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 component of my migraines 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 (relatively) 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! ).
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 highly toxic form of chronic stress. That’s to do with repressed emotions. You know – all that resentment, frustration, annoyance and anger with people – especially those really annoying people close to us?
Repressing these emotions isn’t good for us. But angry outbursts aren’t good either. Anger isn’t all bad – if assertively handled, anger is great. But most of us aren’t taught assertiveness, and our anger tends to seep out in the form of passive-aggressive behavior and snide put downs, or the opposite, overt aggression. Or both. Sadly, aggression tends to erode our intimate relationships, leading to stressful loneliness.
Fortunately there’s a healthy 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.
I LOVE getting a massage. As if I needed any extra incentive, research has shown that massage is not only effective at reducing migraine severity, but also reduces anxiety and the stress-hormone cortisol.
Massage was also shown to improve sleep in people with migraine. I found that sleep-finding especially interesting. If I go to bed or wake up with a migraine, I feel like I’ve hardly slept at all. In fact my own post-grad research found that while there no difference in number of hours slept between people with and without migraine, the people with migraine reported significantly worse quality of sleep.
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.
But wait, there’s more … vitamins!
A trusted health professional I know, suggested I take magnesium for my own migraines, which, while much reduced over the years, I still get occasionally. HOWEVER I have not had a migraine since I started taking 800mg (the recommended daily dose) of magnesium aspartate complex (Red Seal brand).
If possible, avoid the commonly available magnesium oxide. It’s not as well absorbed as other forms (such as magnesium aspartate, which I have, and magnesium dicitrate) and may even cause stomach upset. This from the NIH: “Small studies have found that magnesium in the aspartate, citrate, lactate, and chloride forms is absorbed more completely and is more bioavailable than magnesium oxide and magnesium sulfate,” (https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/#h14)
FYI: The proposed mechanism of action by which magnesium reduces migraine is – (if I have this correct, please any science teachers reading this let me know if not) – that nerve cells require calcium to contract, and magnesium to relax. Stress causes contraction of the muscles which, if sustained, can lead to tense muscles, including the shoulder and neck muscles that feed up into the scalp, which can trigger or aggravate migraines and headaches.
Consequently, under stress, normal dietary magnesium may be insufficient to help our muscles relax after constriction. And that’s where supplements can help.
As below, the online literature, in the main, supports the effectiveness of magnesium supplements in reducing migraine.
This systematic review provides Grade C (possibly effective) evidence for prevention of migraine with magnesium. Prophylactic treatment of migraine by means of high levels of magnesium dicitrate (600 mg) seems to be a safe and cost efficient strategy in clinical use.
Stress is widely accepted to play a role in migraine frequency and severity.
Stress makes heavy demands on the body, including the B group of vitamins. Consequently, Vitamin B supplements may assist with reducing migraine. It does seem to be the case, and this association is supported in the literature. You can read a review of the the role of nutrients in the pathogenesis and treatment of migraine headaches here.
For myself, a blood test showed I had a deficiency of several of the B vitamins. Taking supplements (and abstaining from alcohol for several weeks!) not only almost immediately improved my skin (the best it had been in years) but also reduced my migraines.
That was some months ago. Currently I’m taking a daily B complex along with the magnesium, and also zinc. I’m also again taking a break from alcohol. I wasn’t drinking a lot, but I had some inflammation and I suspect that my tolerance to alcohol has decreased. Frankly, I like alcohol, but I like migraines much less.
Aside from loving our livers, there’s another reason to cut back on alcohol, and that’s because it can interfere with absorption of nutrients, including Vitamin A, B1, B2, and B6. Consequently, aside from hangovers, alcohol may aggravate migraines by blocking absorption of B vitamins.
Worse, in severe cases, alcohol induced vitamin B deficiency can cause a common (but little-known) form of dementia known as Korsakoff syndrome
On that cheery note: while the B vitamins are water soluble (and several of the B’s give you yellow pee!) and this means the worst side effect is likely to be expensive urine, I would still strongly recommend getting a blood test to check levels of vitamins and minerals for best and correct and safe supplementation doses.
One more thing on the B vitamins: I know a woman whose elderly father received regular and massive intravenous doses of vitamin B. Along with these intravenous does he would undergo a personality change, shifting from, basically being an asshole, to being nice. He had not been a good father when he was young, and it was quite shocking to her that at least some of her father’s unpleasantness was due to a reversible vitamin deficiency.
I mentioned this to an acquaintance with stress and anger problems. He then took a double dose of a standard over-the-counter Vitamin B complex, and was astonished at the increase in his energy. He mentioned this to the men at his workplace and they all did the same; took double doses, had very yellow pee, and a big boost in energy.
BUT please remember, if stress is causing a vitamin B deficiency, and this vitamin deficiency is implicated in your migraines – by all means take supplements to address the imbalance, but please also address any stress that may be causing the imbalance in the first place. I feel in most cases it’s best to do both – treat the symptoms AND address the underlying causes. Chronic stress causes many more health problems than vitamin deficiency and migraines.
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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TESTIMONIAL: KATE HOMMELHOFF, MT GAMBIER, AUSTRALIA
“Hi Rebecca, I wanted to thank you and let you know what happened to me after our session. I have to say you were like a dog with a bone and as much as I was trying to ‘only play with the surface stuff’, you really forced me to look and go next level during our session.
As uncomfortable as that was … you changed my life with that session.
Within 3 months I had left the worst job of my life, left the most toxic relationship I’ve ever had and then continued to look and work deep with how and why had I let myself get into those situations. This beginning a real journey of positive self discovery and healing …
My transformation has been mind blowing and our session was definitely the beginning of it all for me.”
MARCIA KAPUVAI, HANMER SPRINGS, NZ
“I’ve lost 20 kgs by exercising more and eating better. It really helps remembering what Rebecca says about weight-loss: that it’s not the most important thing in life.. yes I will get skinnier but does that mean that it would make me happier? No, it will make me healthier and fitter, which will make things easier physically, but weight-loss is not the main thing that would make me happier – if that makes sense. It also helps remembering that weight-loss is more bearable if you are happier, love yourself and remember your self worth”
TERESA AHERNE, AUCKLAND, NZ
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I wanted a trophy boyfriend! This is my most embarrassing articles to date – and the competition is fierce.
Brain orgasms! One of two things that I really didn’t expect from meditation – not just about meditation! Highly relevant to reduction of stress and migraines!
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