Each year, 40 million Americans suffer from migraine. Migraine is a neurological disease where people experience sudden attacks of severe head pain and nausea, during which normal sensations—light, smell, sound—are very painful. Because migraine peaks during a person’s 20s, 30s, and 40s, it can really interfere with life milestones. Going to college, developing a career, getting married, and having children are all more difficult when also juggling unpredictable and painful migraine attacks.
Migraine and Psychology
Migraine is a biological disease. Certain people develop migraine disease because of their genetic makeup and other biological factors like hormones. People with migraine don’t do anything to cause the disease to happen. However, once people have migraine disease, psychological factors can play a role in determining when people experience migraine attacks.
Stress is the most common psychological factor that affects migraine attacks. Some people may experience a migraine attack on a day of high stress–when they have a presentation at work or have a particularly difficult commute. For others, days of high stress are not a big deal, their migraine attacks, instead, happen post-stress, such as on a weekend or the first day of vacation. In either case, the solution is to keep stress consistently low.
Many interventions reduce stress. Relaxation, biofeedback, and cognitive-behavioral therapy for migraine all reduce stress and can reduce how often you have migraine attacks, how painful those attacks are, and how much migraine interferes with your daily life. But for many people with migraine, the skills taught in these interventions scratch the surface of how invasive migraine is in their everyday lives.
Mindfulness and Migraine
Mindfulness is a particular way of paying attention, which reduces stress. When you are using mindfulness, you are trying to pay attention to “right now,” rather than the past or the future, and without judging it as “good” or “bad.” Mindfulness helps you become more aware of your experience of life, without getting sucked into feeling guilty about things that have passed or worried about things that have not happened.
When you are dealing with unpredictable migraine attacks, it is easy to get caught up in the “what ifs.” What if this tightness in my temple turns into a migraine attack? What if my boss decides my migraine attacks are disruptive and I lose my job? Mindfulness provides an alternative to these thoughts. By paying attention nonjudgmentally to the present moment, you can more deeply live the reality of your experiences: What is going on right now? What does it feel like to live in my body? Mindfulness reminds us that we are whole human beings; migraine is just one part of us.
We are just starting to learn how mindfulness may be able to help migraine. Evidence-based mindfulness interventions, like Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) have consistently reduced migraine-related disability after completing 8-12 weeks of interventions. My team at Yeshiva University has recently conducted a randomized clinical trial that both demonstrated a short-term reduction in migraine-related disability, as well as a long-term reduction in migraine symptoms themselves, although it may take months instead of weeks before these changes can be detected. If you have migraine and you are tired of how much it impacts your life, mindfulness interventions may offer some relief in both the short and long-term.
Getting Started with Mindfulness
If you are interested in learning mindfulness skills, you can start by checking out local mindfulness classes or downloading meditation apps. For more in-depth learning, talking to a psychologist, particularly a psychologist who focuses on mindfulness and pain, can help you apply mindfulness skills directly to your life circumstances and migraine disease.
One of my favorite mindfulness activities is the leaf on a stream. To do this activity, find a comfortable position and close your eyes. Pay close attention to your breathing for about a minute to get into the spirit of mindfulness. Then, vividly imagine a stream in a forest. Think about the sound of the water, the feel of the damp breeze, and the smell of the trees. Notice a tree drop a leaf on the stream. Pay attention to how the leaf flows down the stream, quickly out of view. Then notice the next leaf. And the next. Pay attention to how the leaves land on the stream, then simply pass out of view.
Now comes the tricky part. Try to catch a thought passing through your mind. It can be any thought, it does not have to be particularly profound. Try to imagine that thought on a leaf. Watch as the thought on the leaf flows down the stream, out of view, and then move on to the next thought that arises.
Your thoughts may start off mundane: I might have lasagna for dinner. (Let it flow down the stream). Did I send that email? (Let it flow down the stream). I need to call my friend. Let it flow down the stream).
The longer you mindfully pay attention to your thoughts, you will notice thoughts that normally have a lot of power. Power to throw off your day. Power to change your mood. Power to determine your reactions to stress and migraine symptoms.
Will this ever end?
This isn’t fair.
And just the same, you let the thoughts pass, like a leaf on a stream. Because you are not your thoughts. These thoughts do not get to determine your present or your future.
Mindfulness offers a tool to people suffering from migraine. It helps us learn how to live more fully, acknowledging the realities of living with migraine, without letting migraine overtake our lives.