Non-Medicinal Techniques for Managing Migraines and Headaches
Some estimates put the number of people stricken by migraines at 37 million in the U.S. alone, with women - typically between 35 and 55 years of age - more than twice as likely as men to get migraines.
"Headaches are one of most common complaints in medicine," says Dr. Shilagh Mirgain, a UW Health psychologist who has organized a Headache Management and Coping Group to help people anticipate the stimuli that trigger migraines and take non-medicinal measures to manage them. "Our group is unique in that we teach behavioral strategies patients can use themselves, beyond medications."
One of those behavioral strategies is something we all do, all the time – breathing.
Migraine symptoms often affect stress responses in the body, creating an imbalance in the autonomic nervous system. In response, shallow breathing, muscle tension, decreased blood flow to the extremities and incoherent heart rate can occur, making headaches and mood worse.
One of the aims of the headache coping group is to teach relaxation mind-body strategies to calm the stress response, which, in turn can lessen the effects of headaches. Through techniques such progressive muscle relaxation and autogenic training, participants learn to reduce tension in their bodies, which can also help to ease headache pain.
"We teach proper diaphragmatic breathing, to increase the relaxation response in the body," adds Dr. Mirgain. "The optimal breathing rate is to breath in for four seconds and breathe out for six seconds."
Group participants can use a special handheld biofeedback device that clips to their earlobes to monitor their breathing and heart rhythms, known as heart rate variability training. Another biofeedback device used in the group measures participants' hand temperature tracking improved blood flow to the arms and hands.
"We actually print out graphs of their training sessions, so group members can monitor their progress," says Dr. Mirgain. "It's a nice measure of balance in the autonomic nervous system."
When someone experiences the warning signs of a migraine – such as auras which include blind spots and blurred vision – it can cause them to focus on the fact a migraine is starting, which may even make the migraine worse. It's called catastrophic thinking, a thinking pattern common to migraine sufferers. The breathing exercises help interrupt the pattern.
"At the early signs of headaches, the tendency is to fall into automatic negative thinking," says Dr. Mirgain. "Migraines create a sense of powerlessness and make people feel they've lost control. It's helpful to challenge those thoughts, so people realize there is something they can do in response to the early signs of headaches."
A key element in asserting control over migraines also comes in the form of support. Joining together in a group helps break the isolation migraine sufferers experience. It’s common to withdraw from social situations but being with others who have similar experiences helps people feel connected. Participants also learn specific strategies for communicating assertively with family members and friends about their headache condition and its effects on their day-to-day lives.
Group members often comment about how chronic headaches can affect relationships. Often sufferers shy away from making plans, because they never know when a migraine will strike or how long they're going to last.
"People who have persistent headaches really start to get isolated," says Dr. Mirgain. "It can lead to a pattern of hopelessness. The group format enhances motivation. If you see a fellow patient doing well and experiencing positive changes in their lives due to the lessons learned in group sessions, you become more motivated to practice these coping strategies."
Date Published: 11/26/2014