The Migraine Brain
Page 28
Find some relaxation techniques that work for you and blend them into your life on a regular basis, at least several times a week, and at any specific time that you need to calm down. During a stressful meeting or during an argument with a loved one, you can breathe deeply without anyone realizing it. Yoga and meditation reduce stress, as does exercise.
One of my patients who didn’t have many financial resources needed an inexpensive relaxation technique. On my doctor’s pad, I wrote her a prescription: She was to put on some relaxing music, set the timer on her stove for ten minutes, turn out the lights in the room, sit comfortably in a relaxing position, and breathe deeply until the timer went off. Even this short, simple exercise went a long way in interrupting her body’s fight-or-flight response—it lowered her blood pressure, relaxed her muscles, and calmed her mind.
Some tips for reducing stress in your life:
Take on fewer tasks. Say no to things that you really don’t have to do. One of the best pieces of advice ever is this: You don’t have to do everything at once. When you’re busy raising young children, you don’t have to serve on volunteer boards or start a time-consuming vegetable garden, too. There will be time for that when the kids are older. Conserve your energy.
Keep your life balanced. Your health is as important as income—even more so. Don’t get lured into putting material gain over health and family time.
Avoid negative things in your life, including negative people, when possible.
Don’t engage in negative thinking or putting yourself down.
Don’t get overwhelmed. Break huge tasks into smaller, livable bites.
Drop perfectionism. The house doesn’t have to be spotless, especially when you have small children and other demands.
Simplify your life whenever possible. This is a great goal! When things start to feel complicated, step back and ask what you can get rid of.
Ask for help whenever you need it. It’s not a sign of weakness. And good friends don’t mind—it feels good to help others.
Have an attitude of gratitude. When things seem bleak, write down ten things you are grateful for.
Have a strong support network: family, friends, new friends you make through a group such as a migraine support group
If you’re feeling overwhelmed momentarily, take a break. Do something else for a few minutes. Deep breathing is always an excellent option.
Let go of things you can’t control. Practice acceptance. There’s much in life over which we have no control. Learn to recognize these, and let go.
Here’s a great migraine-specific tip I heard from a patient. When making a dentist appointment, make two appointments within two weeks of each other. That way, if you can make the first one, that’s great—cancel the second appointment when you get to the dentist’s office. But if you wake up with a horrible migraine on the day of the first appointment, call in and cancel—and you have another appointment on the schedule just two weeks later.
And—for fun—make time for yourself whenever you can. This works wonders at relaxing you:
Walk through the woods or around your neighborhood. Make this a relaxing walk, not to be confused with your brisk thirty-minute exercise walk.
Stretch!
Take up painting, drawing, dancing, or some other creative activity. Don’t judge yourself. Any form of creativity—baking, gardening, cutting hair—is good for you. You may not make a living from it, but you just have to enjoy yourself.
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Stop Worrying About the Next Migraine…
“I get so worried about getting one that I work myself into a state, and I think that’s what actually makes it happen. The stress of worrying about getting a migraine triggers the migraine, which is so bad I start to worry about the next one. It’s a cycle. And I don’t know how to stop it.”
—Deborah, 40, poet
We could call this “migraine-induced anticipatory anxiety disorder”—you’re so traumatized by the pain and sickness of past migraines that you live in fear of the next one. In fact, 44 percent of women in a migraine study said they worry about getting the next one, 38 percent said they fear it, and 23 percent said they are afraid to leave the house when they think a migraine may be on its way. That’s the negative effect migraine has on our lives—even when we’re not in the middle of an attack—and that’s why effective treatment is so important. Once you know your migraines are treatable and controllable, your fear likely will diminish. It’s one reason that people who use triptans, which can be so effective, call them miracle drugs. You carry them with you everywhere and don’t have to worry when you feel a migraine on its way: you pop your triptan, and they stop the attack in its tracks. For those who use preventive methods, seeing a steady decrease in the number of migraines they get also gradually reduces this fear.
If you feel a migraine on its way and start to feel stressed and worried, take your medicine, but also use the relaxation techniques described above and in Chapter 11.
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Write. Keep a journal—besides your migraine journal—to write your daily feelings, observations, whatever you want to write. Try writing stories, just for yourself, if you like.
Hot baths are great for relaxation.
In the Women’s Headache Center, we play soft classical music or New Age music all the time. Our patients—and staff—say it helps them feel calmer.
CHAPTER 13
Family, Home, Sex, Mental Health
“Before I got in a car accident in 2000, I’d never had a headache in my life. After the accident, I started getting migraines all the time. Sometimes I’d have a migraine that would last three days, where I wouldn’t even see my husband. He would have to sleep in a different room because I was so sensitive to light and smell. He became like a mouse. He had to eat outside our condo. This January, I finally got some treatments that are working for me, and I’ve only had six migraines since. My husband and I were sitting in a restaurant, laughing, having a great time, and he said, ‘I like being with you so much more now that I don’t have to worry so much about you. I don’t mean to hurt your feelings, but I don’t know if you realize how much my life has improved since January.’”
—Felicity, 29, college professor
One of the worst things about having migraines is how they affect your family and loved ones. It sometimes may feel like the entire household revolves around your illness, even when you try hard not to let that happen. Despite your efforts, some days you simply cannot go on as usual. Instead of sitting proudly in the bleachers at your daughter’s basketball game, you’re at home in bed in horrible pain—feeling guilty, perhaps, or angry, or depressed. When you have to cancel yet another dinner with friends, your spouse may be sympathetic, or frustrated, or irritated, or all of these at the same time. And you may feel your family doesn’t give you enough support.
No matter what you do, your migraine illness probably has a significant impact on your loved ones. Over 76 percent of migraineurs have had to postpone family activities because of a migraine attack. That’s countless birthday parties postponed, soccer matches missed, vacations where Dad or Mom spent the week moaning in pain. If we gut it up through these events, not wanting to disappoint our loved ones, we are in agony instead of enjoying ourselves and them.
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The Emotional Cost of Migraines
In one study, 41 percent of migraineurs said they couldn’t take good care of their families during a migraine attack, 23 percent said migraines caused stress in their personal relationships, and 16 percent said their significant others didn’t believe they had migraines.
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In this chapter, we’re going to look at ways that you and your family can minimize the toll migraine takes on your lives.
The first, most important step is for you to take care of yourself. You can’t be available for anyone else if you’re sick. So you must put your health—especially your Migraine Brain’s health—first. You also need to plan ahead for migraine attacks so that they disrup
t the family as little as possible. We’ll talk about that a little further into this chapter.
But before we do, I want to bring up an important point in migraine wellness: self-forgiveness. A lot of migraineurs feel guilty about having migraines and the negative effects they have on their family and friends. It’s terrible to feel that we’re letting down the people we care about. But remember this: Migraine is a disease you were born with. You didn’t ask for it, and, if you could, you’d get rid of it. So forgive yourself for having migraines. It’s not your fault.
We and our loved ones want the same thing: for migraine to stop interfering with our lives. Then you can move into the positive—getting better and staying well, for everyone’s benefit.
Living with a Migraineur
“I would say that early, when his migraines were very infrequent, I felt sympathetic. Then they became more frequent and I started to wonder if it was a psychological thing because they would come sometimes when he didn’t want to do something, like a social function. It made me feel like, ‘Oh, it’s an excuse!’ That’s why I got irritated. Not that the physical pain wasn’t real but that it could be induced by that attitude.”
—Marie, 28, married for five years to a migraineur
“I remember being surprised that anyone would marry me because there were so many days each week where I had to lie in bed. I’ve lost friends over migraines, who think you’re making excuses when you say, ‘I can’t go out with you, I’m sick.’ They say, ‘How can you be that sick?’ They can’t believe it’s that bad, they think you should just take some Advil and get over it. Losing friends over migraines has been hard for me.”
—Felicity, 29, college professor
Many migraineurs’ families don’t really seem to understand what a migraine is like. So you’re going to educate them: Explain what migraine is and isn’t, what the pain feels like, and how they can help. And, in turn, you’re going to hear what your illness is like for them. Clear the air. Talk with your family about your migraines, and share any anger, frustration, or sadness that you or they feel.
It’s astonishing to me how few people have done this. A woman in her mid-forties came to see me about completely disabling migraines. She got so many, and they were so painful, she was unable to take care of her family including her seven-year-old daughter, since she spent many of her days in bed with the blinds drawn. She felt terribly guilty that she was doing so little as a mother and wife. When I asked if she’d discussed her migraines with her family she looked puzzled. “We’ve never talked about it,” she said.
Communication is key. If you don’t talk about your illness, your family—particularly children—may be very worried that you are seriously ill or even dying each time you get sick. Or, they may be convinced that you’re malingering or exaggerating how bad you feel to get out of family duties. You, on the other hand, may feel they aren’t sympathetic enough, resent your illness, are angry at you, or don’t believe you.
A frank, open conversation about your migraines will be really helpful to you and your family in clearing up misinformation and concerns, and repairing resentments. You need to explain what migraine is—and isn’t—and ask for their help in keeping you as healthy as possible. This is a key step in feeling better.
Talk to Your Partner
“My wife jumps in and picks up the slack when she knows I’m down for the count. It’s been so many years together with it that she’s not particularly sympathetic. If I crash, she’s not bringing me an ice pack. But she’ll leave me alone, which is fine.”
—Tom, 44, lawyer
Besides you, your partner is often the person most affected by your disease. He or she lives with its effects, too. Unless your migraines are really infrequent, your illness is having probably a serious impact on your spouse, who may up the slack when you can’t do chores or care for the kids, who is disappointed when social events are cancelled, and who tends to you while you’re sick in bed.
It’s important to talk to your partner about migraine. And make it a dialogue. Explain migraine disease and how it makes you feel, and listen to your partner as he talks about what it means to him. You may learn he’s been very worried about your health, frightened, or feeling guilty that he’s somehow contributed to your attacks. He may suspect that you get sick because it lets you withdraw completely from the world for a while. Even if your partner is sympathetic and caring, she may sometimes feel overwhelmed by having to assume all the care for the family and take up the slack when you are sick.
Ask your partner: What do you understand about my migraines? Do you know that they are a neurological disease? Do you know what it’s like for me to have a migraine? Describe the pain as vividly as you can: “It feels like a hot poker going in and out of my eye.” Give basic information about migraines and offer this book to read. You may want to highlight passages for him. If he need a “Cliffs Notes” version, use the one we’ve created, below, which gives basic information about your migraines.
Get buy-in from your partner on helping you feel better. Have a frank discussion about the importance of basic wellness—not only so you’ll have fewer migraines, but so both of you will lead healthier, happier lives, and influence your children, too.
Ask your partner for help in designing your treatment plan, if this works for your relationship. For example, ask if he’s noticed any pattern in when your headaches come. He may answer, “You always get sick before we go to my mother’s,” or “You get a headache every time we order out from Chinese Dragon.” He may identify triggers you haven’t. As you try to avoid or minimize triggers, your spouse may have useful suggestions. Ask if he or she would like to come with you to an appointment with your headache specialist. Your doctor may get a better picture of your migraines if your partner has noticed patterns or symptoms you haven’t.
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For My Partner: What You Should Know About My Migraines
Migraine is a neurological illness that I was born with. It’s not my fault.
Migraine isn’t a type of headache. It has many symptoms, such as severe headache, vomiting, nausea, and the need to lie still in a dark room until the attack is over. Migraine symptoms vary from one person to the next.
The pain is often extreme, which is why they are so disabling.
Migraines happen because my brain is very sensitive to any changes in what it’s used to. To get fewer migraines, it’s really important for me to take really good care of my health. That means eight hours of sleep a night, healthy foods every four to six hours, exercise five times a week, and plenty of water through the day. This won’t stop the migraines but may help reduce how many attacks I get.
Everybody has different things that set off migraine attacks, called “triggers.” Common triggers are stress, lack of sleep or poor sleep, not eating regular meals or eating poorly, strong smells, bright lights, and many others. It’s important for me to figure out my list of triggers and try to avoid them whenever possible.
Stress may be a trigger for me. This doesn’t mean I am weak or trying to avoid responsibilities. Stress causes chemical changes in the brain, which is most likely how it triggers migraines. You can help me minimize stress by encouraging me to incorporate relaxation techniques such as meditation, yoga, or deep breathing into our schedule. It’ll be good for you, too.
Both you and I want to minimize how often migraine attacks come. So please be supportive in my wellness plan.
If I take migraine medications, please make sure I have them on hand at all times. Offer to get my prescription refilled when needed.
Please don’t get angry or upset with me for being sick even when you’re disappointed about missed family events and other interruptions to your life.
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Here is a sample plan to avoid migraine triggers to review with your partner. Ask your partner to identify triggers she or he may have noticed that you’ve missed. (There is a blank form in the appendix.)
My Partner’s Migraine Triggers
How We Can Try to Avoid Them
Not enough sleep—she needs eight hours of uninterrupted sleep each night
Go to bed at 10 each night. I’ll get up with the kids at night. We’ll add room-darkening shades.
Strong odors especially perfume
I won’t use aftershave anymore. We’ll switch to unscented soap and laundry detergent. I’ll gently explain to my mom that when she comes to visit us that she needs to not use perfume.
Weather changes
Can’t avoid—will help make sure she has her meds and isn’t stressed out at this time.
Not eating healthy meals at a regular time
Eat breakfast and dinner on time. Encourage her to make sure to eat lunch on time during the workday. Keep healthy foods in the house.
Talk to Your Children
“I remember in our old house my mom was in bed and she had a migraine. I was maybe four or five years old. I remember I felt—and still feel—that I have to take care of her because I want to help. But I couldn’t do anything. I felt sort of scared. I didn’t know if she was okay. I just didn’t know.”