Migraines: Treatment, Triggers, How I Cope

In the second grade I wound up in the hospital for a week. At the time, no one knew what was wrong with me, eventually I was diagnosed with migraines. Through the process of a therapy called bio-feedback, keeping a food journal, and paying attention to my triggers I learned how to manage and keep my migraines at bay almost entirely. I went from getting migraines regularly to just a few times a year (knocking on wood as I write this).
I got a lot of requests for a post on how I’ve managed my migraines, so I wanted to pull together every single piece of information I could possibly share. The reality is, migraines are awful. They are debilitating, painful and can take days to recover from, so I take prevention really seriously. It took me years to figure out the best ways to prevent them. Unfortunately what works for me, might not work for you. I encourage you to seek the advice of your doctor or a specialist if you struggle with migraines and are unable to manage them on your own.
I decided to break this post down by identifying triggers: environmental/physical and diet. I’m not going to get too deep into treatment but will share a few things that work for me if I do end up getting a migraine. I’m not a doctor and this is just my experience and what works for me. Ultimately, my goal is prevention, once I have a migraine, it’s game over, so not getting one is always my priority.
Another thing to note, one of the quickest ways for me to end up getting a migraine is if I’m in a multiple trigger scenario, for example, I am stressed and dehydrated or I am jet lagged and drink alcohol. One of the things I realized in my 20s was the need to prioritize my health even if it was uncomfortable. What I mean by that is, maybe everyone’s day drinking on the beach, or maybe they order red wine at the company dinner party, it’s ok to say no. I learned really quickly that I had to speak up or opt-out if it meant the situation was going to put me at risk of a migraine. Put your own well-being before your desire to be polite. Sticking to a routine is one of the most important things for me in managing migraines (which is why I always go to bed early, get up at the same time, eat at the same times, etc). It may sound extreme (and people love to make fun of me for it) but if you’re a fellow migraine sufferer I’m sure you understand why I don’t mess around. If sticking to a routine means I’m reducing my risk of getting migraines, it’s worth it.
If you’re still struggling with migraines and don’t know why, I highly recommend doing a headache diary and a food journal to help identify your triggers.
Jess Ann Kirby shares her triggers and treatment for migraines including environment, diet and stress.

Environmental & Physical Triggers

Probably not surprisingly, stress is a major trigger for a lot of migraine sufferers. When I started my first job in NYC I was getting migraines constantly. I wasn’t great at managing my anxiety or stress and it took a major toll on my physical health.

Stress – The key in managing your stress is identifying what makes you stressed. Is it work, social situations, a relationship? Once you know what makes you stressed it’s easier to manage it.

Bright light – I never ever leave the house without sunglasses (polarized- this pair is amazing and worth every penny). I can’t sit in the sun all day and always wear a hat and sunglasses if I’m at the beach or I know I’m going to be outdoors a lot.

Smells (cigarette smoke, perfume, paint thinner) – Cigarette smoke is a huge trigger for me. I can’t be around it, period. Strong perfumes and other smells like paint fumes, etc. can also be triggers. One of the reasons we only use water based paints like Farrow & Ball and water based polyurethane in the house.

Sleep (jet lag, missing sleep) – Traveling is tough for me especially when it’s a significant time change. Lack of sleep always puts me at risk so I have a pretty good routine now about getting enough rest and sleep. It can be challenging, especially when it’s for work, so I always prepare by taking Advil, drinking lots of water and avoiding alcohol.

Diet

Eating a healthy diet is a major factor in managing my migraines. It basically forced me to eat healthy and pay attention to everything I ate from an early age. What I eat is just as important as how much I eat. I can’t go for more than a few hours during the day without eating and I definitely can’t fast. There’s tons of trends that come and go in the health space when it comes to diet but if you are a migraine sufferer, pay attention to your body and what it needs, just because someone says intermittent fasting is great doesn’t mean it will work for you.

Chocolate – Chocolate and pretty much sugar in general is a trigger for me. I can have it in small amounts, but rarely do I crave sweets, probably because I’ve gone without them for so long.

Maltodextrin (common preservative) – I discovered this in recent years, there was a chip brand I loved and a certain flavor kept giving me headaches (not full on migraines but a headache can lead to one). I noticed it had maltodextrin and stopped eating them, along with anything else that had that ingredient. It’s in a lot of packaged foods (including organic) so you really need to read labels.

Caffeine (too much or too little) – I have a cup of coffee every morning, if I don’t, I can end up with a migraine, if I have too much, same thing.

Soft and moldy cheese – I don’t eat dairy anymore so it’s not an issue but strong cheese like blue or brie if I had too much would definitely lead to a migraine.

Sulfites (found in wine, processed foods) – Wine is high in sulfites and also a major trigger. I can occasionally have a glass of white wine, typically Sauvignon Blanc is my best bet.

Tannins (beer, wine, brandy, whiskey, tea, chocolate) – I mention below I avoid most alcohol because it’s a huge trigger. Some I can have small amounts (gin, tequila, white wine) and others I can’t have at all. I can’t have red wine or dark liquors like whiskey, brandy, etc.

Nitrites & Nitrates (common preservative found in: hot dogs, pepperoni, sausage, etc.) – Meats like pepperoni, salami, bacon, etc. are all triggers for me. Some I was able to tolerate more than others but I’ve stopped eating pork and red meat so it’s no longer an issue.

Alcohol – Any alcohol is a potential trigger for me. In addition to the sulfites and tannins found in wine, most alcohol has high amounts of tyramine (also found in smoked meats, aged cheese, soy products) which can be a major trigger for migraine sufferers. When I do drink it’s only one (I can tolerate some white wines, tequila and gin) and I always have a full glass of water before and after. I don’t drink any red wine or dark liquors.

Hydration – Dehydration is one of the quickest and easiest ways for me to get a migraine, particularly if it’s combined with another trigger like stress, lack of sleep, poor diet, etc. I always bring a reusable water bottle with me and make sure to hydrate even more if I’m traveling, drinking, exercising, in the sun/outdoors, in a high stress situation, etc. I pretty much exclusively drink water, mint tea, and kombucha (I can only drink certain brands I’ve found some actually give me headaches).

Artificial sweeteners and sugar –  I mentioned before but I just try to avoid sugar as much as possible and definitely any artificial sweeteners, sugar alcohols or sugar substitutes (splenda, stevia, etc). I use honey in my coffee and if I’m baking I’ll use raw brown sugar, coconut sugar, dates or maple syrup as a sweetener.

Treatment

When I was first diagnosed with migraines at the age of 7, one of the treatments my parents had me try was biofeedback. It was an alternative to medication that was knocking me out to the point that I was falling asleep at my desk. I strongly believe it’s one of the reasons why I have a better grasp on controlling my migraines now and it has helped me deal with one of my biggest triggers my entire life, stress. Up until my sophomore year of high school, I would miss the first week of school because of a migraine. I’d go to school on the first day and by the end of it, have a horrible migraine. The anxiety and stress of going back to school was a major trigger for me and it took years until I finally learned how to manage it. Essentially biofeedback helped me learn how to manage and control my stress through exercises and techniques which I continue to use to this day. I think now, there’s so much more information about yoga and meditation you could probably do that and get similar results, but if you’re interested in biofeedback here is some information. I also use biofeedback in everyday life, to help me in stressful situations or to help if I’m having trouble sleeping. I’ve actually used it with Craig if he is having trouble sleeping, I’ll walk him through some exercises.

If I feel a migraine coming on, I immediately start hydrating with water and coconut water. I also take two advil liquid gels, start my relaxation techniques and go to a quiet, dark place. If I can I will try to fall asleep (no phones, tv, etc.). Ultimately rest, hydration and sleep are the quickest way for me to treat a migraine. I’ve tried a few different prescriptions for treatment and didn’t like any of them but I encourage you to consult with your doctor and do what’s best for you.

Would love to hear any other techniques, triggers, etc. that you’ve used to cope with migraines. Let me know in the comments.

11 Comments

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  1. Jessica says:

    I had my first migraine last year at the age of 34 and it was a terrifying experience. When it started, I thought I was having a stroke because I was having hallucinations and blurred vision, then the excruciating pain set in, then the debilitating nausea. Overall, it lasted several hours and then took days to recover. I’ve had a few less intense ones since then but I still get a lot of headaches. The two biggest triggers that I’ve identified for me are alcohol and bright light. I really enjoyed reading this post and thank you for sharing your experience!

    Jessica

  2. Megan says:

    As someone who suffers from migraine with aura and can’t find the exact triggers that set my migraines off, this was helpful with giving me ideas of what my triggers could be. Migraines are so frustrating and difficult to deal with because they are so different from everyone. Thank you for sharing.

  3. Cory says:

    Ugh…nothing more debilitating than a migraine. I completely agree that diet and hydration are the biggest keys to prevention. I have made huge changes to the way I eat over the last year or so and I have only had a few headaches and zero migraines. When I do feel one coming on, I take two Excedrin Migraine and just go to bed.

  4. Luz says:

    My mom has migraines too. Not too often, about three times a year. They are the kind of migraines where you can’t stand light and need to be in a dark room, sleeping and taking painkillers. It doesn’t last a long time but I understand how one can take lots of measures if you have them often. I have headaches as well, though I wouldn’t consider them migraines. What I know are my biggest triggers are:
    -bad posture, sleeping in an uncomfortable position
    -being on my period and not taking enough water
    -just like you, taking too much coffee or too little coffee are not good for me either
    -not taking care of my sight(too much screen time)

  5. Tabitha says:

    I get migraines as well, and hit my breaking point when I was pregnant & couldn’t take pain medication to manage them. A friend mentioned that I should try acupuncture, and it’s been amazing in preventing my migraines. Stress is a huge trigger for me as well – and I wasn’t able to make it to my acupuncture appointments initially once my baby was born. I was fine the first few months, but then my baby got sick & my dog passed away all in the same weekend, and the migraines returned (no surprise there) – I immediately booked my first appointment back with my acupuncturist and I’ve been avoiding them ever since (since January). Highly recommend!!

  6. Sam says:

    I come from a migraine prone family, because of this my mom always watched for signs and when I inevitably started getting them she started monitoring what I had been eating, where I had been and what I had been doing so she could figure out what my triggers were. She had been on medication for migraines, but quickly stopped because of the side effects so she did everything possible to make sure I didn’t have to take medication.

    For the most part I avoid my food triggers (all similar to yours, however my biggest trigger is any Red food dye), but it does get hard to avoid environmental & physical triggers (also similar to yours). Cigarettes and perfume can trigger a migraine in a matter of minutes if I’m near either for too long I’m guaranteed to get a migraine.

    When I feel one coming on I usually take Aleve, grab a coconut water (electrolytes!) and sit in the shower in the dark with running lukewarm-cool water, occasionally I’ll turn on the fan since the faint hum acts as a calming white noise. When I get a migraine I’ve always needed to be in a cool, dark, smell-less, quiet room, which is probably why I prefer the bathroom, I know it’s weird but it also makes it easier since I usually end up getting extremely nauseous, and also the tiles feel cool on my feet. I’ve noticed that anything warm (carpet, blankets, pillows) can make my migraine worse. Luckily I’ve had a handle on my migraines for a while now and hope everyone else reading this article is able to do the same!

  7. Kathryn says:

    I had my first migraine in second grade too! I remember missing so many birthday parties, soccer games, etc. because of them. Starting in high school, my migraines would come with auras. The first time I got an aura, I called my mom from the bathroom at school because I thought I was having a stroke. I’ve tried SO MANY different medications, preventative and abortive. I’ve kept diaries and still can’t figure out my triggers which is SO frustrating. Over the last couple years, I don’t seem to get as many *knocks on wood*, but when I do, I pop 2 Excedrin Migraine and a Dramamine because sleep and time are the only things that make the migraine go away. Ugh, they’re literally the worst.

  8. Navjot Atwal says:

    I started getting migraines in grade 9 and they were debilitating. My doctor told me about natural herb called feverfew which helped me immensely and was meant to prevent migraines. It’s worth looking in to 🙂

  9. Paige says:

    Thanks for sharing your experience. I don’t get migraines, but I have a few loved ones who do and this helps me understand what they’re going through a little more.

  10. Meg says:

    Thank you for a great article! I’ve had migraines most of my life and learning/avoiding triggers and correcting imbalances has been life-changing. I still get them, but not as often as I used to, and my recent ones haven’t been as severe.

    My biggest trigger is hormonal imbalance, but that’s so complex, because hormones are so affected and intertwined with everything a person does or eats, etc. Hormonal birth control was a huge issue for me. I was on it for eight years, and I’d be fine on a pill or the ring or whatever for a year or two, then the month-long migraines (legit lasting a whole month, 24\7) would start on. I’d switch pills, and repeat the same thing. I finally went off totally, which has been a good choice for me. These days, I often can’t tell anything’s “off” hormonally until it’s either ovulation or PMS time and a migraine hits. That’s my cue to look at things like diet and exercise and really clean those areas up. Whole food soy (like tofu or edamame…not soy protein isolate in protein bars or whatnot) has also really helped my hormonal balance, although I know it’s a trigger for many, so YMMV on that.

    Blood sugar spikes/low blood sugar is another trigger. I’ve started eating 95% whole grains, skipping sugar and other sweeteners, swapping in sweet potatoes for white potatoes, etc., and trying to eat a higher percentage of protein in my diet. It’s also helped hugely.

    Alcohol factors into both of these, since it messes with blood sugar and causes estrogen to spike. So, I hardly drink these days. A drink per week or less is best for me.

    Because I eat largely vegetarian or vegan meals (I’m neither, but tend toward eating that way), I ended up deficient in magnesium. Adding a supplement in (250mg, once a day) decreased my migraine days from 5-7 per month to 1-2. I also found that popping two magnesium pills right away when a migraine hits can sometimes stop it in its tracks for me.

    Lastly, I started using CBD oil for some mood issues I have (I’ve used Lord Jones and Cordial Organics — both hemp-based, since that’s what’s legal in my state), and while it doesn’t help once a migraine has started, I’ve noticed using it daily for the mood stuff has, as a nice side effect, cut down the number and severity of my migraines and menstrual cramps over the course of my monthly cycle. I have some months with no migraines now and minimal cramps, and the CBD is all that’s changed.

  11. Lynell says:

    I started having migraines when I was about 13 and now have Chronic Migraine. I could write about it for pages. Mine are strongly tied to hormones but I have many triggers, including stress, dehydration and foods. Use of over-the-counter painkillers for years also lead to gut issues including food sensitivities and IBS, so, yay. I’ve tried all kinds of management techniques including yoga, acupuncture, chiropractor, medication, TENS, diet changes, physical therapy, natural supplements, multiple MRI’s, etc, etc.

    Lately I’ve been having some luck with cognitive behavioral therapy through the Curable app, and would recommend it for anyone suffering with chronic pain. Cheaper than most alternatives and worth trying.

    Best of luck to all you out there dealing with this monster. I know it’s not fun!