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Expert Answer: How can I manage triggers such as stress & environmental changes?
February 22nd, 2011 - Posted by Teri RobertAs for stress being a trigger, there’s still some controversy, but I hate to see anyone accept that stress is a trigger without at least trying to see if they encounter triggers during stressful times that they either don’t encounter at other times or they’re only triggers when the body is stressed.
The International Headache Society has removed stress from their list of Migraine triggers and put it on their list of exacerbating factors- things that make us more susceptible to our triggers. I’d have sworn stress was a trigger for me until I kept a very detailed diary for a few months. I hope you’ll thoroughly investigate this as I think we do ourselves a real disservice by thinking stress is a trigger for us and not looking closely for other triggers during stressful times.
If by environmental changes, you mean weather changes/changes in barometric pressure, some Migraineurs have found that they can avoid at least some Migraines from this trigger by taking Diamox when they know a weather front is coming. This also applies to Migraines triggered by flying or changes in altitude.
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"I had my first migraine when I was 12. I thought I was going blind, the spots in my vision all grouped together and everything went black. The pain was intense and felt like my head would crack open above my right eye." 
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I also have noticed that the onset of a weather change about a day ahead of the change coincides with the onset of a pressure over my eyes and the developement of a migraine head ache.
Eating salty things like olives and pickled cucumbers seems to preempt a headache about 8 to 12 hours later.
Most disconcertingly beef products like a good steak seem to bring on a pressure head a few hours later.
I have had migraines since I was 8, and I’m now almost 50, so I know my body well. I am a stressed person in general. I definitely get the worst migraines when I have extreme stress. The headache will appear immediately following an awfully stressful situation.
Weather is my biggest trigger. I am better than the weather man. I am not even the one that discovered it. A dear friend of ours said did you notice when we get a storm that morning or the night before you get a migraine. Almost every time. I am going to the Dr today to see what we can do for preventive. I don’t think a pill taken when a storm is coming in is the best option because there are so many variables but we will see.
Jane,
I tracked all kinds of things that I might do differently during stressful periods…
• When I ate. (messed up meal schedule)
• What, how much, and when I drank fluids. (dehydration)
• Not drinking too much caffeine.
• If my sleep got messed up.
• Crying
The other thing is to watch all of our “regular” Migraine triggers when stressed. It’s kind of like catching a cold. If you catch a cold during a stressful period, it’s not the stress that caused the cold. It’s the virus. Stress just made you more vulnerable to it. Same thing with Migraines and stress. Stress affects our bodies in ways that make us more vulnerable to our triggers.
Amrita gave to the link to our diary tool. To this day, during really stressful times, I take a piece of brightly colored paper, write “MIGRAINE TRIGGERS” on it, and put it on the bulletin board next to my desk. It helps me remember to take better care of myself during such times.
Hope this helps!
Teri
Stormlaughter,
I’d have sworn stress was a trigger for me until I was challenged on it. I’m so glad now that someone did challenge it because I’ve learned what I do or don’t do during stressful times that really are triggers for me. That means so many fewer Migraines then.
Diamox (acetazolamide) is one of those multi-function drugs. It has some anticonvulsant properties and some diuretic properties. It’s often used to treat idiopathic intracranial hypertension / pseudotumor cerebri. It’s theorized that what makes flying, altitude, and barometric pressure changes trigger us is that they impact our cerebrospinal fluid pressure. Thus, using Diamox as a preventive. I know several people who use it as an “as needed” preventive, not taken daily, but when flying, traveling to higher altitudes, or when a weather front is coming through.
Let me know if you try it and if it helps?
Teri
Barbie,
It’s worth asking your doctor about Diamox.
Now about these cluster headaches. Are you saying ONE cluster headache lasts five days? If so, it’s most likely not a cluster headache. Cluster headaches last 15 – 180 minutes and occur in groups/clusters, thus the name.
Teri
Benice,
In a word, yes. I have both TTH and Migraine with and without aura. When I get a TTH, I know I have to knock it fast, or it will indeed trigger a Migraine. If that’s happening to you, it couldn’t hurt to talk with your doctor about what you should do for your TTH.
Teri
Hi Jane – There are a variety of triggers you may want to consider in addition to foods, including sleep (too much, too little), your eating schedule, smells, sounds, bright lights, etc. You can read more here: http://migraine.com/migraine-triggers/
If you are interested in keeping a Migraine Journal, we have an online tool here at Migraine.com. The Journal has some trigger options that you can select from, or you can manually enter others.
http://migraine.com/migraine-tools/migraine-journal/
Hope this helps!
I was wondering about the detailed diary…what type of details did you keep track of? I have kept a record of what I have eaten to see if there are any food triggers but I am curious about what else you tracked. Thanks for your thoughts.
I’m in your camp on stress, Teri.
After I did the same thing you did keeping sometimes minute by minute records, I discovered that anxiety was my trigger, not stress by and of itself. Stress without anxiety isn’t a problem.
I’ve spent a year working very hard at anxiety management and good emotion hygiene. I can’t say my efforts have had more than modest effects so far, but I believe with continued work I’ll learn how to head it off at the pass, if you’ll pardon the pun. XD
I need to look into Diamox. I’ve heard of it but don’t know a thing about it. If it might help through prevention, I’m there.
I will ask my neurologist in a couple of months about Diamox…..I’m intrigued only because I do get a lot of pressure headaches with weather changes. My irritation is with the cluster headaches that can last up to 5 days, with no known trigger.
I am wondering if stress can trigger a muscle tension headache which can turn into a migraine if left untreated. Inadvertently can stress not play a role in migraines? I think how we handle stress would play a part in whether it triggered a migraine.