & Suicide (and Dutch Women & Depression)

Anyone with a headache disorder has a stake in depression news. Not only do headache and depression tend to go together, antidepressants are common headache preventives.

Antidepressants Rated Low Risk in Pregnancy

Taking an antidepressant like Prozac may increase a pregnant woman’s risk of having a baby with a birth defect, but the chances appear remote and confined to a few rare defects, researchers are reporting today.

The findings, appearing in two studies in The New England Journal of Medicine, support doctors’ assurances that antidepressants are not a major cause of serious physical problems in newborns.

But the studies did not include enough cases to adequately assess risk of many rare defects; nor did they include information on how long women were taking antidepressants or at what doses. The studies did not evaluate behavioral effects either; previous research has found that babies suffer withdrawal effects if they have been exposed to antidepressants in the womb, and that may have implications for later behavior.

Antidepressants May Speed Bone Loss: SSRIs Linked to Reduced Bone Density in 2 Studies

In one study, older women who took SSRI antidepressants showed a 60% acceleration in bone loss, compared with women who did not take antidepressants. . . .

The accelerated bone loss was not seen in women who took another type of antidepressant.

The men in the [second] study who took SSRIs had lower bone density in the hip and lower spine than men who took no antidepressants. There were no significant differences between those who took tricyclic antidepressants and men who took no antidepressants.

“That sounds very alarming, but we don’t really know if it is clinically meaningful, and we cannot definitively say that the SSRI use was the reason for the bone loss,” Diem says. “These are preliminary findings which need to be confirmed.”

Because depression itself is associated with an increased risk for bone loss in older people, a better understanding of the impact of antidepressants on bone is urgently needed, he says.

Also: SSRIs Chase Depression But Bones May Pay Price

On the Horizon, Personalized Depression Drugs

Instead of the hit-or-miss approach . . . it will soon be possible for a psychiatrist to biologically personalize treatments. With a simple blood test, the doctor will be able to characterize a patient’s unique genetic profile, determining what biological type of depression the patient has and which antidepressant is likely to work best.

Suicide Patterns in Depression Unrelated to Antidepressant Use

Data on more than 130,000 new episodes of depression showed that regardless of treatment type, the number of suicide attempts was highest in the month before therapy, next highest in the first of month of therapy, and lowest thereafter, the investigators reported in the July issue of the American Journal of Psychiatry.

“Our study indicates that there’s nothing specific to antidepressant medications that would either make large populations of people with depression start trying to kill themselves-or protect them from suicidal thoughts,” said Dr. Simon.

“Instead,” he said, “we think that, on average, starting any type of treatment-medication, psychotherapy, or both-helps most people of any age have fewer symptoms of depression, including thinking about suicide and attempting it.”

Why Dutch Women Don’t Get Depressed

After scores of interviews with historians, psychologists, fashion designers, image-profilers, personal shoppers, magazine editors and ordinary Dutch women, Ellen de Bruin, a Dutch psychologist and journalist, throws down the gauntlet. [S]he argues that women in the Netherlands are a whole lot happier than their counterparts in most parts of the world.

“It has to do with personal freedom,” said de Bruin, whose work, sure enough, is titled “Dutch Women Don’t Get Depressed.” “Personal choice is key: in the Netherlands people are free to choose their life partners, their religion, their sexuality, we are free to use soft drugs here, we can pretty much say anything we like. The Netherlands is a very free country.”

[via Kevin, MD]