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ADHD and Migraines are Likely Partners



Migraines are extremely painful headaches that can include nausea and sensitivity to light or sound. These headaches often co-occur in many children, adolescents and adults affected by ADHD. One study found that men affected by ADHD were more than twice as likely to have migraines as other men, and another study in children found the severity of ADHD symptoms is in direct proportion to the frequency of migraine headaches.

Why do migraines and ADHD co-occur?

Researchers have proposed several theories about why people diagnosed with ADHD seem more likely to also have migraine headaches. Because women tend to experience migraines more often than men, some research has pointed to hormonal fluctuations. Some research has shown an association of migraine with symptoms of mood and anxiety disorders. Others suggest that the pain of the headaches may cause more distractibility and irritation, especially in children with a short attention span, or that a separate disorder underlies both conditions

Marco Antônio Arruda, MD, PhD, a pediatric neurologist at São Paulo University in Brazil, suggests that genetic factors may be at play, with stress and other stimuli affecting neurotransmitters, including dopamine. 

“When attending children with headaches,” says Dr. Arruda, “clinicians should explore school performance, absenteeism, and mental healthespecially symptoms such as inattention, hyperactivity, and impulsivityin order to make a correct diagnosis.” 

Children who have ADHD and experience migraines have greater learning and social challenges than their peers. Early diagnosis and treatment may improve school performance and the child’s wellbeing. 

Headaches versus migraines

Medications for ADHD are often an important part of treatment. Some people, though, when beginning a new medication, may experience headaches. For most people, these are mild and will soon cease as your body adjusts to the medication. If discomfort continues, it’s important to discuss with your prescriber. Medication-related headaches are typically not migraines and are usually manageable, for example, by having something small to eat just before or when taking your medication.

Migraines, in contrast, are a neurological disorder with symptoms that interfere with daily life. Most people affected by migraines have attacks once or twice a month, although some have many more. Migraines tend to occur on one side of the head, and frequently have one or more symptoms:
  • visual disturbances
  • nausea 
  • vomiting 
  • dizziness
  • extreme sensitivity to sound, light, touch and smell 
  • tingling or numbness in the extremities or face

What you can do

Migraines are often associated with specific triggers, which are events or conditions that bring on these headaches. Triggers can vary for each person, and something that triggers a migraine for one person doesn’t always trigger it for another. You may want to try avoiding, where possible, some of these common triggers:
  • A change in sleep patterns, skipping meals or fasting, dehydration, alcohol, over-exertion, exercise, stress.
  • Strong smells, fluorescent or bright lights, smoke, pollution, altitude, air pressure changes like those that occur in an airplane, motion sickness.
  • Changes in weather, including temperature or barometric pressure, humidity (both high and low), bright sunlight.
  • Changes in hormone levels during the course of a month, pregnancy, menopause, hormone replacement therapy, or use of oral contraceptives.
  • Overuse of pain medications (both over-the-counter and prescription), or side-effects from a medication.
  • Specific foods may become triggers when combined with other triggers. Common food triggers include artificial sweeteners, MSG, nitrates, fermented foods, aged cheeses, freshly baked yeast bread, alcohol, and caffeine.

Getting help for co-occurring migraines

ADHD and migraines co-occur for both children and adults, and individuals affected by both conditions are likely to have more severe ADHD symptoms than usual. It is important to work with qualified and licensed healthcare providers who can conduct an evaluation for both conditions. Keep in mind that more than one profession may be needed for these evaluations.

There are several types of professionals who typically diagnose ADHD. These include physicians—especially psychiatrists, pediatricians, and neurologists—psychologists, social workers, nurse practitioners, and other licensed counselors or therapists such as professional counselors and marriage and family therapists.

For an evaluation of migraines, a certified headache specialist or comprehensive headache center that uses a collaborative approach to treatment can work with your healthcare provider who is focused on ADHD. This allows the professionals to coordinate a treatment plan tailored to your needs.

For more information, and to find healthcare professionals:


This article appeared in ADHD Weekly on September 07, 2017.
     


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