How to cope emotionally with chronic migraines at 41?

Question

Hello doctor,

I do not even know where to start with this. I have had migraines since I was 19, and now I am 41. Every MRI scan I have had has come back normal.

I keep track of my migraine attacks, and I am currently averaging around 15 migraine days each month.

The hardest part is that I have found myself crying recently, not even because of the pain, but because I feel completely exhausted knowing that another migraine is always around the corner. My husband tries to understand, but I do not think he truly knows what it feels like.

How can I cope emotionally after living with chronic migraines for decades? At this point, the physical treatment is not the hardest part anymore. It is the emotional weight of feeling like this is simply going to be my life.

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query and understood your concern.

I understand your concern. Experiencing around 15 migraine days per month is very difficult and falls into the severe category.

I believe your long history of migraines may have contributed to a depressive disorder, and I can sense the emotional burden in what you have written. Depression commonly occurs alongside chronic migraines because living with ongoing pain can cause feelings of hopelessness.

Symptoms of depressive disorder may include loss of interest in daily activities, fatigue, low motivation, disturbed sleep, and difficulties with your personal, social, and work life. Depression can also make migraines feel worse.

Your condition may benefit from preventive (prophylactic) treatment. One option is Amitriptyline, which is a tricyclic antidepressant (TCA). It works on different brain receptors and can help manage both migraine and depressive symptoms.

Possible side effects include weight gain, drowsiness, dry mouth, and constipation. Please discuss this option with your neurologist or psychiatrist to see if it is suitable for you.

If prescribed, it is usually taken for around three to six months before assessing the full benefit. Although it can have side effects, for many people the benefits outweigh the risks, especially when migraines are significantly affecting daily life. The goal is to help you regain control and improve your quality of life.

It is also important to identify and manage your migraine triggers. For example, some people develop migraines after skipping meals or not getting enough sleep. If you notice specific triggers, such as lack of sleep, certain foods, stress, or dehydration, working on those can help reduce the number of attacks.

Other preventive medications include Topiramate and Sodium Valproate. The best choice depends on your health, medical history, and the possible side effects, so this should be discussed with your treating doctor.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.