By the Numbers
Male migraineurs are four times more likely than female migraineurs to have PTSD.
Veterans with migraine are twice as likely to have PTSD, depression and anxiety than those without migraine.
Source: American Academy of Neurology
“ People with migraine have a hypersensitive, hypervigilant nervous system,” he says.“ I think it’ s easier for people who have that underlying sensitive brain to end up developing PTSD.”
Conversely, stressful events will actually cause biochemical changes in the brain, and aspects of PTSD— including nightmares that disrupt sleep— make it difficult for the brain to relax. Dr. Ready says this could worsen the underlying migraine condition.
Resources for Recovery
Addressing the symptoms of PTSD can reduce related migraine pain. To help with this, Michael Ready, MD, recommends book therapy.
“ With any kind of chronic condition, the more we learn about it, the better we do,” he says. He suggests the following two reads:
The Post-Traumatic Insomnia Workbook: A Step-By-Step Program for Overcoming Sleep Problems After Trauma
By Karin Elorriaga Thompson, PhD, and C. Laurel Franklin, PhD
Brain Injury Survival Kit: 365 Tips, Tools and Tricks to Deal with Cognitive Function Loss
By Cheryle Sullivan, MD
Don’ t have time to dive into a book? Try this mobile solution created by the U. S. Department of Veteran Affairs and the Department of Defense:
PTSD Coach: This smart phone app offers PTSD treatment information, tools for tracking symptoms, tips for handling stress and links to support— all at your fingertips. You can download PTSD Coach for free from iTunes or Android Market.
In addition, mild traumatic brain injuries— the defining wound of the wars in Iraq and Afghanistan— are almost always linked to headaches and are often associated with PTSD.
it is treatable
Research has shown that people who suffer from both PTSD and migraine are more likely to have headacherelated disability, so it is important to seek treatment as soon as possible. In addition to taking traditional migraine medications, such as triptans, sufferers need to address the psychological component with therapy.“ If we treat the PTSD, the pain gets better,” Dr. Ready says.“ It doesn’ t necessarily go away, but it’ s an essential part of what we need to do.”
Certain lifestyle changes, such as exercise, improved diet and increased hydration, are also beneficial. Dr. Finkel notes that maintaining proper sleep, as well as managing the patient’ s environment, are particularly important.
“ People with PTSD may feel very uncomfortable in crowds and in an unsafe environment,” he says.“ That kind of stress can lead to more headaches.”
As researchers continue to explore the relationship between PTSD and migraine, Dr. Ready hopes their findings serve as a wake-up call for both physicians and veterans.
“ If you’ re having frequent headaches, I think it’ s important to ask,‘ Could I have PTSD with this?’” he says.“ Because if it’ s there and we don’ t treat it, chances are it will make it harder to get your headaches under control.”
For Nunnery, working with his physician, spending time at the gym and practicing tai chi have helped significantly reduce his migraine events.
“ If you have PTSD, don’ t deny it,” he says.“ It was hell until I started getting help … now I almost have a normal life again.” HW
www. headwisemag. org | National Headache Foundation 21