[Zeroid]

Hi all,

I was wondering if any of y'all get migraines. I have them quite horrifically, when unmedicated, and they also affect my moods. Also there are visual disturbances and hallucinations, which are special fun.

I think that I might have a tendency to get them when manic, which confuses things for me. Anybody else?

[*Beth*]

Absolutely, yes. I began having vicious migraines when I was 7. Way back then there was no treatment for migraines except aspirin (didn't do a thing). By the time I was in my 20's migraines were a determining factor in how I lived my life.

The migraines have lessened in frequency and severity since I've reached middle age - but then, there are meds to treat them now, so maybe they just seem less severe.

I believe that migraines can be (often are) connected to BD. Both are episodic, and so many people who have BD also battle with migraines.

It's interesting that you point out the connection between mania and migraine. I have never even thought of the correlation before! I have to say that, yes - migraines and mania are, without a doubt, connected for me, too.

I'm sorry you've been suffering from migraines, Zeroid. It was odd, I only really had them off and on over a 2 to 3 year period maybe 5 years ago? I had never had them before. I don't know why they started or why they stopped. I started with more typical types (head pain and vomiting) then they became silent migraines, mostly. At that time, I was also experiencing dissociative symptoms, which included occasional hallucinations. I had been on bipolar medications the whole time. A neurologist prescribed sumatriptan injections for me to combat the typical ones, with vomiting. Sumatriptan worked great for me. Really great!

I've written a couple relevant researched articles about migraines in my blog. If anyone is interested, let me know. Their titles are:

"Light can trigger migraines, mania, and/or seizures in some people"

"Interesting similarities/links between bipolar disorder & other conditions"

[Under*Over]

According to the Heinz Prechter bipolar study:

Migraine headaches were found to be more frequent among BP compared with controls (31% vs 6%; odds ratio (OR) = 3.5, 95% confidence interval (CI): 2.1–5.8), with greater risks associated with female sex, increases in measures of severity (earlier onset and greater frequency of mood episodes) and a history abuse or neglect.51

Cohort Profile: The Heinz C. Prechter Longitudinal Study of Bipolar Disorder

So yeah. They are really common with bipolar and bipolar type disorders. I get them too. I started medicine for them and it helps A TON though. I couldnt believe how much it helped. Might be worth checking out for you too.

[scatterbrained04]

I used to get them a lot in my teens and early to mid 20s. As I've gotten older, I still get them but much less frequently.

[Catchingthesun]

I’ve had migraines ever since my late teens but now I get them almost every Saturday or a couple Saturday’s a month. I have regular meds to treat them but my psychiatrist seems to think they are mania/anxiety related due to work. Looking back at the pattern I can see that.

[Moose72]

Originally Posted by Under*Over

According to the Heinz Prechter bipolar study:

Migraine headaches were found to be more frequent among BP compared with controls (31% vs 6%; odds ratio (OR) = 3.5, 95% confidence interval (CI): 2.1–5.8), with greater risks associated with female sex, increases in measures of severity (earlier onset and greater frequency of mood episodes) and a history abuse or neglect.51

Cohort Profile: The Heinz C. Prechter Longitudinal Study of Bipolar Disorder

So yeah. They are really common with bipolar and bipolar type disorders. I get them too. I started medicine for them and it helps A TON though. I couldnt believe how much it helped. Might be worth checking out for you too.

Im in this study. Its still on-going, I believe.

[neverending]

Yes I too get migrainez. They started in my early teens. Interestingly enough the visual auras and migraine headaches occur separately. I have either one or the other. The auras have decreased tremendously over the years. They headaches aren't as devastating anymore but still occur frequently. I don't find any association with my moid swings though.

Interestingly enough I have found relief through CBD tincture. Non THC type. And CBD balm.

[Zeroid]

Originally Posted by Under*Over

According to the Heinz Prechter bipolar study:

Migraine headaches were found to be more frequent among BP compared with controls (31% vs 6%; odds ratio (OR) = 3.5, 95% confidence interval (CI): 2.1–5.8), with greater risks associated with female sex, increases in measures of severity (earlier onset and greater frequency of mood episodes) and a history abuse or neglect.51

Cohort Profile: The Heinz C. Prechter Longitudinal Study of Bipolar Disorder

So yeah. They are really common with bipolar and bipolar type disorders. I get them too. I started medicine for them and it helps A TON though. I couldnt believe how much it helped. Might be worth checking out for you too.

Thanks for the link, I hadn't found that one. I am getting treatment for the migraines, Botox, physical therapy, and Emgality which is one of the new classes of prophylactic medication. I used to be on Topamax, which was before my BP diagnosis, and it helped a lot, but with the side effect of mental deterioration. I quit that when I eventually got the Lithium.

[Zeroid]

Originally Posted by Catchingthesun

I’ve had migraines ever since my late teens but now I get them almost every Saturday or a couple Saturday’s a month. I have regular meds to treat them but my psychiatrist seems to think they are mania/anxiety related due to work. Looking back at the pattern I can see that.

Thank you, it's really good to know that. It also reaffirms that I do not need a high stress job, just a busy one.

[BipolarWolf]

Yes. same here, I get them a lot. I am not taking anything to treat them. it helps to just close my eyes and lay in my bed. I often see halos and auras around things and people.

[BeyondtheRainbow]

Yes. Mine were worst around menopause but I still get a couple each month (used to be 15-25 days per month). There isn't a triptan that works with my MAOI so I have a script for vicodin for the bad ones. I rarely use it but it does help when I'm desperate. Now that I'm past the menopause ones if I can catch it with ibuproferon and a big glass of water at the very beginning I can often stop it or reduce it to something I can tolerate.

[Wild Coyote]

This is an interesting topic, for sure. There are at least several threads on this topic if anyone is interested. BirdDancer's blog has interesting entries on this same topic.

I would like to mention (once again) the work Oliver Sacks, M.D. He is now deceased; yet, he has left a lot of his research available to the general public. Just one of his books is entitled: Migraine. I have gained a much better understanding of migraine and related conditions through Dr. Sack's research.

I have had disabling migraines for years. My migraines would last up to 20 days straight until my neurologist was concerned about potential brain damage from allowing migraines to go for so long. The neurologist left a standing order at the ER, asking the ER docs to interrupt the migraine.

I cannot take the usual/new migraine meds because my auras last so long. I risk actually closing the vessels further, potentially causing a stroke.

If a migraine lasts 48-72 hours, I go to the ER, where they abort the migraine.

My whole family suffers from migraines. Migraines are often familial. Many in my family suffer hemiplegic migraines, as well as various flavors of migraine.
Hemiplegic Headaches/Migraines: Symptoms, Causes, Treatments

After years of severe and very frequent migraines, this was further investigated. I had /have an autoimmune condition called "Antiphospholipid Antibody Syndrome" (aka: APS). My antibodies were attacking my own blood and were causing increased "viscosity," which was causing micro-clotting. I had to use blood thinners for 5 years, until the antibodies had disappeared. I am still checked for the presence of the antibodies at least twice a year.

I mention this because it would be very easy for my treating physicians to attribute my migraines to most anything . I have at least a few of the "conditions" which are thought/known to be related to migraines.
It is a good thing they had looked into it further. (The blood thinner did relieve my migraines.)

We have had some in-depth discussions on the relationship of migraine to BP, to Temporal Lobe Epilepsy, etc. I hope anyone interested in this topic will look up these threads. As I have mentioned, BirdDancer's blog also addresses these topics.

I would like to thank you for starting this thread and am grateful to those participating!

[Nammu]

My migraines were so bad that when I was 9 the family doc sent me to the mayo clinic. Wasn't until I was 30 that they came out with a med that worked. Then the migraines stopped after menopause. The BP has gotten less intense too. They also looked into seizers and I did develop tonic-clinic nocturnal Sz but that went away after a few years. They say there's a link between all of those.

[Moose72]

"Most studies support that migraine is associated not only with bipolar disorder but also with major depression, panic disorder, social phobia [8, 9], drug abuse [10], suicide, and neurological and internal diseases too, for instance stroke or hypertension [11]. " 1.

"Vice versa, according to a review of literature of McIntyre et al. [12], subjects with other neurological diseases, such as epilepsy or multiple sclerosis, seem to have a higher occurrence of bipolar disorder." 2.

"There is no proven treatment regimen for migraine with comorbid bipolar disorder, so that pharmacological therapy is still a matter of trial and error. Nevertheless, some remedies seem to have effects on both of the diseases, but one must be wary of purchasing the benefit of a remedy in one disease by worsening the other." 3.

"Migraine is an important comorbid disease in bipolar patients. It not only strengthens the cause of bipolar disorder but also worsens the recurrence rate with regard to depressive episodes. Bipolar II patients have a higher susceptibility of having comorbid migraine." 4.

"Approximately 4% of the population suffers from bipolar disorder, but bipolar illness is seen with increased frequency in the migraine population.3Studies have indicated that from 7.2% to 8.6% of migraine patients fit the definition for bipolar spectrum.3,4 Conversely, several studies have indicated an increased risk for migraine in patients with bipolar spectrum disorders.5,6 One study indicated that in bipolar patients, 14.9% of the men and 34.7% of the women had a lifetime occurrence of migraine.5 Additional studies of the bipolar population resulted in a lifetime migraine prevalence of 39.8% for men and 44% for women.6" 5.

"Recognizing bipolarity in headache patients has a significant impact. When bipolar disorder is not recognized, these patients often are given antidepressants alone, with predictably poor results. While of some benefit, these medications generally are not effective for the bipolar spectrum and may trigger mania or hypomania. The presence of bipolar illness complicates the treatment of RCM. Mood stabilizers that help both conditions, such as lamotrigine or sodium valproate, are important. Atypical antipsychotics—quetiapine (Seroquel, others), olanzapine (Zyprexa, others), aripiprazole (Abilify), etc.—sometimes help both headaches and moods. Psychotherapy plays a vital role with these patients." 6.

"The most interesting finding was a substantial difference between patients with BDI and BDII, with migraine being clearly more prevalent in the BDII than in the BDI group. In our second study, 82% of the patients with BDII had migraine, compared to 27% of the patients with BDI (Figure). There is much evidence, including our own, indicating that patients with BDI and BDII represent two different nosological conditions (Coryell, 1996). Our results are similar to those of Endicott (1989), who found, among patients with major affective disorders, the highest frequency of migraine (51%) in patients having characteristics similar to patients with BDII as defined in the present study." 7.

"In two epidemiological studies, one from Zurich, Switzerland, (Merikangas et al., 1990) and one from Detroit (Breslau and Davis, 1992), a clear relationship between migraine and major affective disorders has been found (Breslau et al., 1994). In the Zurich study, people with migraine had a threefold-increased one-year prevalence of bipolar spectrum disorders (9% versus 3%), a nonsignificant increase in manic episodes and a twofold-increased prevalence of major depression (15% versus 7%)." 8.

"Several studies, both open and controlled, have shown that valproate (Depakene) has prophylactic effect in migraine, reducing the number of attacks, duration of headache and intensity of pain (Silberstein, 1996). Valproate thus has effect on the three main symptom groups in patients with migraine and comorbid affective disorders: headaches, mood instability and panic attacks (Freeman et al., 2002)." 9.

1, 2., 3., 4., https://www.hindawi.com/journals/crim/2012/389851/

5., 6. Difficult to Treat Chronic Migraine: The Bipolar Spectrum and Personality Disorders

7., 8., 9. Are Migraines and Bipolar Disorder Related? | Psychiatric Times

[Wild Coyote]

Originally Posted by Nammu

My migraines were so bad that when I was 9 the family doc sent me to the mayo clinic. Wasn't until I was 30 that they came out with a med that worked. Then the migraines stopped after menopause. The BP has gotten less intense too. They also looked into seizers and I did develop tonic-clinic nocturnal Sz but that went away after a few years. They say there's a link between all of those.

Thanks, Nammu!
I am sorry you had suffered these headaches. It had to be especially challenging as a child.

The relationship of one diagnosis to another is very interesting. I had not heard of actual tonic-clonic seizures in relationship to migraine activity; yet, it only makes sense.

It is interesting as to what is happening with the brain when a migraine occurs. I think there are likely different types of causes. Any given migraine is likely to have multi-factorial causes: Vasospasms, seizure activities, genetics, hormones, exposures to "toxins" (environmental sensitivities), reactions to sounds, lights, foods, meds, aberrant immune responses, and more.

This is all all very complex. I find it interesting. Despite all of the studying on the part of passionate neurologists, it is still a bit of a mystery.

I am glad both the migraines and BP have gotten better for you, Nammu!

[Wild Coyote]

Wow, Moose!
Food for thought.

[Moose72]

Originally Posted by Wild Coyote

Wow, Moose!
Food for thought.

Thanks for the wow. I looked this subject up several months ago! Its amazing how migraines and bipolar go together. I get bad migraines too and sometimes sumatriptan doesnt even help.

[Wild Coyote]

Originally Posted by BeyondtheRainbow

Yes. Mine were worst around menopause but I still get a couple each month (used to be 15-25 days per month). There isn't a triptan that works with my MAOI so I have a script for vicodin for the bad ones. I rarely use it but it does help when I'm desperate. Now that I'm past the menopause ones if I can catch it with ibuproferon and a big glass of water at the very beginning I can often stop it or reduce it to something I can tolerate.

It had to be very difficult to suffer migraines without relief.

I agree with you, the most efficacious approach is to catch it as early as possible and take as many measures as possible, in hopes of aborting the migraine.

I was also given pain meds for migraines, as the type of migraine I was experiencing make it dangerous to use the newer drugs. When I would go to the ER, they would give me massive amounts of morphine and an anti-nausea med. I would have to stay for several hours.

I am sorry you had to go through that, too.

[Nammu]

The mayo clinic must have concluded I had some type of seizure activities cause they gave me phenobarbital to take 3-4 times a day. After about a week or two I refused to take it anymore cause it made me feel funny and it didn't stop the migraines. My parents didn't push me on taking it.

[Wild Coyote]

Originally Posted by Nammu

The mayo clinic must have concluded I had some type of seizure activities cause they gave me phenobarbital to take 3-4 times a day. After about a week or two I refused to take it anymore cause it made me feel funny and it didn't stop the migraines. My parents didn't push me on taking it.

You were smart!

[xRavenx]

I have developed migraines within the past couple of years. I'm at risk for them when experiencing a lot of anxiety or when I'm in a bad episode. I began seeing double during a migraine, and my blood pressure dropped and was hospitalized as a result a few months back. My last migraine was a few days ago. Terrible.

[Under*Over]

Originally Posted by Moose72

Im in this study. Its still on-going, I believe.

Me too. Its an interesting study and like with this migraine and bipolar connection, well, it just proves that more and more answers ARE being found which I think is super cool.

I hope in years to come this continues.

[Zeroid]

Originally Posted by xRavenx

I have developed migraines within the past couple of years. I'm at risk for them when experiencing a lot of anxiety or when I'm in a bad episode. I began seeing double during a migraine, and my blood pressure dropped and was hospitalized as a result a few months back. My last migraine was a few days ago. Terrible.

Do you know about the new class of migraine drugs? They are the first ones designed specifically for migraines and they work really well for me. They are horrifically expensive, but the drug companies are mostly giving them out for free or very cheap until the insurance companies agree to pay for them.

[jaymoq]

I'm late to this thread, but wow- thank you OP for this. I hadn't ever really thought about them being connected. I am new to the Bipolar II diagnosis (they just classified me as major depressive for years but were confused why none of those meds worked). At any rate-- this makes a lot of sense. And holy cow- the mania link is accurate for me too.

I've had migraines since I was in the 7th grade. They are familial, but my family also has closeted mental health diagnosis so- who knows which is driving the other. I notice I get terrible migraines when I am manic- usually when I'm at the end of my mania and rolling back in to the depression. My mania always seems to reach a crescendo. I've had a migraine now for (3) days. Ugh!

Unfortunately, the migraine medications make me feel a bit loopy and as I travel a lot for work, I have learned to cope with them. Dark rooms. I wear blue-light glasses which helps my aura. Polarized lenses REALLY helps my aura- I found that out by accident. My aura gets so bad that I have lost vision in one eye for temporary lapses of time.

I know that I have physical triggers -- certain lights, smells, etc. But, maybe I am predisposed to them as well? Both my maternal and paternal sides of the family have migraines, so I was pretty well destined to struggle. But, ironically no one but me in the direct family gets them. Figures!

Just wanted to chime in and say thank you OP and those who responded with studies. I will definitely be taking a look.