Migraine life comes hand in hand with being ‘not ok’.

For most of the last month I’ve been dealing with the most intense depression I’ve ever experienced. It scared me. It’s taken a while to be able to confront the darkness and label it what it is: just part of living with migraine.

The assault migraine has on our mental health can be brutal. Usually, managing the migraine manages the mental health. But lately, with my migraine better managed than ever, I’ve had these really sharp and sudden onset waves of depression. They last for maybe an hour, sometimes the whole afternoon… and then would lift as suddenly as they came on.

I cast around for a while for a reason. What was I upset about? Was it just finishing my PhD and suddenly being without purpose? No, I have plenty of purpose. Was it financial? Perhaps, but that’s not unusual. Was it needing to find a job in a global depression? Maybe, but if that were the case I would feel hopeless all the time. This wasn’t really psychological. It was physical – or at least chemical. Very sudden and extreme shifts in the chemicals in brain that would resolve almost as quickly.

So I did what we migraine people do – even though it is bad for our mental health to do them long term – and started diarising when these crashes into despair happened and what may have been triggering them. And there it was, on paper, clear as day… the migraine cycle. It was happening on the days I didn’t sleep between 2 and 3 in the afternoon – my migraine nap. Aimovig takes care of almost all the symptoms of migraine attacks – except for the prodrome (thank you God for this miracle drug!!). Which is what was making it hard to pick that these waves of depression were prodrome (historically my prodrome is punctuated by insomnia, craving bread, and maybe being a bit short tempered).

The migraine nap has been re-implemented as a high priority and I’ve gone a few days now without these scary crashes. Which is a really, really, really good thing. I desperately did not want to go on anti-depressants. No one I know (well) who lives with migraine and depression has done well on SSRIs or SNRIs – even the tricyclic antidepressants can leave a trail of destruction. The doctors tell their patients to persist to treat the depression despite the migraine worsening and the depression not improving, and then after a couple of months of their patient getting worse, and worse, they finally relent.

On the to-do list: convince big pharma to make anti-depressants for the migraine brain.

Needing to manage your mental health is just part of migraine life. A part that sucks. I got this bit under control for now, but I know it is a constant battle. I think what happened is that without the adrenalin of elections and my PhD to push me through, that nap became critical again. I will need to figure out a way to manage it for my return to work – a late lunch and a quick kip in the car (presuming I don’t have an office and am not working from home) should do the trick, most days I only need 10 or 15 minutes.

My biggest battle will be not talking myself out of returning to work just because some days I need a nap. My biggest battles are always with myself.