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How to Manage Migraine Attacks — and Maybe Even Prevent Them

Migraine is a debilitating neurological condition that 39 million Americans suffer from, and it’s three times more likely to affect women than men. While it’s best known for the trademark head pain a migraine attack can produce, it’s much more than that. It’s an ever-present condition, and managing it requires a long-term plan. Because as most migraine suffers know, it can be difficult to stop a migraine attack once it starts. 

People often mistake migraine attacks for everyday headaches, albeit bad ones, but each attack features potentially incapacitating neurological symptoms that can last anywhere from four to 72 hours. These symptoms include dizziness, nausea, vomiting, visual disturbances (e.g., seeing an aura at the beginning of an attack), tingling or numbness in the extremities or face, throbbing pain on one or both sides of the head, and extreme sensitivity to light, sound, touch, and smell.

Pam Oliver, a professional sports broadcaster and migraine sufferer, endured over two decades of crippling headaches. “Early in my career, when I was 23, I started having excruciating headaches that were both personally and professionally debilitating,” she told SheKnows. “I figured the headaches were caused by something I was doing or that I wasn’t adapting well to situational stressors.” Like many people, Oliver sought relief through over-the-counter medications, but the pills she took were not migraine-specific and offered only temporary relief. Since being diagnosed, she has managed migraine with an ongoing treatment regime. “Pain is not a natural state to be in,” Oliver said. “Don’t be a trooper. Find out if you are a migraine sufferer and get the right treatment.”

Once you’ve been correctly diagnosed, you can begin to prevent and manage migraine attacks. Here are five ways to get started.

Know Your Migraine Triggers

Dr. Merle Diamond, co-director of the Diamond Headache Clinic in Chicago, told SheKnows that people with migraine have more sensitive nervous systems. “It’s extremely impacted by changes in hormones, lack of sleep, skipping meals, red wine, smoke, and stress,” she says. There are even very specific food triggers, such as chocolate, citrus, and nut butters. “These triggers lead to changes in the brain, which turn on the brain stem and that then dilates blood vessels and causes inflammation.” Inflammation is what ultimately causes pain.

Try keeping a diary with notes about what was going on in the days before an attack. What did you eat? Were you sleep-deprived? Stressed? Dehydrated? What was the weather like? Where were you in your menstrual cycle? Once you spot patterns, you can begin to experiment with lifestyle changes, which can prevent migraine attacks before they begin.

Maintain a Healthy Schedule

Erratic eating and sleeping habits is hard on anyone, but it’s especially hard on the sensitive nervous systems of migraine sufferers. Make sure you get enough quality sleep and follow a healthy diet, eating regularly since low blood sugar from skipped meals is a common trigger.

You might want to also consider limiting your caffeine intake. “A little is okay, but overuse can cause a rebound headache or migraine,” says Dr. Diamond. Of course, if your caffeine consumption is currently high, you’ll want to gradually wean yourself down — caffeine withdrawals can also trigger a migraine attack. Keep in mind that some migraine medications contain caffeine, so if you take one, adjust your caffeine intake accordingly

Manage Your Stress Levels

Even if you don’t think stress is one of your individual triggers, the American Migraine Foundation says the migraine brain is vulnerable to it. Even good stress — the kind that motivates you and even feels good — can cause a migraine attack.

Stress-reduction techniques like taking a walk, deep breathing, meditation, or changing your perception of your stressor can help, though you may also want to consider things like setting healthy boundaries with coworkers, family, and friends and building better communication skills. These can not only stop stress before it starts, but they can help you navigate situations when it’s building.

Exercise Regularly

Put exercise on your healthy schedule, even small amounts of it. It can help regulate stress levels and improve sleep, which are both great ways to prevent migraine attacks for many people. It also releases endorphins, which act as natural painkillers.

The American Migraine Foundation recommends a mix of cardio, strength training, and flexibility training, but Dr. Diamond says it’s best to find a form a movement that works for you, especially if you’re just starting out. “Anything that helps you think about your body and tune in is a good choice.”

Talk to Your Doctor About Other Treatment Options

While good habits and lifestyle changes are incredibly useful in managing migraine, you definitely want to have an ongoing conversation with your doctor about it. Migraine varies from person to person, and with your input, doctors can help identify the right treatment options — whether it’s medication or alternative treatments like acupuncture, biofeedback, and nutritional supplements. The goal is to find what works for you, and to ensure it keeps working.

 A version of this article was published in October 2008.

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