Reducing
the impact of stress...
hints for migraine sufferers
From the clinical experience
of Richard Pinneau, Ph.D.
If you have ever suffered from migraines, you know that they are complicated things that can be triggered
by numerous factors: diet, weather, stress, hormonal fluctuations, allergies.
No one can guarantee 
they
know exactly what causes all your migraines, but we know stress can certainly aggravate a migraine (and often trigger
one). The stress management hints on the bottom half of this
page have helped many a person prevent, ease, or terminate a migraine.
Understanding stress, tension, and migraines
If you already know everything you care to know about migraines you may
choose to skip the following two sections. However, this information may help you develop an effective
migraine-reduction strategy.
1. The common and “classic” types of migraines
- Common (no warning signs) or classic (with warning signs) migraines both begin with vasoconstriction in the
head, which is what causes “classic” migraines' visual phenomena (prodromes/auras) before the pain
begins. This is the best time to intervene: a time when most people can learn to easily short-circuit the headache
process altogether.
- Common/classic migraine sufferers often tend toward cold hands and/or feet. This is because the same process
is causing the vasoconstriction, both in the extremities and in the head. If you do not have noticeably
cool hands/feet, it may be that your migraines are triggered by muscle tension (see below) or by food allergies.
- After sufficient vasoconstriction in the head has continued for long enough, blood vessels compensate
for their oxygen deficit: they dilate abnormally,
beginning the pain. Once
the pain begins it often throbs with each heart beat, especially if the head is lowered. Steps to relieve the
headache should be taken as soon as possible after the pain begins.
- If the vasodilation continues, blood vessel walls begin to thicken (edema), especially
when one is retaining extra fluids for hormonal or other reasons. This thickening of the blood vessel walls
enables migraines to last for hours or days. Although this is the most challenging headache stage for anything to
help, I have seen many sufferers get significant relief during sessions of deep relaxation.
2. The muscle-tension-triggered migraine
- For many migraine sufferers, the problem begins not in the blood vessels in the head but with tension in the
neck and shoulders. That tension pinches off circulation to the head to produce the same suffering as with the
common or classic migraines.
- Prevention of muscle-migraines requires reducing the tension in the neck and shoulder areas.
Relaxation and/or biofeedback to prevent migraines
Whether their discomfort is initially caused (or triggered) by muscle tension or by vasoconstriction, migraineurs
benefit from learning to relax deeply and to employ that relaxation in stressful situations:
- Relax the abdomen and let the breath flow from there as much as possible (rather than just from the
chest). Slow the breath; deepen the breath: inhale over a slow count to five; hold for five; exhale over five.
If comfortable, the count may be lengthened to ten. Deep is good, but only when slow.
- Consciously relax all the muscles of the body, especially jaws, neck, shoulders.
- Visualize a favorite pleasant relaxing scene. Don't try too hard: you do not have to be great at creating
vivid images in your mind. (Migraines seem especially common among perfectionistic individuals who even try to
relax too perfectly.)
- Replace worried, self-critical thoughts with positive, hopeful, self-affirming thoughts.
- Be sure to practice deepening your relaxation skills at times when you are headache-free, because
everything is easier to learn when you are not in pain and because it will help your mind and body develop new
patterns where your life is less vulnerable to the stresses that can trigger a migraine.
As you ease into your relaxation, you will know that it is having the desired effect when you feel the
hands warm or the shoulder tension ease (these are your body's built-in biofeedback systems). If you already have
a headache, continue to deepen your relaxation until you are sure the headache is under control (or has been
averted).
If you have a medication for your migraines, you may want to take it before settling in to relax — at
least until you have confidence in your ability to relieve them through deep relaxation.
Caffeine and migraines
- Caffeine aggravates muscle tension and constricts blood vessels, so eliminating caffeine from the diet is critical,
especially during the process of learning to control migraines. Once you have your migraines under control
you may find you can return to it in occasional small dosages.
- Be careful about going cold-turkey. Even people who don't usually get migraines find that they trigger a
days-long headache by going cold-turkey. For many heavy caffeiners it's better to cut consumption in half for
a few days, then again in half, and so on... until they are down to about a half-cup of coffee (40mg) per day,
and finally eliminate it entirely.
- Be aware that many over-the-counter analgesics contain caffeine, a strategy that can be helpful if they are
taken when vasoconstriction is needed. However, if you are taking something like Excedrin or Anacin
regularly, you are ingesting the equivalent of many cups of coffee. You may experience that you are virtually
addicted to the OTC medication because when you stop you get a headache. That is probably a caffeine-withdrawal
migraine. (I have been there.)
Doing your own therapy
If you have had migraines for years or if you know you are presently under relentless stress, you might consider
seeing a qualified biofeedback therapist. The biofeedback equipment used in such a training may not end up
being critical to your victory over the migraines, but there's no substitute for the clinical experience and sensitivity
of an experienced biofeedback therapist. Your doctor can probably make a referral, and many insurance plans cover
biofeedback therapy.
On the other hand, you may find that you can learn on your own to use slow breathing, positive visualization,
and mental/muscular relaxation to relieve most of your migraine problems. If you do, please write and tell us your
story: The
WellPath Resources office.
In the near future we will have recordings available to guide your home practice. Best of luck with it all!
