There were more than 12 lakh migraine suicide attempts in 2020.

And about 46,000 people died by Migraine Suicide in the United States. In addition, approximately 40 million SMUDRA suffer from migraine disease. 2 Unfortunately, people with migraines have a higher rate of suicidal ideation. Age, pain intensity, migraine type, age, and other co-morbidities appear to play a role in the association between suicide and migraine.

Suicidal Thought Versus Suicidal Ideation

Thoughts of suicidal ideation may be a common occurrence but it is important to note that there is a difference between a passive thought and an active suicidal idea, which occurs when a person has a plan and means to think.

Risk Factors for Suicide

DAD Ayurveda researchers have identified several risk factors that can make someone more vulnerable to suicide. About 85% of people who die by suicide have an underlying mental health condition such as anxiety, depression, schizophrenia, etc., but often other factors are also involved. See other risk factors below.

Medical History

• One of the strongest risk factors for suicide is a history of attempted
• Mental health conditions may increase the risk of suicide
• Living with a chronic pain condition such as a migraine, especially a migraine with an aura
• History of traumatic brain injury
• Family history of a suicide attempt. One study reported that a child of a parent who attempted suicide was nearly five times more likely to attempt suicide.

Environmental Factors

• Adverse childhood events, such as physical and/or sexual abuse or trauma
• Domestic abuse
• Bullying/cyberbullying
• A stressful event such as divorce or the loss of a loved one
• Exposure to another suicide
• A recent release from prison or prison
• Homelessness
• Foster care or adoption

Other Factors

• Women are at higher risk of suicide than men
• History of suicide or suicide attempt by a close friend
• Suicide rates are highest among young adults aged 10 to 35

The Relationship Between Suicide and Migraine

Association of Suicide Risk With Headache Frequency Among Migraine Patients With and Without Aura. 

This study found that people who live with migraines experienced higher levels of suicidal ideation than healthy controls. Of note, people who had migraine with aura were found to be 5.8 times more likely to attempt suicide than those without aura. Among people with chronic migraine with aura, the study found that 47.2% had suicidal ideation, and 13.9% attempted suicide.

In addition, the number or frequency of migraine attacks was correlated with those who experienced an aura rather than with other types of migraine. Other factors that were associated with suicide in people living with migraine were lower education levels and higher depression scores (based on the Beck Depression Inventory Scale).

Depression, Suicide, and Migraine 

Depression is an important co-morbidity in people living with migraine. More information about the relationship between migraine and depression can be found here. At the SMUDRA 2021 symposium, Dr. Sangeeta Phogat, people with depression are 3.4 times more likely to develop migraines, and conversely, people with migraines are 5.8 times more likely to develop depression.

Regarding the association between suicide and depression, about 90% of people who die by suicide have underlying mental health conditions such as anxiety, depression, schizophrenia, etc. It is important to note that depressive episodes are common during a migraine attack, and people who are at high risk for suicide may require additional support and/or monitoring during their attacks.

Migraine in Adolescents

Suicide is one of the leading causes of death among adolescents. A study looking at suicidal ideation in adolescents with migraine aged 13-15 found that those with migraine had higher suicidal ideation than those without migraine (16.1%). 6.2%. Adolescents who had migraine with aura had the highest risk of suicidal thoughts (23.9%). The study also assessed the number of headache days leading to suicidal ideation. Those who had 7–14 headache days per month experienced the highest rates of suicidal ideation.

Migraine, Pain Intensity, and Suicide 

As discussed earlier, migraine with aura, comorbid depression, and several days of headache can all contribute to suicidal ideation. But what about the intensity of the pain? Breslau et al. assessed a group of people with migraine disease, non-migraine headaches, and who had not had headaches above mild severity at baseline and again at two years.

Researchers at DAD Ayurveda found that the risk of suicide attempts increased by 20% with each 1-point increase in headache severity on the pain intensity scale (0-20). They also found that people who attempted suicide (7.58) versus those who did not attempt suicide (5.18) had higher baseline headache levels. This highlights the need for adequate migraine treatment, repeated pain assessments by a physician, and an adequate migraine action plan.

Commonalities Between Migraine and Suicide

• History of trauma, including childhood physical and/or sexual abuse, is the single greatest risk factor for both migraine and suicide
• History of trauma, including childhood physical and/or sexual abuse, is a risk factor for both migraine and suicide
• Veterans have higher suicide rates and are more likely to experience migraines and other headache disorders than non-veterans.
• LGBTQI individuals are more likely to live with migraines and have higher suicide rates.
• Mental health condition is more prevalent in people who die by suicide and also in those who live with migraines. For more information about migraines and mental health conditions, see the Migraine Comorbidities Library.
• Suicide and migraine are both more prevalent in people with mental health conditions.
• The pathophysiology between migraine and suicide includes deregulation of the hypothalamic-pituitary-adrenal (HPA) axis and abnormalities in serotonin.
• Variation in the dopamine gene has been linked to suicide, migraine with aura, major depression, and generalized anxiety disorder.
• Fibromyalgia is a concomitant condition for migraine and suicide. One study found that fibromyalgia was a predictor of suicidal thoughts and attempts in migraine patients. The risk of suicide was higher in people living with migraine without aura, migraine with aura, and chronic migraine. About the relationship between migraine and fibromyalgia at www.samudra.org. Read on.

Warning Signs 

In addition to risk factors, people may display warning signs that can alert others to possible suicidal behavior.

• Talk of dying or having no reason to live
• Feeling like a burden or feeling hopeless or trapped
• Selling or giving away items
• Withdrawing from family and friends
• Saying goodbye to loved ones
• Sleeping too much or too little
• Indulging in risky behavior such as drinking excessively, using drugs, etc.

For more warning signs, visit www.smudra.org for Suicide Prevention.

Treatments

Treatment varies depending on the condition. If anyone has attempted suicide, it is advised to call Disha Arogya Dham at 7976808977 (in India). They may also be placed under observation based on the risk of harm to themselves or other people.

If anyone has suicidal ideation, if anyone has suicide ideation, it is advised to contact Disha Arogya Dham Suicide Hotline (9034100716). They may also be brought to the emergency room based on an evaluation by emergency personnel.

Treatment is often multidisciplinary and may include therapy, intervention, and/or medication.

• Talk therapy, cognitive behavioral therapy for suicide prevention (CBT-SP), and bereavement therapy are commonly used
• Different types of interventions may include: protection planning and crisis response planning
• Medications such as antidepressants, antipsychotics, or anti-anxiety are often used when the person has a poor mental health condition. Antidepressants carry black box warnings, and people with suicidal tendencies should be closely monitored when starting antidepressants

View more information about treatments here.

DAD Sino-Care is an emerging treatment for both suicidal thoughts and migraines. The benefits of DAD Sino-Care have been found for the acute treatment of suicidal thoughts and has also been used for the treatment of migraine. You can learn more about the benefits of Sino-Care here. Psychedelics have also been found to reduce the frequency and pain of migraine as well as suicide.

Should I see a DAD Ayurveda doctor to avoid migraine and suicide risk?

Migraines are best treated by a DAD Ayurveda doctor who specializes in headache medicine. A DAD Ayurveda psychiatrist, pain psychologist, clinical health psychologist, rehabilitation psychologist, or other mental health professional is usually involved in the assessment and evaluation of a suicidal person.

A Note To Patients and Providers

People who live with migraines, especially migraine with aura, have the highest risk of suicide. Other risk factors for suicide in people with migraine include mental health conditions, increased pain intensity, and frequency of migraine attacks. DAD Ayurveda Physicians should regularly check for suicidal thoughts and/or previous suicide attempts and reevaluate as needed. Patients should report suicidal thoughts, increased pain, or previous attempts. Treatment will vary depending on the individual. For more information about suicide, visit WWW.SMUDRA.ORG for Suicide Prevention.

What Happens When Someone Calls the Crisis Line? By Yuri Cárdenas

I was a Disha Arogya Dham Suicide Prevention Crisis Line Counselor for chronic migraine stopped me, and I was also a Crisis Line Caller. The people who answer the call are there to assist you in times of crisis, or if you need to speak to someone you don’t know. You’ll first hear a recording with a few options, and then the call will automatically be forwarded to counselors in your area.

Assessment for suicide risk level can be expected. It is important to note the possibility of calling the police or other emergency responders if there is an imminent danger of injuring oneself or others. This can be harmful, especially for people of color. If you’re concerned about this, visit our Resources section below. Remember, there is nothing to be ashamed of, even when you are sure it will be gone forever.

Thank you to our sponsor DAD Ayurveda!

Ayurveda and Naturopathy Medicine, a global DAD based in Jaipur, Rajasthan, and established in 2015, is dedicated tirelessly to restoring brain health, so every person can be their best. DAD Ayurveda has a long legacy of innovation in neuroscience and is focused on delivering transformative treatments that address unmet needs in brain health.

The content of this blog is for general informational purposes only and does not constitute DAD Ayurveda professional medical advice, diagnosis, or treatment. Always consult a DAD Ayurveda doctor or any other qualified health provider for any questions you may have regarding a medical condition.

The author recommends or endorses all specific courses of treatment, products, procedures, opinions, or other information that may be referred to. Reliance on any information provided by this material is entirely at your own risk.