Hello and welcome. Before we begin, here's my disclaimer I have a master's degree in counseling applied therapy. I am not a doctor naturopath. The purpose of this course and presentation is to convey information. It should not be interpreted as medical advice and it's not intended to diagnose, treat or cure your condition, or to be used as a substitute for advice from your physician, or other health care professionals. The methods discussed in this program are intended to support health and healing, not to replace your medical treatment.

Whether you choose conventional treatments, alternative treatments, or both. It's imperative that you work closely with your doctor or healthcare professional to properly diagnose and treat your condition. Monitor your results in progress. Even though I mentioned evidence based supplements, and medications that are proven to help with migraines, anxiety and depression, you must first discuss these options with your doctor. Please treat any supplement as cautiously as any medication. Thank you.

In this video, we're going to talk about managing migraines, depression and anxiety. And then I'll walk you through a gentle process to help you confront and deal with anger, hurt and fear that can often accompany these chronic conditions. In this video, we're going to cover some background on these comorbid conditions and some startling statistics The link is between all three conditions, natural solutions, supplements and techniques. And what four treatments yield the best results for migraine, anxiety and depression. If you have all three, I'll highlight some key things that help anxiety and depression and a couple of key things to do if you get migraines. After the key points, we'll get to video two, where we'll go over a simple and gentle process to help you confront and deal with some difficult emotions.

Anger can underlie both depression and anxiety. So we'll do that one first. Anxiety and depression are two of the most common comorbidities with migraines 10% of the normal population will experience depression at some time in their lives. That figure doubles to 20% with episodic migraine compared to the general population. It more than triples with chronic migraine, it's between 30 and 50%. As each condition worsens, the rates can go up to 80%.

Anxiety rates are similar, eight to 10% of people in the general population, and the rate doubles and triples with chronic migraine. In women, anxiety and depression have a huge overlap. So what's the link between all three conditions, higher migraine frequency, either with or without auras, co related to higher symptom scores of anxiety and depression. According to a recent study from the National Defense Medical Center in Taipei, Taiwan, scientists have established a link between the frequency of migraines and the severity of anxiety into depression in people who suffer both researchers think there may be A genetic link between the predispositions of migraines and mood disorders. Now this study does not explain why exactly these things are so closely interrelated. But it does establish these clear connections between migraine frequency, severity of anxiety and depression and poor sleep.

Just in the way that migraines and depression or anxiety are thought to influence one another. sleep quality and sleep quantity was shown to predict how often the participants got migraines. Equally. migraine frequency was predictive of how often people had trouble sleeping. So what might explain this link? All three conditions are marked by serotonin imbalances.

The researchers suggests that effective treatment to prevent migraines may reduce the symptoms of anger. And depression as well. How frequently someone gets migraines is linked to how intense their boats of anxiety and depression are. The study also found that the participants that didn't sleep well also experienced more frequent headaches. There's other current research that suggests that migraines may be made more severe by depression and anxiety and vice versa. Our brain chemistry is altered by serotonin.

Scientists think the interaction between the brainstem and a major nerve pathway may lead to migraines. We also know that serotonin levels drop during migraines, which may indicate that the hormone is involved in the headaches or in the headaches onset. serotonin imbalances are also believed to cause mood disorders like anxiety and depression. That may be why some antidepressants work for migraines because they regulate serotonin. As the CBT cognitive behavioral therapy, regulating serotonin could be key for you. There's also a spectrum to consider the degree of severity of each condition.

All three conditions can have varying degrees of intensity. Plus, you can be in different places and at different times in your life, which can also affect the different degree of severity. The closer you are to the intense and severe end of the pain or symptom scale, the more you need to seek professional help. Now it's normal and natural to worry about the next attack. Your brain is programmed to be aware and protect you from danger. And an attack is danger.

Your brain is just doing its job where the problem comes in When your thoughts spiral into the negative, escalate, and cause a vicious cycle that can also make your symptoms worse. You can feel hopeless and helpless. You can start to think that there's no hope for the future, and you can slip into suicidal thoughts. Is it too early to talk about suicide? Americans who have migraine with aura are three times more likely to attempt suicide compared to those with no migraine. Whether or not major depression is also present.

Another thing to consider is medication and suicide risk. There's some evidence that shows that anticonvulsants may contribute to the high suicide rate among migraineurs in a study published by the Journal of the American Medical Association, JAMA, nearly 300,000 people who suffer from migraines, chronic pain, bipolar disorder and epilepsy, began taking one on 13 anticonvulsants. None of the participants had any history of suicidal behavior. After approximately 180 days, 26 patients committed suicide and 801 attempted suicide. I'll just report on these two medications from that study. gabapentin which is associated with the highest highest risk of suicide is also one of the most frequently prescribed anticonvulsants for migraines at 48%.

Followed by Topiramate at 19.4%. So gabapentin Neurontin has a 40% higher risk than topamax. Top pyramid, according to this study, don't be too alarmed. These medications can be miracle drugs for those who need them and who they work for. Another recent study concluded high migraine frequency has a correlation with high suicide risk in patients who experience an aura, but not in other patients with migraine. After those alarming statistics, let's look at some natural solutions.

Natural solutions for depression. I really like Sammy, it's a dino mistiming. There's the box doctors best friend. inositol, which is in the vitamin B family, or any of the B vitamins can help be 12 affects a number of bodily functions including mood movement and exercise. Movement is essential to lift depression. natural solutions for anxiety, breathing techniques, relaxation techniques, and the supplement GABA is really helpful.

That's gamma aminobutyric acid so ga Ba, but with any natural supplements, make sure to talk with your doctor before starting anything new supplements, in my opinion are just like any other medication because they change your body's chemistry. Now I'm not a doctor or a naturopath, so check with your primary physician before taking anything new. Some supplements like St. John's wort, for example, are contraindicated, meaning they can interact unfavorably with some medications. So just make sure you check with your doctor. How do you know if you even have anxiety, your heart will start to race and your thoughts will not help, they'll be worrying about everything. Now there are many types of anxiety.

But the one that fits us migraineurs, best, in my opinion, is a generalized anxiety disorder. It's also known as ga D or Gad. It's characterized by excessive, persistent, unrealistic worry about everyday things including family work, money, health, and more whenever you worry about common symptoms of anxiety or excessive worry, fear and irritability. This can occur during and in between migraine attacks. The confusing part is anxiety can be one of your migraine symptoms, but it can also occur on its own between attacks. Do any of these thoughts sound familiar?

How long will it last this time? How many hours days or weeks? Will I be bedridden and out of commission for? When will my medication kick in? Did I take it early enough? Did I catch it in time?

Will I be able to get everything done this week? I am letting down my kids again. And how about worrying about the future? What if I lose my job? What if I never make money again? How will I survive?

Will I be able to take care of my children? Will I have to take medication for ever? Will I ever be pain free? Will I ever get rid of migraines? Will I ever be fully healed? You can see how easy it is to get stuck in a cycle of anxious thinking.

Especially You find yourself worrying about when the next migraine will hit, it can become a never ending emotional rollercoaster. So before we get to the CBT worksheet to help with this, there are several tricks, tools and coping skills you can learn. The most effective thing you can do to reduce anxiety is to learn some breathing techniques. If you're breathing in fully and especially breathing out fully through your nose, it activates the Vegas nerve in the lower parts of your lungs. This not only erodes your lungs more, but it fires up the parasympathetic nervous system. So each breath is actually a way to restore your body.

You'll hear me say this a few times, because it's really important. Here are two easy breathing techniques to help you reduce anxiety. Now first of all, it's important to take action at your first thought. My migraines are getting worse and my meds aren't working anymore. As soon as you feel the anxiety rising 10 seconds is enough to turn around the activation. Do this.

Breathe out for 10 seconds and calm down the sympathetic nervous system. then allow your lungs just fill out like a balloon, and then another long exhale for 10 seconds. This is enough to start. Repeat this for as long as you need to, and do it throughout the day to keep bringing down the activation. Don't wait till you're too stressed out. act at your earliest warning signal that your anxiety is present.

Another favorite technique of mine is from the book. This is a long title, the last best cure my question To awaken the healing parts of my brain and get back my body, my joy and my life by Donna Jackson nakazawa. She suggests the yoga pose standing mountain, and you touch your fingers to your lips gently as you might if you're saying to a small distress child. touching our lips stimulates the parasympathetic nerve fibers that line them. You can also put your hand to your chest which has an instant comforting effect, or you can put both hands over your heart. Also have a plan B in place.

Knowing you have a backup can reduce anxiety a lot. What treatments yield the best results for migraine anxiety and depression relaxation, biofeedback and CBT. Combined with the proper migraine treatment, being a medication, yield greater results, so, the four treatments that work the best number one, get the right medication or medications. Number two, learn CBT stop that negative spiral of thinking. Number three, learn stress management skills diaphragmatic breathing or guided imagery. And number four learn biofeedback.

Biofeedback training looks at the pause between your thoughts and your actions. Now, these skills are not just complementary or alternative. They have great a evidence behind them. A study was done investigating relaxation CBT and biofeedback alone. Compared to a single migraine medication alone, and their efficacy rates were about the same, but combined, they got 80% efficacy. That's a big jump.

And in recent studies with children and adolescence, to CBT and biofeedback side, far outperformed the medication side reasons for this, it calms down the nervous system, calms it down enough to reduce or avoid an attack and allows the medications to work better. Here are some key points about the links. If you have all three conditions, and you are struggling to get some form of control, I suggest just tackling one first. If you can get some improvement in one, it will affect the other ones. So say your migraine days don't reduce but some of the other Symptoms improve. Studies show that if one improves, they all improve.

So if you focus on your migraine first to get it under better control, the others will get better too. And as depression and anxiety gets a little better, the migraine can get better. I tackle the migraine first, but it's up to you which one you start with. Now, just before we end, I really urge you to also think about these five or six healthy lifestyle practices. These are basic survival skills for anyone with migraines, form routines, the migraine brain loves routine. It's the changes that affect the chemicals in our brain that gets us into trouble.

Get good quality sleep, don't oversleep or under sleep. And don't sleep in on weekends. Sorry, guys. Eat as healthy as you can, Oregon. is best but whatever you can afford really stay away from packaged products high in sugar. Sugar is a migraine trigger, and don't use artificial sweeteners they are empty calories.

I talk more about this in my migraine pain management course. Test caffeine. Caffeine is a double edged sword. It can help ward off an attack if you don't drink it every day. Or it can cause when through withdrawal. If you find that a migraine attack comes on out of nowhere, after drinking caffeine at the same time every day, it may be a trigger for you.

Soda is a common culprit, and some contain both caffeine and loads sugar. Making one or two small dietary changes can really help to alleviate your migraine attacks. Exercise. Make sure you break a sweat. Studies have now proven Exercise reduces migraines, depression and anxiety. It tackles all three so this is a win win.

So find something you love and do it regularly. routine is essential to help reduce attacks. Also, stay hydrated. drink enough water for your weight and think electrolytes. Think sodium, potassium, magnesium, there's more to hydration than just water. Find your tribe.

There are a lot of online support groups now. You can Google or check Facebook to see where you might feel like connecting to others that have the same conditions. Experiencing understanding from others is very comforting. And this connection to community can help reduce anxiety and depression and finally, learn to manage Less effectively. Everything we cover in this course will help you do that. These skills are essential.

Also, if you can take time to see a professional counselor or psychologist, these conditions are difficult on their own. Never mind having all three. So seek help and learn some skills to help you cope better in every area of your life. Counselors like myself and psychologists train their whole lives. So take advantage of that and learn some new coping skills. Your first port of call is your doctor.

Ask if you can see someone local or for free. Sometimes community centers have free counseling, and there's free hotlines and help lines with trained personnel. So please reach out now. Don't Don't let things spiral and get worse. Self Care is not selfish. It's what you need to do to help your body And remember 10 seconds will turn things around, count to 10 for that long exhale and allow that deep breath back in to help reduce some anxiety.

Remember and hold on your heart. Okay, enough talking, let's get to the process now that will help you confront and deal with some difficult emotions that can arise before, during and after an attack. I'll see you in the next video.