TO READ: Migraines and depression -- What's the connection?
I want to report today on migraines, usually considered a neurological, not a psychiatric issue. However, I contend that for some of us there's a real connection. I say this because of personal experiences, and because of similar stories numerous others have told me about their illnesses. (See, for example, the comment from "Patricia" below the November 1 posting in this blog.) My ill health actually began, 20 years ago, as severe daily migraines that appeared suddenly for the first time, and made it very hard to work. After a year of trying various medicines, during which my depressive symptoms first appeared, an old tricyclic antidepressant took care of both ailments. At least it largely took care of the migraines; the depression has returned umpteen times. Of course, not everyone has even that much success, though medicines used have advanced a great deal.

Interestingly, however, there may soon be non-pharmacological treatments for migraine sufferers. The New York Times reports this week on two experimental treatments being studied in large trials for migraine -- ONS, or occipital nerve stimulation, and TMS, transcranial magnetic stimulation.

ONS uses electrodes implanted just under the skin on the back of the head to deliver electric current to a specific nerve. The electrodes are wired (under the skin) to a pacemaker-like device implanted in the upper buttock. The treatment sounds analogous to the VNS, or vagus nerve stimulation, therapy now used for treatment-resistant depression, where a device implanted in the upper chest is wired to electrodes in the side of the neck and delivers pulses of electricity. Very different nerves -- similar idea.

And TMS is already being studied for the treatment of both major depression and bipolar depression. I've previously described in this blog how fabulous TMS treatment has been for me. The idea in using TMS for migraine is similar. Instead of the side-of-the head stimulation I've gotten, here the back of the head is targeted. Again, a device pressed against the head provides brief magnetic pulses, which alter the electrical activity in a localized region of the brain. In neither case is it known exactly how the stimulation helps, and it doesn't help everyone. Also, the migraine studies so far are limited to those who experience an "aura," or a premonition period, before the migraine. Still, the idea of having more electrical -- as well as chemical -- treatment options for both depression and migraine is exciting. Stay tuned for more results.
Beth