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.
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.
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.
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.