Helpful tips for partners & spouses
Recently I was talking to my 18 year-old about the key to a successful relationship. My views are shaped by the theories of Sue Johnson. She developed a style of couples counseling called Emotion-Focused Couples Therapy. Twenty-five years of marriage has certainly shaped my opinions, too. It occurred to me that the information I shared with him could be helpful to migraineurs and their partners or spouses.
It’s all about security.
Relationships fail in large part because of the perceived lack of security. We all have the innate longing to be loved unconditionally by that one special person. True security comes from believing that someone will never leave, no matter what. When that sense of security is threatened, we naturally act in ways that attempt to restore that security. Some people become clingy while others start fights or withdraw in hopes of engaging their partner once again. Most petty arguments are not about the subject of the fight. They’re about one thing…
Can I count on my partner to be there
for me when the world falls apart?
If your partner has Migraine, it’s really important that he or she knows you will be there for the worst of it. I know what you are thinking. I can already hear you saying, “But what about my need for security?” I get that. I am both migraineur and wife of a migraineur. Trust me. I have a message for your migraineur, too. Just be patient with me. Okay?
A migraineur’s needs during an attack
Your migraineur may not understand this or be willing to share it with you, but you need to know that every attack is much more than just a bad headache. It is a neurological hurricane that impacts all five senses, emotional stability, and rational thought. It impairs communication, comprehension, and the ability to think logically. The symptoms are often so strange that your migraineur may believe he or she is “going crazy”. There may even be times when there is no pain at all, but he or she is still very disabled by neurological symptoms. If possible, choose an attack-free time to talk about his or her needs. At least choose a time when symptoms are mild and tolerable. Find out what he or she needs before, during, and after an attack. Here are some ideas to discuss:
Know the triggers.
Every migraineur has a unique set of triggers. If your migraineur doesn’t know his or her triggers, then it’s your job to help track the attacks to find a pattern. You may notice something your migraineur doesn’t see. Possible triggers to look for:
- Weather changes
- Bright or flashing lights
- Loud noises
- Strong smells
- Alcoholic beverages
- Sugar substitutes
- Caffeine (or withdrawal)
- Nitrates in processed meat
- Fermented foods
- Aged cheeses
- Soy sauce
- Worchestshire sauce
- Histamine-containing foods
- Let-down after stress
- Sleep disturbances or irregularity
- Eye strain
- Getting over-heated or chilled
- Skipping meals
- Grinding or clenching teeth
- Jet lag or time change
- Any change in normal routine
Early warning signs
They can happen up to 24 hours before the headache starts.
- Mood swings
- Neck stiffness or pain
- Blind spots in vision
- Phantom smells or noises
- Food cravings
Signs the attack has started.
In addition to a nasty headache and nausea, these additional symptoms may last for 4-72 hours.
- Blank stare, scowl, or squinting
- Frequent rubbing of the eyes or closing eyes
- Rubbing neck, temples, or forehead
- Pale, clammy skin
- One-sided paralysis
- Slurring words or garbled speech
- Wearing sunglasses indoors
- Holding head in hands
- Short temper or irritability
- Sudden loss of humor
- Suddenly getting quiet or refusing to talk
- Difficulty with verbal communication
- Loses train of thought
- Word loss
- Complaints about noise level or bright lights
- Loss of appetite
- Difficulty staying awake
- Crying spells
The “hangover” is next.
When the pain stops, the attack is not over. It can take another 12-24 hours to fully recover. During this time, your migraineur may experience:
- Continued sensitivity to light and sound
- Muscle aches & general weakness
- Extreme sensitivity to touch (allodynia)
- May complain that their “hair hurts”
- Difficulty speaking and understanding others
Did you add up all those hours?
A single migraine attack can last up to FIVE days! I realize that’s a long time to care for someone. You are probably thinking there is no way you can stop your life for up to five days. Relax. Your migraineur will likely be functional for at least part of the time. That doesn’t mean you’re off the hook entirely. Stay vigilant because symptoms can quickly change from tolerable to totally disabling.
Most experienced migraineurs don’t like to bother people with their symptoms. They have developed ways to disguise their suffering and may put off starting treatment so as not to draw attention to themselves in public. Plus, we’ve been forced to develop independence because we’ve learned that most people really don’t want to know how bad it can get.
That’s where you come in. By learning the subtle signs of an impending attack, you can quietly and discretely remind your migraineur that taking care of his or her needs comes first. When your migraineur knows you will run interference for them with other people, then they can relax and get the care they need to recover from an attack.
Specific things you can do to help:
Think back to the last time you got sick with the flu. What did you need? Was it a good time for loved ones to complain or problem-solve? That’s the way it is during an attack. Migraineurs are at their weakest during an attack. All of their senses are on overdrive and their abilities to reason and communicate are seriously impaired. You can help your migraineur by doing the following:
Sounds are magnified and painful. Whisper, turn down the volume on the TV or stereo, send the kids outside or encourage quiet play, turn off the phone ringer.
Turn off or dim the lights. Close the blinds or install light-blocking drapes. Help her or him find those sunglasses
It’s not the time for cooking foods with strong odors. Avoid using cleaning chemicals, perfume, cologne, air fresheners, or incense. Even some essential oils are too strong. Scent-free is the way to go unless your migraineur specifically requests a scent. Some migraineurs are sensitive to cigarette smoke, exhaust fumes, gasoline, and even the smell of burning wood.
Work with your migraineur to create a migraine toolkit and keep it in the same place all the time. Educate yourself on what is included. Learn what tools he or she prefers in certain situations. Movement makes the attack worse, so save your migraineur the trip. Make runs to the kitchen for drinks and healthy snacks. Administer medicine, refill ice packs, fluff pillows, and help get him or her settled in for some rest.
Gently remind your migraineur to take her medicine, drink water, and suggest comfort measures he or she might forget. If your migraineur is worried about something, reassure him or her that
1) you will take care of it or
2) it can wait until the attack passes.
Ask and accept the answer you’re given about pain level and other disabling symptoms. Now is not the time to problem-solve what triggered the attack or question truthfulness. Save those discussions for after the attack has ended. During an attack, just be with your migraineur. Be their advocate and mediator. Your job is to defend against outside attacks and interpret symptoms to other family members and medical professionals.
I know it is hard work loving and caring for someone with Migraine. Those unpredictable and debilitating attacks put a damper on life, often making it difficult to plan for anything. It can feel like you are all alone. Your migraineur really appreciates that you took the time to learn more about their disease and what you can do to help.