What do Depression, Anxiety, Chronic Fatigue Syndrome, and Migraine have in common?

I am a recovered migraineur and I regularly write about the cause of migraines, their ill effects, and how to prevent and treat migraines. While anxiety can be part of the migraine experience, depression and chronic fatigue are not usually connected to migraines. For me depression and chronic fatigue seemed to be a separate set of conditions, sharing no similarities with migraines at all. That was until I bumped into an article in the Scientific American “I Suddenly Feel Calm” (Lonzano and Mayberg) and another one in the news online. Since then I have searched through many journal articles, online posts, etc., to find possible connections among migraines, depression and chronic fatigue. I found both pro and con arguments that seem valid. However, all articles, including those finding that salt helps to treat these conditions, and those that describe experiments with deep brain stimulation (DBS) techniques, miss a very relevant point of connection. In this article, I intend to connect the dots for you.

Salt and Migraines

I would like to begin by explaining a bit about another set of important dots I connected first that lead me to the establishment of a protocol for complete migraine prevention and treatment without medications. This is informative here for connecting depression and chronic fatigue to the same causes as migraine. In summary: the pain of migraine is a symptom of an underlying condition that I call  hyper-sensitive sensory organs (heightened sensitivity to odors, light, touch, sound, etc.,) caused by energy depleted cells. A substance required, but often missing, for additional energy production is salt.

Depolarized brain regions (cortical depressions) can be a result of salt depletion. Salt is necessary for ion channel functioning, required to polarize all regions of the brain. Thus, my migraine group members and I have been able to prevent and treat our migraines simply by eating salt as part of a hydration protocol. The migraine pain itself is created by the actions of the healthy polarized brain regions as they send waves of electric signals (cortical spreading) to wake up the depolarized regions. This is similar to how we try to shock life back into the heart of a heart attack victim. A research team viewing cortical spreading in the scanner, while people were having either migraines or seizures, found that when the cortical spreading is fast it leads to a seizure and when it is slow it triggers a migraine This suggests that migraines and seizures are related in some way.

We know that many migraineurs suffer with anxiety and many more also are depressed and have chronic fatigue, can salt deficiency be related to those symptoms as well?

Cortical Deporalization and Depression

Researchers using fMRI found that those with clinical depression have a “black inactive brain region” deep inside the brain. This inactivity was due to permanent depolarized state so they did what we do for heart attacks: zapping that region by an electrical current in a difficult way. They surgically opened the scull and stimulated the depolarized region by electricity of various strengths to awaken it. The person undergoing this surgery is awake since it is painless—there are no pain sensors inside the brain. The person would then be able to explain how she or he felt and the depression lifted as long as the electrical stimulation was active. Similarity point one: depolarized region exists in both migraine and depression and appear to cause the respective either pain or depression, respectively.  Point two: electrically stimulating regions that are depolarized alleviate pain in migraine for just about everyone and alleviated depression for clinically depressed people in the experiments. This seems logical: the cause appears to be the same only in different regions. This also explains why some migraineurs sometimes get a migraine with depression and sometimes they do not. It is possible that the regions depolarized may be capable of initiating both migraine pain and also depression, depending on location. This implies that the location of migraines is important and this recognition should help us lead to a proper treatment, and it is not likely to have anything to do with antidepressants.

I don’t know if you can see the connection clearly here so let me put it in a different way.

Migraines are caused by depolarized zones.

Add salt => polarization => migraine gone.

Depression is caused by depolarized zone.

Add salt => polarization => depression gone?

This has not been tested scientifically but informally I can state that in the current membership of my Facebook migraine group of over 1000 migraineurs, most with anxiety, some with depression, chronic fatigue and also fibromyalgia, an overwhelming majority uses the salt protocol very successfully to prevent and stop migraines and none remains depressed or experiences chronic fatigue after the protocol. Of course I do not know if they were clinically depressed since that has not been the focus of the group. But if the problem is a depolarized region in the brain that responds to salt as the polarizing agent and if that is in fact the cause of depression, why not try salt for the treatment of depression?

This concept is further strengthened by the news article’s distinction between five different types of clinical depressions of which migraineurs share a lot with the 4th form: “Low-Folate Depression.” It seems that this group of depressed people, similarly to most migraineurs, is low in B-12 and often need anxiety medications—benzodiazepines with long half-life appear to be the most beneficial (lacking B-12 can often mask folate B-9 deficiency).  People receiving SSRI with low folate tend to become violent. Could this form of depression be similar to migraines?  Just as SSRIs don’t work for migraines and they also don’t work for this kind of depression that represents 20% of all depression cases, would that mean that this type of depression may be helped by salt the way migraine is?

Chronic Fatigue and Migraine: Is There a Connection?

Chronic Fatigue Syndrome (CFS) falls straight into the category of not having enough polarization.  It affects people who aren’t necessarily migraineurs— they may not have the gene for hyper sensory sensitivity—they need salt to achieve proper polarization at a different level than what the cookie-cutter salt recommendation of the USDA advises. The USDA recommends a moving target sodium level of anywhere between 1300 mg to 2700 mg per person. A 1951 study (the only one I could find measuring this factor) found that migraineurs empty 50% more sodium in their urine than non-migraineurs; they also noted that migraineurs were “busy brain” people, which is equivalent to hyper sensory organ sensitivity. Thus migraineurs need 50% more sodium if they excrete 50% more in order to keep up with their busy brains.

Migraine and Anxiety

Now let’s talk about anxiety. Nearly 100% of migraineurs have anxiety problems likely related to the initial hyper-sensitivity of the sensory organs perceiving danger and causing anxiety. Such hyper-sensory organ sensitivity provided valuable benefits that saved lives in our evolution. Smelling the lion in the bush from 2 miles instead of 2 feet has definite advantages—I have this sensitivity, so I know. This sensitivity comes with anxiety for a good reason! Anxiety is a normal part of our life to save us from danger. Our city life reformulated anxiety into a burden, just as it did with our hyper sensitivity. Because we do not run away from the lion in the bush we end up with IBS, anxiety syndrome, RLS, and several other connected conditions as a result of not expending all that adrenalin that builds up. It is hard to envision that salt would have anything to do with all this but I think it does. Let me explain.

With anxiety comes the release of adrenaline. Adrenaline initiates a number of brain activities. To fuel this increased activity, our brain needs a lot of energy. When someone is salt deficient, the ion channels that open and close the gates to cells and neurons, allowing the activity of these cells to continue to exchange nutrients, are impaired. Fuel sources become more limited and cell function declines, resulting in migraines for many people. With anxiety a hyper sensory organ brain uses more salt for the extra polarization needed to respond to the environment. Not having enough salt, thus may mediate the perceived sense of anxiety. Anxiety experienced by migraineurs may be the result of salt depletion by sensory organ hyper use suggesting that a common thread among migraines, chronic fatigue syndrome, depression, and anxiety is the presence of salt depletion in certain brain areas.

Why Salt?

While we may or may not understand exactly how most medicines work, we know precisely what salt does. It is essential to our cells’ ionic balance and the maintenance of proper action-potential for creating electrically charged active transport systems that control what can move into and out from our cells. Salt is essential to polarize cells and to keep balance. If there is no depolarization in any part of the brain, there is no migraine, there is perhaps no depression (more research is needed on that) and perhaps no anxiety or chronic fatigue either!

I believe that the importance of salt in health has grossly been underestimated.  Without salt we die, since no cell can function. The studies finding depolarized regions in the brain hint at the positive effects of salt use. Let’s go after depression, chronic fatigue, and anxiety now.

Sources:

Probing and regulating dysfunctional circuits using deep brain stimulation. Lozano AM1, Lipsman N. Neuron. 2013 Feb 6;77(3):406-24.

Salt craving: The psychobiology of pathogenic sodium intake Michael J. Morris*, Elisa S. Na*, and Alan Kim Johnson Physiol Behav. 2008 August 6; 94(5): 709–721

Augmentation of antidepressants with atypical antipsychotic medications for treatment-resistant major depressive disorder: a meta-analysis. Papakostas G I, Shelton R C, Smith J, Fava M. Journal of Clinical Psychiatry 2007; 68(6): 826-831

Deep brain stimulation for treatment-resistant depression. Taghva AS , Malone DA, Rezai AR. World Neurosurg. 2013 Sep-Oct;80(3-4):S27.e17-24. doi: 10.1016/j.wneu.2012.10.068. Epub 2012 Oct 27.

Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterol, and triglyceride. Graudal NA , Hubeck-Graudal T, Jurgens G. Cochrane Database Syst Rev. 2011 Nov 9;(11):CD004022.

A multicenter pilot study of subcallosal cingulate area deep brain stimulation for treatment-resistant depression. Lozano, M.D., Ph.D., F.R.C.S.C., et al., J Neurosurg 116:315–322, 2012

Brain electrodes fix depression long term. Alison Abbott Nature doi:10.1038/nature.2012.9727

The Brain Reward Circuitry in Mood Disorders. Scott J. Russo and Eric J. Nestler. Nat Rev Neurosci. 2013 September ; 14(9)

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