The Migraine Brain

by Bernstein, Carolyn; McArdle, Elaine

  Ignoring your health doesn’t make sense timewise, either. Taking care of yourself so you get fewer migraines can actually give you back hours of your life.

  Exchange sick time from a migraine for exercise and more sleep, which prevent migraines.

  How? Trade in your sick hours from migraine for wellness hours that you spend on staying healthy, so you avoid migraine attacks. You’ll come out ahead. Look at this example:

  For migraine prevention, you need two and a half hours of exercise a week (half an hour a day, five times a week) and eight hours of sleep a night. Let’s say that right now, you get no exercise and you sleep six hours a night. You get a bad migraine once a week that knocks you out of commission for an entire day.

  By adding two and a half hours of exercise a week into your life, and two more hours of sleep each night, you’re tacking sixteen and a half hours into your weekly schedule. Where will you find the time? By grabbing it back from the migraine. If your new lifestyle eliminates the weekly migraine that soaked up twenty-four hours of your life, then you’ve actually gained seven and a half hours that week. And they will be happy, enjoyable hours, compared with the miserable ones of a migraine.

  You’re thinking it sounds good. But practically, how can you fit these things into your day? Let’s look at an example.

  Start by sleeping from 10 p.m. to 6 a.m. every night. That’s your migraine sleep antidote. When you wake up, eat something light and walk briskly around your neighborhood for half an hour. There’s your migraine exercise antidote. By 6:40 a.m., you’re in the shower. And now you’re ready to face your day.

  Obviously, you have to be very organized and plan ahead to make this work. But everyone who wants fewer migraines has to be organized and plan ahead. It’s a small price to pay for feeling better and avoiding sick days.

  Here are the eight steps that everyone needs for good health. They’re nothing you haven’t heard before, but we’re listing them here because they are inextricably connected to your migraines. View them as preventive medicine. They won’t cure your illness. But you’ll get fewer migraines and be better able to fend off the attacks that come.

  Eight Steps to Wellness for Migraine Brains (and everybody else, too)

  Exercise—Half an hour a day, (at least) five days a week.

  Sleep—Get seven to eight hours of restful, uninterrupted sleep each night.

  Healthy eating—Eat high-fiber, high-protein foods in order to keep blood-sugar levels even throughout the day. Eat small amounts of these foods every four to six hours.

  Stay hydrated—Drink at least six eight-ounce glasses of water a day, throughout the day, and more when you’re exercising or in a hot climate.

  Stress reduction—Learn to use meditation, deep breathing, yoga, or other methods to keep your stress levels down. If you can, make your life easier. Simplify things, don’t overextend, learn to say no to unnecessary requests for your time, ask for help.

  Social relationships and emotional connection—Human beings need to connect with others, whether it’s to friends, family, or pets. Loneliness and isolation will make you sick.

  Altruism—Helping others really does make you feel better. It’s an age-old adage—and it’s scientifically documented.

  Spirituality—We all need a connection to something greater than ourselves, however we choose to express that: through religion, a connection to nature, enjoying the arts, or something else.

  These rules are all tied together. Exercise affects not just physical health, but also mental and emotional health. So does nutrition. And sleep. If you aren’t sleeping well, it will be harder to exercise. If you aren’t exercising, you won’t sleep as well. And healthy relationships are a critical part of emotional and mental health, which in turn affect your physical health. In the following chapters, we’ll go into detail on many of these.

  It’s hard work to take care of yourself, but it’s essential to a long life, to a good quality of life, and to fewer migraines.

  CHAPTER 12

  Exercise, Sleep, Nutrition, Relaxation

  “I’m getting more migraines now, and I know why. I’m in school and a lot of the good habits I had went out the door. I used to eat regularly, now I eat at odd times. And exercising regularly is not happening. Stuff like going to yoga, everything that used to help me has gone out the window. And that hasn’t been a good tradeoff because this has been the result.”

  —Bethany, 32, graduate student

  Exercise

  What if there were a magic potion that would dramatically reduce your risk of cancer and Alzheimer’s, with virtually no side effects? A substance or practice that would reduce the risk of diabetes, high blood pressure, and death by heart disease—and would cut down on your migraines, too?

  You’d take that potion, of course. So would I.

  There is such a magic elixir. It’s exercise.

  Hold on. If you hate exercise and are tired of hearing how good it is for you, I have some great news: All you have to do is walk—briskly—for half an hour a day, at least five days a week, and you’ll reap all the health benefits you need. But if you don’t exercise, you have a 40 percent greater likelihood of colon cancer. And if, while being treated for breast cancer, you participate in moderate exercise, you may cut your chances of recurrence significantly. Exercise is an antidote to other serious, life-threatening illnesses including obesity, heart disease, osteoporosis, and diabetes. Some studies show that exercise is as effective at curing depression as taking antidepressant medication.

  According to the latest research, exercise makes you smarter because it helps your brain grow by creating new blood vessels and perhaps even new brain cells. And exercise appears to actually reverse the effects of aging on your memory and cognitive functions. People who exercise have lower rates of Alzheimer’s and other forms of dementia.

  People who exercise also live longer. For each hour that you exercise, you gain two hours of life expectancy. And you’ll feel better—sleep better, be less stressed, and have less anxiety.

  And exercise will help your migraines.

  “My mother is a senior citizen, and migraines have pretty consistently been part of her life. So she always would get up and take a walk, whenever she felt one coming. I remember her saying at one point, ‘I am not taking any more medicine,’ and she stood up and went for a walk. And that’s how she controls them now. She gets up every morning and walks two or three miles, and it does help. If I’m right—that her migraines are related to anxiety—it’d make sense to me that something like walking, anything that’s stress-relieving, would treat it.”

  —Katrina, 41, saleswoman

  How does it help? When you exercise, your body releases endorphins, the body’s natural painkillers, a tremendous boon to anyone with a chronic pain condition such as migraine. Exercise reduces stress and helps you sleep at night, countering two of the most common migraine triggers. In short, exercise is a migraine antidote.

  Exercise will not cure your migraines. But it is an essential part of your treatment plan. It will reduce the number you get and how bad they make you feel. You may also find that, when you do get a mild migraine or feel one just starting, you can stave it off with mild exercise, which gives you an endorphin rush!

  If you hate exercise, try this. Go for a walk around the block after dinner, three times a week. Do this for several weeks. Mark it on the calendar, if that motivates you, and commend yourself for getting up and moving.

  Then increase the challenge. Walk twice around the block. Then three times. Just keep doing it. Keep going. Get up to half an hour of walking.

  This is my guarantee: If you exercise five times a week, you’ll feel better—much better—physically, mentally, and emotionally. The emotional benefits of exercise are often overlooked, but you’ll be less stressed, have less desire to overeat, and be calmer and happier.

  Here’s another benefit: You want to be a good role model for your children. In the past thirty years, the rate of chil
dhood obesity has tripled among teens and quintupled among six-to eleven-year-olds. Along with obesity come such serious life-threatening illnesses as diabetes and high blood pressure. Exercise fights obesity. It also makes kids smarter, new studies show. We parents are the most important influence in getting our kids to exercise, doctors say. If we make exercise a routine part of our lives, our kids are far more likely to do so, too, especially if we include them in our activity, at least some of the time.

  So find an exercise that suits you and is really, really convenient. Don’t make it an ordeal or time-consuming. Don’t join a gym that’s twenty-five minutes or even ten minutes from your house if you’re not going to get there most days. Don’t pledge to wake up at 5 a.m. every morning to jog if you love sleeping in. If you enroll in an aerobics class but really hate it, switch to something else. The key is to find something that works for your life, so you’ll do it and keep doing it.

  I know that it’s really hard to squeeze exercise into your life. But you have to. I consider myself a really busy person, but I still make time to exercise five times a week. I run or go to a yoga class or, at the very least least, take a half-hour walk after dinner. I make exercise an essential part of every vacation I take, by choosing a hiking vacation, for example.

  Many of us women struggle with weight and food issues. Here, too, exercise is a magic bullet. It’s next to impossible to lose weight and keep it off through diet alone. By adding moderate exercise, you’ll lose weight, maintain your healthy weight, and be able to enjoy foods that otherwise feel off-limits. The mental-health benefits are equally tremendous because your mood and self-esteem will improve. You can use your exercise as a half hour of “me” time each day. For many women, especially those who are overweight, it’s good to focus on the health benefits rather than how exercise might change your physical appearance. It’s easier to stay motivated when you view this as a matter of feeling good instead of as looking good. It’s about taking care of your body, not trying to look like a supermodel.

  One of my patients became a regular exerciser twenty years ago, almost by accident. She was a binge eater who ate whenever she was upset or stressed out, and she couldn’t seem to control her obsession with food and weight. She’d tried many things, but nothing seemed to work. Eventually she joined a group therapy session for women with eating disorders. At the first meeting, the therapist gave everyone a tough mandate: They shouldn’t return the next week unless they could commit to exercising half an hour a day, five days a week. If they couldn’t do that, she kindly but firmly said, there was no real point in coming back. “If you don’t exercise, I won’t be able to help you,” she said. “But if you do, you’ll have so many physical and emotional changes in your body and mind that your eating disorder will improve.”

  Can’t find half an hour to exercise? Cut out watching TV. Or watch it while you walk the treadmill or ride an exercycle.

  At the time, my patient hated to exercise. But she was really tired of binge eating and obsessing about food. She wanted to do more with her life than count calories and worry about how much she weighed. So she decided to give it a try.

  She began by walking briskly for half an hour a day, which equated to two miles, five days each week. She stuck with it, day after day. After a few weeks, to her surprise, she found she actually liked it. For one thing, it brought her outdoors each day, out into nature or to new neighborhoods. And it was time to herself, when she could clear her mind and organize her day, or simply enjoy the sights around her. After a while she bought a headset and began listening to the radio as she walked. She began looking forward to her walk.

  Within a few months, her entire life had changed—she’d dropped fifteen pounds and found she no longer wanted to binge eat. Her mood lifted substantially because she was no longer hostage to the food obsession that had made her depressed. She was better able to focus at work and was happier overall.

  That was twenty years ago. Over the next two decades, exercise became a defining factor in her life. She fit it into her schedule no matter where she was or what was going on in her life. People now regard her as somewhat of a jock, which she finds amusing. She still isn’t a fanatic about exercise, but she does it, at least five days a week. She sometimes jogs a few miles, and loves roller-blading, skiing, and surfing, but her old standby is still her favorite: brisk walking. She’s now in her late forties, has not had a return of her problem with binge-eating, and is in tremendous physical and emotional health. And this was a woman who thought she hated exercise.

  Find Exercise You Like

  The most rabid exercise hater can find something to like; it’s just a matter of figuring it out. Do you like to exercise alone or in a group? Indoors or outdoors? What time of day works for you? If the very sound of the word “exercise” makes you cringe, call it play time, or “me time,” or whatever you like. But find a way to keep your body moving.

  I have a twenty-five-year-old patient who hates any form of conventional exercise but loves alternative music. So she goes to clubs three to four times a week, and dances for hours. She sweats up a storm, meets people, and has fun. “It really works for me,” she says. “I feel much better. And I love it.” That’s being creative in keeping moving.

  If you like being alone, trying running, swimming, cycling, walking. If you like group support, try a yoga class, aerobics class, Jazzercise, or other dance class. You can also walk or run in groups or with a buddy. Or organize a group of friends who commit to exercising together. Hiring a personal trainer is expensive but if you can afford it, it’s an excellent means for staying motivated.

  Tried and True Ways to Move

  Walking. Walking is the best exercise there is. Almost anyone can do it, you can’t get injured (barring some odd occurrence), and you can do it anywhere. All you need is a comfortable pair of shoes and a half hour a day, five days a week. Be sure you walk briskly! That means you should be swinging or pumping your arms or using walking poles (which will help tone your arms, too) as you stride along.

  Do whatever it takes to make it fun. Buy a headset or iPod and listen to music or books on tape. Park your car near a beautiful part of town and enjoy the scenery. Get a dog as your walking companion and motivator. Walk during your lunch hour at work, while you’re waiting for your kid at a dentist appointment, or at any other opportunity. Get your book group to include a half-hour walk in its meetings. To stay motivated, get a subscription to a walking magazine. Make walking part of your vacations. It’s a great way to see sights, and much better for you—and far more fun—than sitting on a bus.

  Running. Running is absolutely great for getting your heart pumping and infusing your body with endorphins, the feel-good natural chemicals. You don’t have to aim for a marathon. Just half an hour of running is all you need, with a five-minute warm-up and a stretching period afterward, to try to avoid injuries. Injuries from the stress on your joints are the biggest downside of running. As great as running feels, it’s hard on your knees, feet, and other body parts. Make sure you have a really good pair of shoes made for running, and get new shoes when the cushioning wears out. Running on a treadmill at a gym or home is easier on your body than outdoor running. But outdoor running is loads of fun and has its own benefits of fresh air and seeing new things.

  Cycling. You can do this popular sport alone or as part of a group or club. It’s much less stressful on your body than running and provides excellent cardio fitness. It doesn’t have to be expensive. You can use a simple bicycle or, if you’re serious, go for a really high-tech one. It’s also a fun family activity. Always wear a helmet and be careful with road safety rules.

  Swimming. A terrific aerobic sport, swimming has a low risk of injury and a wonderful meditative aspect. But you need a pool, of course. If this appeals to you, join a gym or your local YMCA.

  The Gym. There are lots of choices for good aerobic exercise at most gyms and fitness centers: elliptical trainers (which are low-stress on your body); treadmills for walk
ing or running; exercise bikes; exercise classes; swimming pools. Some health plans give you a discounted membership to a gym—because they know you’ll be healthier if you exercise, which means your employer and the insurer spend less on your health care.

  Here are some options:

  Curves women’s fitness centers are perfect for many women, especially those who hate to exercise. I have recommended Curves for many of my patients, with a surprising rate of success. At Curves, you work out for half an hour, three times a week. (And you can always add in other exercise, such as walking two days a week.) Curves makes exercising as easy and comfortable as possible. There are no mirrors or showers. You simply come in, exercise, and leave. Curves has a strong, supportive community, which is really helpful in staying motivated. It’s inexpensive and there are more than 10,000 Curves in dozens of countries around the world. There is probably one near you, and you can find one when you are on vacation or traveling on business.

  There are other women-only fitness centers, including ShapeXpress, as well as regional or local gyms that cater to women.

  Gyms often offer new classes and other motivators because they recognize that boredom with one kind of exercise becomes a problem for many people. You can also ask for classes or training in something you’d like to try, such as Pilates.