Tricia Stream was 15 when she got her first migraine.
"It felt like someone was tightening a C-clamp on my head and banging my temples with a hammer," said Stream, now 31, who lives in San Jose, Calif.
As Stream got older, her migraines became more intense and more frequent. By her junior year of college, she was getting them every other day. And they were getting her down.
"I just wanted to lie in a dark room and not talk to anyone," said Stream, describing the extreme aversion to light and sound and debilitating pain that would send her into fetal position. "I became very much withdrawn and wasn't really eating. That's when my roommate said, 'You need to talk to someone.'"
Stream talked to a doctor who diagnosed her with depression, a mood disorder often linked to migraines. According to a new study, women with a history of migraines are up to 41 percent more likely to develop depression than their migraine-free counterparts.
"Our study shows that migraine is a potential risk factor for depression," said study author Dr. Tobias Kurth, a neuroepidemiologist at Brigham and Women's Hospital. "If you have a chronic intermittent pain condition, you may be more likely to develop depressive symptoms or even depression because you're so bothered by the pain. And it's also possible the conditions share similar pathophysiological features in the brain."
The study followed 36,154 women, 6,456 of whom had a history of migraines. Over an average 14 years, 3,971 women developed depression -- a diagnosis much more common among migraine sufferers. Kurth and colleagues will present their results in April at the American Academy of Neurology's 64th Annual Meeting in New Orleans.
Dr. Joel Saper, director of the Michigan Headache and Neurological Institute, said the study confirms a long-suspected link between migraines and depression.
"They can intermingle with each other, and they can masquerade each other," said Saper, adding that both conditions have genetic roots. "And having one makes the other one worse."
Previous studies have found people with depression are more likely to get migraines, suggesting the risk goes both ways.
"It emphasizes the importance of treating both conditions at the same time," said Saper. "Sometimes we can treat both with the same medication."
When Stream started taking Zoloft for her depression, she was delighted to find the selective serotonin reuptake inhibitor also reduced the frequency of her migraines.
"I get them maybe every other month, or even every three months now," said Stream, whose depressive symptoms have also waned.
Five years ago, Stream tried to wean herself off Zoloft.
"It did not go well," she said. "I started to get sick and very dizzy, and my migraines came back. My doctor said, 'Nope, sorry. You're a lifer.'"
Migraine and depression are more common in women than in men, which Saper attributes to fluctuations in estrogen.
"Estrogen makes both of these worse," he said, describing the headaches and mood changes often triggered by the menstrual cycle. "Women are more prone to depression and more prone to migraines, and women who take oral contraceptives are often worse off."
Stream said her migraines were worse when she was on the pill, and stress was the biggest trigger.
Although she still gets the odd migraine, and "they still suck," Stream is a happy working mother of healthy twin boys, who were born three months premature in 2010.
"Talk about a stress trigger for a migraine," she said.