And I am, like, a damn case study for this. Given I had Fibromyalgia first, then chronic migraine, and then depression. That depression near killed me. And migraines going chronic decreases functionality substantially.
I can see how comorbid migraine and fibromyalgia increases the risk of depressive symptoms. It is a matter of painload. And when painload gets high and inescapable depression comes knocking.
In fact, I had learned and adapted to coping with fibromyalgia fairly well. But when the migraines hit and became chronic I really, really struggled. I couldn’t cope. I just tried to push through and that just makes things worse. Then the depression sneaks in there. Which creates a sense of hopelessness. It sucks motivation. You feel worthless and guilty. And it becomes so much harder to try and function with the pain. Until you just wonder why you should have to function like that? Or exist like that.
The Study: Fibromyalgia in migraine: a retrospective cohort study In the Journal of Headache and Pain
Migraine is comorbid with Fibromyalgia and occurs in 18-35% of people according to this article ( Fibromyalgia News today). I had actually read this may be larger since headaches are common in Fibromyalgia and so the migraine diagnosed is missed, especially when it occurs without aura. Either way, it increases our disability significantly. And they sort of feed off each other. Especially since lack of sleep is a migraine trigger and with fibromyalgia… well, have fun trying to get any sleep.
The previous studies have shown those people with fibromyalgia and migraine, with high frequency of symptoms, have worse fibromyalgia symptoms when compared to the group with tension headaches.
In this study, they were looking to see if people with fibromyalgia and migraine experience more “depressive symptoms, headache-related disability, or higher headache intensity, than patients with migraine only” Fibromyalgia News today
There were 157 people in the study with migraine and fibromyalgia and 471 control patients with just migraine. It took place from 2012-2017
They looked at patients for a headache database and took note of their frequency of migraine, body mass index, duration of migraines, the age they first had a migraine, and who was chronic (more than 15 migraines per month).
They also looked at the factor of migraine disability utilizing their MIDAS (Migraine disability Assessment scale) score. And they looked at those with depression using PHQ-9 (Patient Healthcare Questionaire-9)
Patients with both fibromyalgia and migraine had Higher PHQ-9 depression scores. Which means more depressive symptoms overall and more intensity of symptoms. Certainly, for me, the combo did cause a very severe long-lasting depression.
They also demonstrated a risk of developing more intense migraines. Again, this doesn’t seem surprising. Maybe because with fibromyalgia we are so sensative to pain. And pain begets pain.
However, MIDAS score amount for the group and the control group had no differences. Perhaps because really with chronic migraines everyone is disabled by their MIDAS score. It is just disabling by itself.
When they looked closely at disability severity, however, the group with comorbidities had a higher level of migraine disability.
“The presence of fibromyalgia has been correlated with lower quality of life in patients with migraine, making it important to know when to screen for symptoms of fibromyalgia in the migraine population,” the team said.
“Our findings suggest that it is important to inquire about comorbid fibromyalgia as this needs to be taken into consideration with regards to creating an optimal individualized treatment plan.” Fibromyalgia News today
It does seem pretty obvious that a group of people with fibromyalgia and migraine would be likely to have more depressive symptoms. Given it is comorbid with both conditions and FM and migraines just completely aggravate each other.