Chronic Migraine
Like many chronic health conditions, chronic migraine takes it’s toll and isn’t well understood by the general community. Sometimes the support of a psychologist can manage the impact of the condition through identifying and reducing triggers as well as reducing any ‘double-struggling’; that is mental struggle such as negative self-talk that compounds physical struggles.
Managing the Migraine Cycle
It is important to understand your migraine cycle well, so that you can manage any episodes as best as possible. Preventative strategies are best to keep you in the interictal (in-between) phase for longer, however this is often a work in progress for many during trials of different medications etc. Abortive medication works most effectively when taken early in the onset of a migraine episode. Similarly there is an optimal window in the pain cycle to take pain killers (i.e. before the pain gets too intense), and taking such medication during that window of time helps to keep your pain level manageable. Anti-emetic (anti-nausea) medication is also best taken at early onset of nausea symptoms or re-emergence of symptoms, as prescribed. It is important to look after yourself with plenty of self-care during the postdrome (migraine hangover) phase.
See Migraine Australia’s page on the phases of a migraine episode: https://www.migraine.org.au/phases.
Preventing & Managing Medication Overuse Headache (MOH)
It is important to know the limits on usage per month for abortive medications, pain killers and caffeine, as over-use can lead to Medication Overuse Headache. This is a chronic daily headache that is caused by consuming too much of these drugs, and as such is best avoided. Limits to these drugs are listed on Migraine Australia’s page on MOH: https://www.migraine.org.au/moh.
If you think you might be experiencing MOH or know you are, then it’s about developing a management plan to recover. This involves stopping taking all of these medications and limiting caffeine for a period of time (e.g. a few weeks), and riding the ‘wave’ of initial intense symptoms that will then lessen over time. Reducing responsibilities and increasing self-care is important during this time. It’s important to remember that it will pass.
Psychology can help with:
Providing information about chronic migraine
Processing any grief around the loss of capacity and aspects of life that you may be missing out on
Developing mindfulness around the ability to choose how to respond to your circumstances
Maintenance and building of foundation aspects of wellbeing such as sleep, diet and exercise (within capacity)
Recognition of triggers and development of strategies to reduce triggers (where possible)
Developing the skill of pacing activities
Developing plans to effectively manage migraine episodes when they occur (reducing any ‘double-struggling’)
Developing a self-kindness mentality and self-care strategies
Building acceptance of the condition
Developing flexibility in working around capacity and adjusting long-term goals
Supporting connection with others who experience chronic migraine for peer support
Liaising with close others about your support needs