The current understanding is that Migraine is a genetic neurological disease. The problem appears to be in how the nervous system responds to environmental stimuli. Essentially, people with Migraine are more sensitive to the environment (our triggers). When our nervous system is overloaded, a process called cortical spreading depression sets off what we call a Migraine attack. Whenever there is a change in our environment, we can become susceptible to attacks.
It is unfortunate that our world is full of changes, because the “Migraine brain” functions best in an environment of predictable routine. It would be wonderful if we could keep everything running according to a routine that works for us. But try as we might, we cannot stop the world from changing all around us.
Wouldn’t it be nice if we could just wrap ourselves in a protective shield to block out any number of changes that might trigger a Migraine attack? It would be even better if that shield were invisible, so we could go about our day without drawing unwanted attention. Fortunately, for many of us, a good preventive treatment plan provides exactly this kind of shield. The right preventive plan can raise our trigger threshold, making us more resilient to environmental changes.
There are also some simple accommodations that can protect us from certain triggers, though not all of them are invisible. Some common items include:
- FL-41 tinted glasses to protect against bright or florescent lighting
- Ear plugs or headphones to buffer loud noises
- Better breathers, Vicks, or Tiger Balm to block unpleasant odors
- Wearable ice packs to ease our pain
We may feel uncomfortable, worrying that people will ask about our use of these items and respond negatively. That’s when we may need to work on our attitude toward using items that are a visible sign of Migraine disease. When I first started using these accommodations in public, I felt self-conscious and mentally unprepared to respond to any negative reactions. To my surprise, the criticism I feared never came. On rare occasions, someone would ask a question out of curiosity. A brief explanation was all it took to turn curiosity into empathy and understanding. I now view these items as necessary tools, much like a wheelchair, cane, or prosthesis. They allow me to fully participate in the world.
Insulation works for some triggers, but it’s not so easy to protect yourself from changes in the weather or your routine during times of stress. When the world around you spins out of control, protection from Migraine triggers gets tricky. That’s when it becomes necessary to protect your lifestyle. Sticking to your individual routine involves:
- Continuing to take your medications on schedule
- Eating regular, healthy meals
- Drinking enough water
- Going to bed and waking up at the same time each day
- Maintaining healthy sleep hygiene habits
- Getting regular exercise
- Using healthy stress coping strategies
- Maintaining healthy social connections
Adaptation requires us to make our physical and emotional health a priority even in the face of competing agendas. It is all too easy to sacrifice our needs to looming deadlines and packed schedules. It took me many years to perfect the skill of sticking to my routine, so don’t think that it will happen overnight. I practiced, failed, and practiced some more. After a while, I learned that taking the time for self-care was essential during periods of increased stress. Failure to do so almost always resulted in a Migraine disaster.
We can insulate ourselves from and adapt to many changes. Still, there will always be some environmental changes that overwhelm our nervous system, triggering a Migraine attack. That’s when we must have an attack plan available for immediate use. Medications and comfort measures do us little good if they are sitting on a shelf at home while we are out in the world. Part of learning to live with Migraine is making sure that we always have quick access to needed treatments when faced with an attack. Only when we understand Migraine as a disease can we fully embrace the challenge of always being prepared.
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Reviewed by David Watson, MD.
© Tammy Rome, 2017.
Headache disorders advocate and patient expert, blogger, and mental health therapist, Tammy Rome maintains a private practice specializing in behavioral pain management, as well as writing for her own blog, Brain Storm. She also volunteers as vice chair of the American Headache and Migraine Association and as president of The Cluster Headache Support Group. You can read more of Tammy’s work on her blog and follow her on Facebook, Twitter, StumbleUpon, Pinterest, LinkedIn, and Google+.