I’ve since been through the stages of anger and resentment, sadness and self-pity. Now, in my 40s, I’ve finally arrived at acceptance. Migraines are a part of who I am, a biological marker I must wear — not with pride, exactly, but with acquiescence. Instead of popping pills — which only precipitated more “rebound” headaches — I have shifted to a preemptive approach. I’ve learned that, taken together, certain lifestyle tweaks in the following areas can mean the difference between weekly and more sporadic attacks.
Light. While the majority of people who suffer from migraines are sensitive to light (“photophobia”) during an attack, bright light or glare can also trigger a headache. At the risk of looking like a diva, I wear sunglasses 365 days a year, even on overcast days.
Diet. There’s no standardized anti-migraine diet. The usual suspects for triggering migraines include aged cheese, processed meats, additives such as monosodium glutamate and aspartame, and even chocolate. (The jury is still out on caffeine. Though a well-timed cup of joe may stave off a migraine, too many cups could spark one.) In addition to avoiding certain foods, I’ve learned it’s important not to skip or delay meals to avoid drops in blood sugar.
Sleep. Too much or too little sleep both have the potential to bring on a migraine. While the optimal amount of sleep varies from person to person, several studies have indicated that poor sleep habits increase the frequency and intensity of migraines. Since I need more sleep than the average adult, not getting enough shut-eye is a guaranteed trigger.
Alcohol. The authors of “Understanding Your Migraines” recommend drinking in moderation and staying hydrated. “Dark” alcohol is thought to be more triggering than, say, white wine, beer and clear liquors. I personally cannot touch a drop of red wine, yet I am usually able to tolerate a glass of riesling when paired with soda.
Weather. Changes in temperature and barometric weather systems can trigger migraines, and studies also have shown a correlation between humidity and migraines. I keep a close eye on the forecast. On particularly humid or stormy days, I can feel the pressure in my head and make a point of staying indoors (even, sadly, on hot summer days).
Stress. When it comes to managing stress, there’s no one-size-fits-all solution. Whether it’s yoga, a massage or hypnotherapy, anything that calms the body and mind is helpful. There is promising evidence that mindfulness-based interventions help prevent migraines. In addition to meditation, I consciously avoid overscheduling by blocking out a couple “recovery” days following a busy period.
Exercise. Various studies have indicated exercise can reduce the frequency and severity of migraines. It makes sense, given that exercise (including sex!) boosts endorphins, our body’s natural painkillers. However, exercise that is too vigorous may have the opposite effect, possibly because it increases blood pressure. Experts recommend warming up thoroughly and drinking plenty of water. Though I enjoy running, I need to take it easy because it can sometimes spark a migraine.
Hormones. With three times as many women affected as men, migraines have suspected links to fluctuating hormonal activity. (Research indicates the ratio of testosterone to estrogen may be lower in men with migraines.) I track my periods carefully, knowing I typically suffer menstrual migraines two to three days before and after my period. Experts recommend keeping a migraine diary to establish patterns and to inform possible treatment, such as the use of oral contraceptives. While migraines in women may worsen in perimenopause, they tend to drop off during pregnancy and menopause.
Though I know other people have had success with them, supplements and alternative therapies haven’t helped me enough to become part of my regimen. Valerian, coenzyme Q10, riboflavin and even marijuana are just some of the many non-pharmaceuticals thought to prevent migraine. While some studies have reported low levels of vitamin B12 and magnesium in people who get migraines, the effect of supplements is largely unsubstantiated, and I didn’t notice any improvement when taking riboflavin. Migraine sufferers should take caution when using herbal treatments such as butterbur and feverfew due to potential side effects and interactions with some medications.
There’s also little hard science to back up the efficacy of alternative therapies such as acupuncture, homeopathy and biofeedback, or experimental treatments such as electrical and magnetic stimulation devices, which are now approved by the Food and Drug Administration. In my most desperate moments, I sought out some alternative therapies. Though I had an adverse reaction to acupuncture, homeopathy seemed to lessen the intensity and frequency of my attacks — for a while, at least.
Some days, in my ongoing war against migraines, I win. Some days, I don’t. Through it all, I am trying to be gentle with myself. If my adopted lifestyle makes me a bit of a bore, so be it. Migraines are simply part of my reality, and by learning to accept the limitations of this chronic illness, I’m actually lessening its grip. (The first step is admitting that migraines are a chronic illness.) Migraines will probably always affect how I live, but I will not allow them to completely hijack my life.