Taking a Treatment Break

A migraineur's appointments can really add up. There's the headache specialist or neurologist, of course, but also a variety of others, depending on the treatments you're currently trying: acupuncturist, physical therapist, chiropractor, naturopath, massage therapist, therapist.... It gets exhausting, especially when none of the treatments appear to be helping.

Sometimes you just need a break, a few months of no appointments or new medications or treatments. This is a time to relax and recharge physically, emotionally, mentally, and even spiritually, if that's part of your life. But, it is crucial to determine whether you're taking time off to rest or because you've given up on finding an effective treatment. Rejuvenating is good; losing hope is scary and can be a sign of depression.

So, how to take a break without descending into a pit of despair?

  1. Be honest with yourself about why you are taking a break. Do you need to recharge or do you feel defeated? If it's the latter, be sure to:
    • Tell your health care providers. It may be time to try a different treatment or to formally sever the relationship. Sometimes health care providers, whatever treatment they provide, reach the limit of their experience, skill, or knowledge. Unfortunately, many are reluctant to admit this to the patient (or themselves) and instead blame the patient or keep trying ineffective treatments. Being up front about how you feel gives them opportunity to be honest, or at least stop a useless treatment.
    • Tell your headache specialist you feel burnt out. Maybe a medication side effect is wearing you down and you need to stop or change the medication. If you simply need a break from trying new treatments, you still need access to your rescue meds, which your headache specialist can prescribe for you. You'll also be in the back of that person's mind if a new treatment becomes available that seems to address your needs (and avoid the side effects you can't stand).
    • Tell an understanding loved one. Whether it is a partner, friend, parent, clergy member, or sibling, it is important that those who are close to you know what you're going through. They can provide practical help or advice to ease your burden.
    • Take an online depression screening. Depression is comorbid with migraine, meaning that people with one disorder are more likely than the general population to have the other. Treating depression could decrease your migraine frequency and/or severity.
  2. Give the break a time limit, say three or six months. Schedule an appointment at the end of that time so you have a clear end date.
  3. Evaluate whether your appointments are fruitful. One headache specialist had me come in once a month. At first this made me feel he was treating my migraine attacks aggressively, but the frequency wasn't productive. I wasn't burned out in general, I just needed to see him less often.
  4. Consider whether you've reached your limit with a particular provider. If it is time to see a new headache specialist, research will take some time. Getting in to see one will take even longer -- a six month wait for a new patient appointment is very common.
  5. This may seem contradictory, but consider seeing a therapist if you aren't already. They can help you work with the grief, fatigue, and exhaustion of living with a life-altering illness. Learning practical coping strategies will ease the grind of treatment management.

Taking a treatment break should be a last resort -- if you feel like you can keep it up, absolutely do so. But if you need a respite, give yourself one. The reality is that being sick is exhausting and we're humans who have to deal with normal life on top of migraine. We have finite resources. Sometimes the struggle to make another appointment and possibly face another disappointment is just too much.

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