Migraine and Mental Health: The Invisible Battle

There is a part of living with a chronic illness that isn’t talked about nearly enough—the toll it takes on your mental health.

Scroll through social media long enough and you’ll see psychologists talking about “mind over matter.” Podcasters insisting that if you just think more positively, your body will follow. As if mindset alone can override disease.

Migraine is an invisible disease. So are mental health struggles.

Someone might be laughing on the outside while internally bargaining with their own brain—How do I stop the pain? How long will this attack last? What’s the cost of missing another day of work?

Migraine doesn’t just hurt. It exhausts. It forces you to fight a battle no one else can see, while still being expected to show up, perform, and keep going as if nothing is wrong.

Migraine enters your life and turns it upside down and somehow, the world still expects you to carry on.

Recently, migraine disease came up on a popular mental health podcast hosted by Mel Robbins, featuring Dr. Alia Crum. Migraine was discussed through the familiar lens of mindset and positivity.

Now, is Mel Robbins an expert in migraine disease? No.
Is Dr. Alia Crum a migraine specialist? No.

Yet the underlying message was familiar and frustrating: we just need to think more positively.

So let’s be clear.

If positive thinking cured migraine, none of us would still be here.

Migraine is the second leading cause of global disability worldwide and people with migraine are two to ten times more likely to experience anxiety and depression.

That isn’t a coincidence.

So why does migraine so deeply impact mental health and why is mindset alone not the answer?

Let’s talk about it.

Before we talk about coping tools, mindset, or mental health strategies, we need to clear something up:

Migraine does not happen because someone isn’t thinking positively enough.

Migraine is a neurological disease. It involves changes in brain chemistry, altered pain processing, and a nervous system that is more sensitive to stimulation and stress. Many of the same systems involved in migraine are also involved in mood regulation—things like serotonin, dopamine, and how the brain responds to threat and uncertainty.

That overlap matters.

When your brain is already wired to be more reactive to light, sound, hormones, sleep changes, and stress, it doesn’t just affect pain. It affects how safe your body feels.

And when the nervous system doesn’t feel safe, anxiety and depression are far more likely to follow.

This is one reason people with migraine are two to ten times more likely to experience anxiety or depression compared to the general population.

Migraine brains live under constant neurological strain.

When your nervous system lives in a near-constant state of alert, anxiety and depression often become familiar companions.

It can sound like:

How long is this attack going to last?
Why don’t medications ever work for me?
Is my life always going to look like this?

Your body isn’t just fighting physically, it’s fighting mentally. It’s incredibly hard to live with a disease where you can do everything “right” and still have no control.

When I was 23, I experienced one of the darkest periods of my life. I was battling severe depression and suicidal thoughts.

Why? Because more than 50 medications had failed me. I was on headache specialist number six and felt like I was getting nowhere. Every day felt like ten steps backward. I couldn’t see a light at the end of the tunnel because it genuinely didn’t feel like there was one.

I felt alone.
I felt like a burden.
I felt like a failure.
I felt an overwhelming level of hopelessness.

Did I logically understand that it wasn’t my fault the medications weren’t working? Yes. But logic doesn’t matter much to a brain that is suffering.

Around this time, I was also diagnosed with Pure OCD (a form of OCD driven by intrusive thoughts rather than visible compulsions). If living with OCD has taught me anything, it’s that logic doesn’t always exist when your brain is in distress.

I knew I wasn’t a failure but that didn’t stop me from feeling like one.

Two things can be true at the same time: acceptance and sadness. I accepted that I wasn’t going to return to episodic migraine.

That didn’t mean I wasn’t grieving.

Comments like: “It could be worse.” “At least it’s not ___.” “You just have to stay strong.”

On the surface, these phrases may sound reassuring. But when you’re already struggling, they can land very differently.

Illness isn’t a competition. Pain doesn’t become smaller just because someone else is suffering too.

What people often don’t realize is that when someone is in a dark place, words carry extra weight. What might feel like encouragement to one person can feel like dismissal to another.

During one of the hardest periods of my life, a doctor once told me, “I have patients who are worse, and they’re doing just fine.”

I wanted to disappear after that appointment. I felt ashamed. Weak. Like a failure.

Instead of feeling supported, I walked away believing that my suffering wasn’t valid, that I was somehow not handling this disease the way I should be.

And that belief pushed me deeper into depression.

After years of being told what should help, I’ve learned that real support looks very different from one-size-fits-all advice.

I don’t believe there is one “right” way in managing migraine and mental health. Only you can determine what helps you because you are the expert on your own body.

What I do believe is this: migraine and mental health deserve equal care and equal priority.

The hard part is that when you’re stuck in survival mode, you often have to choose what you can prioritize.

This still happens to me.

There are times when I prioritize surviving and deprioritize my mental health management because I’m hanging on by a thread. Weeks later, my OCD spirals. I don’t always notice my mental health deteriorating until I’m already overwhelmed, lying on the floor, trying to piece myself back together.

In those moments, I have to find the strength to slowly rebuild routines that support my mental health again. This is honestly so hard to do. Getting back into a routine while feeling terrible is not easy. I know that it is important but when you are running on empty, it is hard to prioritize. 

Mental health care is not one-size-fits-all. What helps one person may not help another and that’s okay. These are simply some of the tools that have helped me. I want to be clear before I share them: none of these fix migraine or eliminate my mental health struggles. They’re not cures. They’re management tools. They’re what help me stay afloat in a body and brain that are often unpredictable.

Therapy
Therapy has been one of the few places where I don’t have to minimize what I’m carrying. Migraine and OCD feed off uncertainty, and having a space to say the scary thoughts out loud without being judged or rushed, has mattered more than I can explain. It took me a long time to find the right therapist. I went through several before I found someone I felt safe with and that I got along with. I use remote therapy because my bad days are unpredictable, and knowing I don’t have to leave the house when things are rough makes it possible for me to stay consistent.

Here are some remote therapy options: Grow Therapy (I use this one), Talkspace

If exercise or movement is currently a trigger for you, you’re not broken and you’re not doing it wrong. Check out this blog post explaining why this happens and how to approach movement safely with migraine.

Reading
Reading has been one of the most reliable tools for my OCD. When my brain is loud and stuck on loops of intrusive thoughts, reading gives me somewhere else to put my attention. It’s one of the only things that consistently quiets my mind. I know reading can be triggering for some people with migraine, so audiobooks can be a gentler option but for me, books have been an escape when my own head feels like too much. Here is my list of 5-star books!

Support Groups
Support groups have carried me through some of my hardest seasons with migraine. They aren’t therapy but they offer something that can be just as powerful: being understood without having to explain or justify your experience.

There’s a different kind of relief that comes from sitting in a space where people already get it. Where you don’t have to translate your pain, minimize your symptoms, or prove that what you’re living with is real.

It took me a few tries to find the right group, and that’s completely normal. Not every group will be the right fit. For me, the right group is one where I leave feeling lighter—not fixed, not cured, but less alone.

If you’re looking for support groups, The Migraine Network offers groups, and I also recommend looking into Miles for Migraine and the U.S. Pain Foundation.

Migraine doesn’t just affect the body—it reshapes how you move through the world, how safe your nervous system feels, and how heavy each day can become.

Struggling mentally while living with migraine is not a personal failure. It’s not a lack of strength. And it’s not something you can think your way out of.

When a disease is unpredictable, painful, and invisible, it makes sense that anxiety, depression, grief, and fear can follow. That doesn’t mean you’re broken—it means you’re human.

You deserve support that acknowledges the full weight of what migraine asks of you. Care that holds both your physical pain and your mental health with equal importance. Spaces where you don’t have to explain, minimize, or pretend you’re okay.

If you’re in a hard season right now, I want you to know this: you are not alone in this. Many of us are quietly carrying the same invisible load.

Migraine may shape our lives but it does not define our worth. And you deserve compassion, understanding, and care every step of the way.