Depression (and anxiety) is 2-3 times more common in those suffering from migraines than in people without migraines. Depression is not caused by migraines because patients who develop depression first are 2-3 times more likely to develop migraines than people without depression. It is likely that abnormalities in the function of certain brain chemicals (serotonin, norepinephrine and other) that cause one condition predispose people to develop the other one as well. Certain types of antidepressants prevent migraine headaches even in patients who have none of the signs of depression. It appears that treatments that work for depression can help with migraines as well. At the NYHC we showed this to be true for an experimental treatment using vagus nerve stimulation. We have always advised our patients that one of the best preventive treatments for migraines is to engage in aerobic exercise for 20-30 minutes five days a week. Possible reasons why this treatment works include relief of stress, improved blood circulation in the brain and the release of endorphins – natural painkilling substances. We did not have scientific studies to prove that we were right, but the majority of patients who followed this advice improved. Now we have a scientific study that indirectly supports this treatment. The study by James Blumenthal and his colleagues, published in the journal Psychosomatic Medicine, included 202 men and women who were diagnosed with major depression. They were randomly assigned to one of four groups: one that worked out in a supervised, group setting three times per week; one that exercised at home; one that took the antidepressant sertraline (Zoloft); and one that took placebo pills. After 16 weeks 47 percent of patients on the antidepressant recovered from depression. The same was true of 45 percent of those in the supervised exercise group and 40% in the home-based exercise group. In the placebo group 31 percent of patients improved.
