Photography by Robin Jolin
Planning the parties, cooking, juggling family and work, and generally taking on too much, especially around the holidays, is it surprising that migraines impact at least 30 percent of women?
The holiday season brings so many delights: Tree trimming, hot chocolate, family visits—I even love wrapping presents with pretty paper and ribbons. But for me and over 30 million other Americans, the holidays can also bring a debilitating side effect: Migraines.
I was in college the year I had my first Christmas Day Migraine. Exhausted by a brutal week of final exams (and no sleep) followed by the flurry of pre-holiday prep, I started to see flashes of light (known as visual auras —a common migraine precursor) while unwrapping my first gift from Santa. By the time my younger sister was ready to go outside and race around on her new Razor Scooter, I was upstairs throwing up and feeling not at all merry.
The irony, of course, is that the migraine didn’t hit until December 25th—after I’d pushed through all the stress and excitement. No matter how crazed you get during the build-up period, holidays themselves should be relaxing. But “let down” migraines are a common response if you’ve been forcing yourself to scale a mountain of stress before you can get to the relaxation. Perhaps this is one reason why migraines are much more common in women (impacting at least 30 percent). We’re the ones planning the parties, roasting the turkey, juggling work and kids and generally taking on way too much.
But take heart, if you’re prone to migraines during the holiday season—or any other time of year—because there is help available. The first step is to recognize that you’re not dealing with any normal headache. “Around 50 percent of migraine sufferers are misdiagnosed or just don’t know why they’re suffering,” says Peter McAllister, MD, director of The Headache Center Associated Neurologists of Southern CT and adjunct assistant professor of neurology at Yale University. In fact, migraine is a complex neurovascular condition that begins deep in the brain, when nerve centers become overwhelmed by external stimuli. This sets off a wave of nerve cell activity where neurotransmitters fire, causing blood vessel inflammation, which causes the blinding pain you know and definitely don’t love.
The good news is that migraine patients can avoid or significantly reduce the frequency of these episodes with the right prevention plan. And while patients with chronic migraines (more than twice a week) usually do best on a preventive medication, there are many alternative therapies and supplements that can help, too. (Consult a board-certified neurologist who specializes in headaches before beginning any new therapy or medication regimen; she can help develop the best plan for you.)
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More and more neurologists prefer to try a course or two of supplements to see if the problem can be controlled naturally before moving on to prescription drugs that may come with more side effects.
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STEP 1: KEEP A HEADACHE CALENDAR
Whether you ultimately decide to treat your migraines with pills, supplements or another alternative therapy, you first need to get a handle on what environmental and lifestyle factors serve as your personal “triggers,” says Dr. McAllister. You can download an app like iHeadache to your iPhone or iPad, use the Migraine Meter at migraine.com, or simply keep track in a notebook. Make sure to document the date, time and intensity of every migraine and then take stock of which triggers you may have encountered in the past few days (see “Track Your Triggers” box, page 66). Over time, you’ll notice patterns that will help you decide which lifestyle modifications may be right for you.
STEP 2: CONSIDER SUPPLEMENTS
If you are experiencing frequent migraines, you probably do need to be on a preventive medication, but more and more neurologists prefer to try a course of supplements to see if the problem can be controlled naturally before moving on to prescription drugs that may come with side effects (and steeper price tags). Here are some to consider. Always ask your doctor before starting a new vitamin or supplement.
•Butterbur Supplements are made from the leaves of this perennial shrub, containing two substances (petasin and isopetasin) that work to reduce spasms and inflammation, which may minimize migraine symptoms. One 2004 study found that taking 75 milligrams daily reduced migraines in patients by 48 percent.
•Riboflavin (vitamin B2) Research suggests that migraine patients may be deficient in riboflavin, which our bodies need to pull energy from food and create red blood cells. You can increase the riboflavin in your diet by eating broccoli, asparagus, leafy greens, almonds, yogurt and whole grains. But if that doesn’t work, some small studies suggest that taking 400 mg of riboflavin daily can reduce migraine frequency by 50 percent after three months.
•Magnesium We need it for proper nerve function and research suggests that patients may have low brain levels of magnesium during migraine attacks. One small study found that taking 600 mg daily reduced migraines by 41 percent after nine weeks — but be warned that magnesium supplements can cause diarrhea and upset stomach at high doses, so check with your doctor first.
•Vitamin D As many as 42 percent of migraine patients have a vitamin D deficiency, according to research presented at the American Headache Society’s annual meeting in 2008—and it’s not easy to get enough vitamin D in your diet (though cheese, egg yolks, salmon and fortified orange juice are good sources). Supplementation may fill the gap.
•Vitamin E This may be particularly effective if you get menstrual migraines; one study found that women taking vitamin E supplements two days before, during and three days after their periods had significantly less pain, nausea and light and sound sensitivity.
STEP 3: ALTERNATIVE THERAPIES
Since stress plays such a huge role in migraines, it’s not surprising that alternative and complementary treatments that help manage stress can offer significant relief. While Western medicine has yet to confirm the efficacy of these therapies through clinical studies, most are steeped in thousands of years of tradition and philosophy.
•Acupuncture or Acupressure These treat pain by regulating your energy flow via pressure points on the body. Research suggests that acupuncture is especially helpful on the cusp of a migraine, so it may be worth it to develop a relationship with a practitioner you can have “on call” for those situations.
•Biofeedback This teaches you how to monitor and control certain physical responses related to stress, such as muscle tension. Researchers believe practicing biofeedback over time helps patients learn to control stress, which results in fewer migraines. An evidence review of 25 trials concluded that biofeedback works just as well as many preventive medications.
•Cold Therapy Using ice bags or cold packs hasn’t received much medical scrutiny — but it’s certainly the kind of old-fashioned, common sense remedy your grandmother would have endorsed. And it works — when the pain feels like a sledgehammer in your brain and regular medications aren’t touching it, pack your head in ice (and find a dark, quiet place to lie down!) to take the edge off.
•Massage Regular massage can release stress and muscle tension and help you sleep better, which may reduce your frequency of migraines.
•Yoga Yoga may help to calm the body’s nervous system; traditional breathing practices are thought to be especially helpful. You’ll also release muscle tension, particularly in the upper shoulder and neck muscles, which can play a role in migraines. (You may want to avoid headstands and other postures that can put pressure on your neck or head.)
TRACK YOUR TRIGGERS
Every time you document a migraine on your Headache Calendar, use this checklist to determine which lifestyle and environmental triggers may have played a role:
•Drank Alcohol (especially red wine)
•Consumed more caffeine than usual
•Consumed less caffeine than usual
•Consumed aspartame
•Too hot
•Hormone fluctuations (PMS, menopause, or early pregnancy)
•Neck pain
•Changes in your sleep schedule
•Skipped meals
•Stress increase
•Stress release (the “let down” migraine that hits on a weekend, holiday, or start of your vacation)
•Consumed MSG
•Exposed to a strong odor
•Exposed to strobe, fluorescent or other trigger lighting
•Exposed to smoke
•Weather Front (changes in barometric pressure, like sudden thunderstorms, are a common trigger)