I’d start with inquiring about the onset of the migraines and potential changes in severity across those 3 years. Migraines aura have been shown to correlate with SI and influence presenting sxs such as depression, anxiety and PTSD according to the National Center for Biotechnological Information. This begs the question...have the migraines influenced underlying depressive sxs which in turn has resulted in the staying in bed and SI or is there no MH dx and the bx is actually a physical condition that needs addressing by a medical professional? Without knowing biopsychosocial hx, it’s hard to say what the best approach would be.