Most health care professionals and people with migraine (PwM) said the headaches are strongly linked to their mental health, noting that the stigma around migraines is a significant challenge for those seeking to discuss their mental state with their health care provider, according to the Migraine and Mental Health Connection Survey.
The survey, conducted by the American Migraine Foundation (AMF) and Biohaven Pharmaceuticals between April and May 2022, included 1100 PwM who also indicated having a mental health condition. The survey also included 302 health care providers who treat neurological diseases, including 50 neurologists, 50 headache specialists, and 202 general practitioners.
The results showed that 91% of health care providers and 67% of PwM feel that individuals who are able to successfully manage stress and mental health conditions can also better manage the symptoms of migraine.
"Migraine is complex and has the capacity to disrupt a person's life, relationships and sense of well-being, which in turn can impact their mental health," said Judy Ho, PhD, triple board-certified clinical and forensic neuropsychologist and former co-host of The Doctors, in a press release. "The Migraine and Mental Health Connection Survey showed that people with migraine and health care professionals are aligned in recognizing that the unpredictable and disabling nature of migraine attacks often creates worry and anxiety that can add difficulty to one's ability to manage migraine and further impact their mental health. This is often referred to as a ‘vicious cycle’ between migraine and mental health. It's important that people with migraine understand that improving mental health can lead to better migraine outcomes, and vice versa."
The investigators noted that a vital step in improving mental health outcomes for PwM is discussing these issues with a trusted health care provider. The results of the survey showed that two-thirds of PwM feel it is important to discuss mental health with the provider treating their migraine.
Further, approximately 60% said they have brought up this issue themselves with their provider; however, most PwM said they wish their provider would initiate the conversation. The results also showed a significant discrepancy around PwM discussing mental health with their provider, with 70% of providers indicating that they often, if not always, discuss mental health conditions with their migraine patients.
The survey results also found that health care providers underestimate how many PwM are experiencing depression and anxiety disorders. Among PwM surveyed, 57% report having been diagnosed with anxiety and 50% report having been diagnosed with depressive disorder, which HCPs in the survey estimate to be occurring in 29% and 30% of patients, respectively.
"Closing the gaps in communication between healthcare professionals and their patients can help improve migraine and mental health management," said Larry Newman, MD, professor of neurology at NYU Grossman School of Medicine and chair of AMF, said in a press release. "I hope that the findings of this survey encourage people with migraine to feel empowered to speak out about their pain and have deeper, meaningful conversations about migraine and mental health without worrying about stigma. These are important conversations that both people with migraine and health care professionals should initiate at every visit."
In the survey, 87% of PwM and 94% of health care providers indicated that mental health would improve with enhanced migraine control. The most often recommended mental health treatments by health care providers in the survey were medication (83%), psychotherapy or cognitive behavioral therapy (71%), and relaxation therapy (70%); however, PwM use these techniques at a rate of 58%, 28%, and 26%, respectively.
The survey also found that 91% of health care providers and 54% of PwM indicated that migraine management needs to be more flexible by targeting treatments to each individual patient’s needs. Further, nearly all PwM surveyed said it is equally important to treat migraine and mental health and want their health care provider to include these priorities in their treatment plan.
"At Biohaven, we are driven to help the millions of people suffering from migraine to better manage their attacks," said Vlad Coric, MD, chief executive officer and chairman of the board of Biohaven, in a press release. "This survey conducted by the American Migraine Foundation allows us to learn more about the perspectives of [health care providers] and their patients with migraine as we work to better understand the complexities of migraine and its impact on mental health."
American Migraine Foundation Survey Shows Nearly All People with Migraine and Healthcare Professionals Believe Migraine and Mental Health Significantly Impact Each Other. News release. Biohaven Pharmaceutical Holding Company Ltd. Accessed August 9, 2022.