I told my friend Marcia about my pounding headaches. The ones that felt like a crushing jackhammer inside my skull each time I moved. The ones that left me feeling really reluctant to move.
“I used to get those headaches,” Marcia replied, “then my doctor told me to drink more water, and I did, and they stopped.”
“But I do drink lots of water,” I protested, clutching my head. Marcia said, “That’s what I told my doctor, and he said ‘Drink more!’ and I did and it worked”
Halleluiah - it worked!
So I drank more water. Rather than taking a mouthful of water from my water-bottle at a time, I’d drink a cup at a time. And the headaches did indeed stop.
The funny thing was, I rarely get tension-type headaches, which they almost certainly were. Normally I get migraines. And I honestly don’t recall having a single migraine or headache until I turned 21. Which, co-incidentally, was the age I joined the police.
I still get migraines, but they are infrequent and mild compared to what they used to be. However, when my migraines were at their worst, I’d have terrible nausea for 48 hours, vomiting on the hour and unable to even hold down water. On the third day the migraine would be gone. And while I’d be delighted by the absence of pain and nausea, I’d also be physically weak and shaky from dehydration and lack of food.
A migraine self-destruct button?
The head pain itself I wouldn’t describe as intolerable. But it had a nasty ‘burning’ quality to it. That unpleasant quality of the pain, plus the sheer relentless duration it, would have me weeping in despair. I’d fantasize about having a ‘self-destruct’ button next to my bed. Just something I could push to escape the pain in my skull.
I tried a range of things over the years - pills, melt-in-your-mouth-stuff, injections, even disgusting feverfew sandwiches (only once!) - and nothing really helped. And then I found the solution - find a doctor who gets migraines!
Now I’m a doctor, but not a medical doctor. My philosophy doctorate in health psychology does come in handy (in fact, I did my masters thesis on the role of stress in migraine - imagine!). But I’m not, in this case, as handy as a GP who also gets migraines.
Get a medical doctor who gets migraines
Getting a GP who also got migraines was a migraine-game-changer. My GP said, contrary to popular opinion, you don’t need super-powerful drugs to treat migraine. All you need is relatively mild painkillers (paracetamol, for example) plus something to treat the nausea and settle the stomach.
One of many reasons headache and migraine are hard to treat is difficulty in diagnosis. Tension type headache (TTH) and migraine have overlapping symptoms, and you can get both types, but they typically require different treatment. However, nausea and light sensitivity are symptoms typical of migraine - but not TTH.
Just to ensure migraine diagnosis isn’t easy, migraine-nausea isn’t always detectable. But - and here’s the point - even low levels of nausea can prevent oral painkillers being absorbed by the stomach. And, obviously, if they can’t be absorbed, they can’t work (hence the melt-in-your-mouth treatments, although I personally haven’t found those to be effective).
Treating migraine nausea
However, if the nausea is treated and the stomach settled, even mild painkillers can be absorbed and effective. It’s not awful being free of nausea either!
So my GP prescribed metoclopramide tablets (10mg) - an anti-nausea drug - to be taken with mild painkillers: one paracetamol tablet and one ibuprofen tablet. If I recall correctly, the paracetamol and ibuprofen work along slightly different but complimentary pathways, so the combination works well together.
And it works!!! For me anyway and my GP.
This is a really good place to re-state that while this advice comes from medical doctors, I am not one. It’s still possible to have allergic reactions even to over-the-counter medications, such as ibuprofen. And there are many possible causes of head pain, so please go and talk to your own GP before trying any of these things that have worked for me.
Non-prescription over-the-counter migraine treatments
That said, you’ll need to see your GP anyway if you want to try metoclopramide. In New Zealand it’s a prescription-only medication. However you can get non-prescription, anti-nausea treatments over-the-counter - such as travel sickness drugs. I find them not quite as effective as metoclopramide, but they still work.
So that’s the drug part of the story - I hope you find it helpful. But there’s another part. There’s long been a thing called the ‘migraine -personality.’ This term refers to a personality type that is sensitive to stress as well as migraine.
Indeed, my master’s research found the obvious result that people with migraine were more stressed by migraine than people without migraine. So far so obvious. But - compared to my control group of people without migraine - people with migraine were significantly more stressed by other things in their life that had absolutely nothing to do with migraine.
Migraine genes - and stress
There is a genetic component to migraines, but there’s also strong evidence for a stress component.
Stress stigma - it’s stressful!
Unfortunately, and unhelpfully, there’s still plenty of stigma around ‘stress.’ If you suffer from migraines - as I do - it can be quite stressful being told your migraines are caused by stress. There are implications that it’s ‘our fault’ or ‘it’s all in our head.’ But it gets worse. This stressful stress-stigma goes hand in hand with a lack of knowledge about psychological stress and lack of knowledge of best ways to reduce stress.
This is where I finally come in handy. There are of course lots of ways of reducing stress. I especially recommend Progressive Muscle Relaxation for tension type headaches (although it will likely help with migraines and is brilliant for aiding and abetting sleep - ask me how I know! ).
Free, migraine-reducing, relaxation resources
There’s plenty of places to get de-stressing and resilience-boosting techniques. For example, there’s a ton of great, free resources on the University of Auckland’s CALM page . I personally recommend Dr Matt Shepherd’s 19-minute Progressive Muscle Relaxation audio (under ‘Practical techniques for managing stress’).
A little-known form of stress
However, remember how I said psychological stress is poorly understood? There’s a little known but really toxic form of chronic stress. That’s to do with repressed emotions. You know - all that resentment, annoyance and anger with people - especially people close to us? Angry outbursts aren’t good either. They tend to erode our intimate relationships, leading to stressful loneliness. Fortunately there’s a middle ground between emotional suppression and emotional outbursts.
Simple psychology technique to reduce stress AND boost immunity
There are safe - and beneficial - ways to express painful emotions. I wrote an article about exactly that. There is a simple, quick, free psychology technique that is proven to boost the immune system. As the technique works via stress-reduction, it’s plausible it can also help relieve inflammatory-type conditions; such as migraines and tension-type headache. You can read the simple instructions here.
Headspace meditation app
Mediation, is of course great. You only need to stay still for a few minutes to experience benefits. Many people use the meditation app Headspace. Last time I looked, there’s a small monthly fee, but also 10 or so free sample meditations. Headspace was created by former monk Andy Puddicombe.
Free meditation app
On the other hand, there’s a completely free meditation app - the Bliss Timer - created by a current monk. Actually he’s my Munkle (monk + uncle). Sure I’m biased, but Munkle is one of the few genuinely happy people I know. I did help pilot test an early version of the app and I was indeed completely blissed out! It’s pretty cool and you can check it out here.
That’s all for now. Please comment below if you’d like to share your experiences with migraine and headaches - what’s helped and what hasn’t. I’d love to hear. Like any chronic pain condition, migraine can be devastating. But the severity can absolutely be reduced - and it helps to have support from people who understand.
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