The Development and Impact of Anxiety With Migraines: A Narrative Review

Migraine is a chronic, disabling neurological disorder characterized by recurrent episodes of headache. Psychiatric disorders have been reported to arise due to a patient's physical and emotional stress caused by migraine episodes, with anxiety disorders being one of the most commonly associated psychiatric disorder with migraine. This association poses the question of similar or shared pathogenesis between the two disorders and raises a concern for the diagnosis and management of situations when these disorders present together. In this review, we discuss the possible shared mechanism for the development of anxiety disorders in the presence of migraine, such as the vascular, nervous, and genetic factors that might hold the key to their association. We also discuss the number of clinical features shared by these conditions and provide evidence for the higher degree of association between these conditions. A focused evaluation of anxiety disorders in migraine might benefit patients with earlier diagnoses and improve their quality of life with effective pharmacotherapy and psychotherapy. This review also emphasizes the importance of preventing future migraine episodes with effective prophylactic medications to reduce the risk of developing anxiety disorders, and the need to discuss the medical and psychiatric management of anxiety disorders in patients suffering from migraines on an acute and long-term basis. ​​​​​​