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Migraines and our Emotions: An Interview with Psychotherapist Nathan Feiles

Migraines and our Emotions: An Interview with Psychotherapist Nathan Feiles

Do you think your emotions and your migraine attacks may be related? Or do you find no connection? A few years back I sought out a migraine support group and attended a couple of sessions run by psychotherapist Nathan Feiles, who specializes in migraines and has put a lot of thought into the matter. I had since lost contact, but then we reconnected when I responded to his blog posts about emotions and migraines on Twitter. I was curious and interested in learning more. Nathan agreed to an interview. Below, we talk about emotions and emotional history in connection to migraine, therapy for migraine, some self-help tools, and much more.

You discuss at length in many of your articles about the mind-body connection with migraine. I’ve read that early childhood trauma can increase migraine risk, as well as risk for chronic pain in general. Have you found a stronger connection in terms of the mind-body connection in migraines as opposed to other illnesses? If so, why do you think this could be the case?

This is quite complicated, as it is difficult to quantify the mind-body connection. There certainly is literature to support the physiological impact of psychological, emotional, and relational distress (including childhood traumas). I’ve written in several articles about the biochemical response to emotion – using stress as an example, and how more cortisol is released when stressed. IBS [irritable bowel syndrome] is another area that sees significant movement based on emotional states. I’m sure one could make a case that other medically-unexplained physiological events could have at least a combination of emotion involved. However, there are many layers to this. For instance, a person would have to be medically “susceptible” (including with migraines) – why are certain people triggered by things that don’t trigger other people? So the medical component of susceptibility is always there, but with the mind-body connection, the triggers can be many things and combinations, including emotional and relational patterns that reinforce an internal biochemical “setup” for the event. (Added stress = tension, tightening of muscles, releasing more chemicals internally – whatever else happens when a person responds to their emotional environment). I don’t know if migraines are the number one mind-body issue (though a lot of people struggle with migraines), or if other illnesses could have a stronger connection (some believe that some forms of cancer have a mind-body connection).

You posit in “Migraines: The Silent Voice of Our Past,” that “emotional history (past and present) can be a significant factor with chronic migraines.” If a person with migraine is considering the possibility of a connection between their emotional history and their migraine attacks, are there any correlations that you or others have discovered that may indicate how strong a factor emotions may be in migraine attacks?

For example:

  1. When the migraine attacks started, i.e. starting in infancy or childhood verses developing later in life.
  2. Childhood trauma.
  3. History of mental illness.
  4. Effectiveness of medications.
  5. Any other factors?

This is also quite complicated. With therapy, and anything related to a person’s psychological, emotional, and relational history, it’s different for every person. This is one of the reasons it’s hard to fully prove mind-body connection – it isn’t consistent from one person to the next. It isn’t consistent how and why a person feels the way they feel, and therefore, how to treat it from one person to the next isn’t consistent (which is why a good therapist has to learn how to respond to the person in front of them, and not just follow a blanket model). Therapy takes many different forms, and different therapies help different people. So, it’s hard to have a study and say, “this is the percentage of emotional involvement for your migraines”. But, what I can say from experience is that there is often significance to when the migraines started. And there is pretty strong research that shows the susceptibility increases for people who have had adverse childhood experiences, including various types of traumas (whether relational, or larger scale).

From my experience working with people in this area, I would say emotional dissociation (and repression, suppression) is a highly significant factor, as are patterns of internal emotional activation to present pseudo-repetitions of old traumas. Again, this plays out differently for each person. But, the difference is noticeable in how people start to feel when they reconnect to previously dissociated states and are better able to manage and work through emotional states without cutting these parts of themselves out. This includes shifting dynamics to make repetitions of harmful dynamics less likely.

If there is another area that stands out to me and has my interest, just based on patterns of observation – passive aggression, fear of conflict, and people-pleasing seem to be common traits in people who experience chronic migraines. This doesn’t mean everyone who has migraines operates in this way, but I have noticed a general commonality in this area. I also wouldn’t say these qualities alone are triggers, but I do wonder about the ripple effect here (what’s being dissociated and bottled as part of this type of process).

To respond to the medications part of your question – not all medications work for everyone. But when people have tried “everything”, and nothing is touching the migraines, and there is nothing visible medically, I would imagine this is a good indicator that there’s more to look at. Emotional history may be a good place to look next.

Could you tell me a little bit about what you refer to as Migraine Therapy – what makes it different from other forms of therapy and what the patient could expect?

Migraine Therapy is the informal term I sometimes use to reference therapy for migraines. First, it’s important to know that when people seek out “therapy”, they are going to get the school of therapy that that therapist practices. There are many, many schools of therapy, and the combination I use is what I’ve found to be most effective in working with migraines.

The reason I called it Migraine Therapy is because it goes a bit beyond what general psychotherapy tends to do. I have had extensive training in contemporary psychoanalysis and comprehensive psychotherapy, also including years of working with cognitive-behavioral therapy, and trauma and neuroscience-based techniques. There are many schools of thought in the history of psychoanalysis alone (I find contemporary analysis to be more effective than classical), and I apply more “relational” approaches.

With relational therapy, I keep a closer eye on the emotional and relational patterns, “enactments” (repetitions of life patterns) that present in the room, as well as the areas of emotional dissociation, while also working within a general therapy frame (meaning, we talk about the person’s life, and all that comes up in daily life, but we also acknowledge the patterns that repeat in real time and tend to be problematic in some way for the person’s life – locating where the dissociated emotion is, for example).

A person can expect to talk about anything and everything they want. It’s their therapy. While I’m here as a supportive person in their life, my ear is also always looking out for patterns and connections that could be problematic in terms of dissociation, and repetitions that can lead to physiological events. When something comes up that seems like it could use some further understanding and exploration, as related to each person’s migraines, I help focus there with each person.

What also makes Migraine Therapy a bit different is that I sub-focus with people on identifying triggers with them, and helping them to adjust to identified triggers (with CBT-based work), and at times using relaxation, mindfulness, and meditative techniques, as needed. It’s really a combination of a migraine therapy and migraine-based coaching.

I also incorporate what is known in the trauma world as “bottom-up” therapy, where at times we go through the experience of emotion and affect to get to the deeper layers, rather than always starting from the mind.

This is all a bit of the theory, but generally, what a person should expect is just to come in and be themselves, bring in any emotions, talk about whatever they would like, and I do my part to listen for the links and connections to migraines. They will have my support as they go through life with migraines – dealing with people not understanding (often, family and friends), as well as the daily fear of trigger and the impact of this on life, and all that comes with migraines – they will have my support, as well as working further to bring relief.

What sorts of improvements have you seen in your practice when a patient pursues therapy for migraine? What is the success rate in patients being able to reduce either severity or frequency? Are there any cases in which migraine attacks cease to occur? And is there a point where you ever feel like you have dug deep enough and the root of the migraines are not emotional?

It always depends. I have seen significant improvement as people work through various emotional points from their histories (it’s rarely just one event from history, but rather a series of events and patterns, which are different for everyone). I don’t look for the migraines to cease completely – I think that would be unrealistic. But what becomes notable is people saying things like, “I haven’t really had a migraine in the last few weeks… I usually get them once a week”, or something to this effect. People start noticing more space in between attacks, and even people with chronic daily migraine have often noticed more space without headaches in their weeks. Without realizing it, people sometimes have gone from several attacks per month to maybe one per month. It’s a process, so it’s not just waking up one morning and the migraines are gone – rather it’s a process where things shift as you go.

As far as figuring out if the root is not actually emotional – I don’t believe that there is necessarily “one” root for most people (unless their triggers are very cut and dry). I think there is most likely a biological susceptibility for most people (though people without migraines in their family history do suffer from them as well sometimes), and from there, when they are primed emotionally, this can trigger that susceptibility. But, there are also many concrete triggers that are important to figure out as well. Many times in the therapy, people start to make connections to triggers they’d never realized before, and this only adds to the benefit of self-reflection in this process. Unless something shows up on a medical test (including hormonally), it’s otherwise hard to say definitively to someone that emotional-relational process isn’t involved, if they are still experiencing chronic migraines after significant medical effort. Some people function on a high level of stress at all times, and many don’t realize how this impacts them emotionally and bio-chemically (the mind-body connection). It can sometimes take a while for people to break through some long standing patterns that could well be reinforcing migraine environment. That being said, if over time I saw nothing changing, and if we’ve been through a lot of work, with little benefit, then it would be worth considering with the individual if this route is useful to continue with. But also keep in mind that I don’t advocate for this therapy to be the only treatment a person is receiving. I believe in a team approach with migraines, with this therapy being one of the parts of that team.

In, “Migraines: ‘No On Understands!’” you talk about the toll migraine can take on relationships and other aspects of a person’s life. I would imagine most people would benefit from some sort of therapy after years of dealing with migraine, at the very least to deal with the emotional hardship that can occur. How are you able to determine whether or not the emotions feed into the migraines or the migraines feed into the emotions? Does it matter in terms of the healing process?

The first thing to acknowledge in this question, is that it’s not necessarily one or the other, it’s more likely to be both. Emotions can feed migraines and migraines can feed emotions. For example, a person may be stressed at work, and the stress of their work ends up triggering a migraine, and they have to go home. Now, they become angry and resentful about having migraines, and more stressed that they can’t be at work during this particularly busy time. Now they are even more primed emotionally to re-trigger. So it can very much be a vicious cycle. It doesn’t so much matter the direction the cycle is moving, in terms of treatment. Part of the treatment is learning how people respond to emotional states, and well as to external life, day-to-day events. The hope is to learn how to internally (and externally) respond to and manage the significant parts of the cycle, including working through emotionally – rather than acting out or acting in emotionally.

If a person is unable to attend therapy (either due to cost or other factors) is there anything they could do themselves to address a possible emotional factor with their migraines? Are there any resources you would recommend?

Try tracking moods daily (including any mood changes during the course of each day). Track when the migraines occur, and what you were feeling in the 24-48 hours prior to the migraines as well. Any emotional states can be labeled as part of tracking this – happy, sad, anxious, nervous, fear, stressed, depressed, vulnerable, inferior/small/discounted, grandiose/superior, in control, ordered, disorganized, etc. To go a step further, consider labeling any correlations. For example – stressed – children talking back; or angry – spouse yelled at me; scared – spouse is drinking again; happy – did well at work, no stresses at home. It takes a lot of dedication to track emotional states, but it would be a good start to see the shifts and correlations surrounding when migraines occur for you.

You discuss the possibility in “Migraines: Personality Inhibition” that repressed emotions, whether it be sexual or emotional, can lead to migraine in some individuals. Do you consider these emotional repressions triggers or a direct cause of migraine?

This is very complicated. Once again, nothing can be proven, otherwise the answer about migraines would finally be solved – we only can go with observations of patterns. Dissociated, repressed, and suppressed emotions and states don’t simply disappear. If a person is afraid to be angry because of the consequences of anger, they either dissociate from it, or repress or suppress the emotion. But where does the anger go? Some people fear conflict and sit with the emotions of frustration, aggravation, and have no outlet for these emotions. They end up acting in. When a child learns that showing certain emotions isn’t safe, they learn to shut them off from being seen from the outside, and essentially bottle everything up. The overflow for each person is different. But I think it’s both – I think it builds the internal migraine environment, and sets the scene for a trigger to more effectively trigger a migraine, and sometimes there can be an actual emotional repetition (or enactment) that can in itself push someone over the threshold for an attack. Cutting off parts of ourselves emotionally (whether it’s anger, sadness, sexuality, assertiveness, etc.) can lead to many different possibilities, including physiological responses (though I focus more on migraines, physiological symptoms can present in a variety of ways).

You mention in “Migraine Therapy — More Effective Than Medication?” that “a lot of patients often come to me for help when they’ve exhausted every conventional and alternative approach to migraines they can think of.” Does part of Migraine Therapy include working with patients to help determine if they have actually tried everything?

I have had many patients tell me in their first sessions that they have “tried everything.” They then often verbally tell me a list of the various treatments and medications they have tried. I help people with the emotional component of migraines, as well as offering support, and help to manage and figure out the struggle of migraines together. I do ask people what they’ve tried, and require them to seek medical support from a neurologist since I do not treat migraines from a medical perspective. In general, I look for what we are missing in the migraine picture, and this could include areas they have not tried. I will at times suggest or discuss adding another approach if it seems it could be useful. However, whether or not there are other things they haven’t tried, I don’t believe this changes the relevance of emotions and relational patterns that can be involved as part of the total migraine picture.

Many people with migraine report that family members, friends and even doctors dismiss their migraines as emotional, saying things like, “It’s all in your head,” or “You’re just stressed.” In the article, “Why the ‘Migraine Personality’ is Total Bunk,” Anna Eidt writes: “Believing that our fixed personality has somehow directly caused us pain; that migraine is somehow intrinsically a part of who we are can lead to shame, hopelessness, and self-blame on top of the already difficult mix of emotions involved in living with disabling migraine attacks, and that’s just not helpful.” With this dialog in mind, how do we remain open to the possibility of an emotional factor in migraine without contributing to the stigma that migraine carries?

It’s not all in anyone’s head. The pain and the entire experience of a migraine is very real. There is nothing imagined or fictional about being in tremendous pain, having trouble seeing, feeling numb, confusion, vomiting, seeing visual patterns, aural/visual sensitivity, and more. I have had my own history with debilitating migraines, and it would infuriate me when someone would say it’s all in my head, or suggest that I’m doing something to cause them. That being said, our emotional and relational patterns are not imagined or fictional, either. The patterns we developed when growing up in this world, based on the various events that shaped our lives, have an impact on who we are, how we respond to scenarios, events, other people, internally, externally, etc. It’s very important to remember – we don’t have control over these patterns until we become aware and start to shift them. Before we’re aware of them, we continue to re-enact whatever our emotional life patterns are, at times to our own detriment. But this is very different than “doing this to ourselves.” It’s one thing to say, “I know if I drink this wine, I could trigger a migraine”, and then drink it anyway. It’s another thing to unconsciously repeat emotional life patterns that have been instilled for many years, that may work against us. This is very unintentional and not even in awareness. Saying it’s all in someone’s head is a very ignorant and insulting stance to take about somatization.

The migraine puzzle is multi-faceted and complicated. It’s very individual – most people don’t seem to have the exact same migraine experience, including presentations, triggers, or history. The idea is to figure out and work on as much of each person’s total migraine puzzle as possible. Emotions and emotional/relational history are one part of this puzzle (I believe it to generally be a significant piece of the pie)… but not the entirety.

You can learn more about Nathan and his work with migraine patients at his website.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

  • Endless Search
    3 years ago

    I viewed Nathan Feiles’s website and I am left with several questions and with feelings of total frustration. Should I contact him to see if there is any chance in the world that he could help me with the tremendous pain and suffering that I have endured for the past 25+ years due to chronic migraine? How is it that he has the ability to address migraine when it is clearly a medical disease? It is, isn’t it? I guess that this last question is why I feel so upset, frustrated, mad, and any other synonym that means just plain disheartened. Do I suffer from the effects of waxing and waning depression? Yes. Do I find it difficult to emotionally handle many of life’s inevitable bumps in the road? Yes. Are these psychological issues that cause of my chronic migraines? Absolutely not. At least that is what I desperately want to believe. Herein lies the path to the feelings of frustration and discouragement. I don’t want to believe that emotions are the root to migraine. Of course I know that stress came exacerbate any disease but I have not trudged through the muddy waters of migraine all these years because of a psychological disorder. I know people with diabetes, epilepsy, asthma, and other diseases who don’t have the burden of having to explain why they are sick. I am resentful that I have to work so damn hard to validate my disease. That in itself is enough to give me a migraine. Whew, I am so relieved that I don’t have to worry about that because migraine is clearly a medical disease? It is, isn’t it?

  • Lisa Robin Benson moderator author
    3 years ago

    Hi Endless Search,

    Thank you so much for your comment. I have often felt the same frustrations as you, which was part of the reason for interviewing Dr. Feiles. First, it is important to say, no matter Nathan’s or any other single doctor’s opinions about migraine, IT IS A MEDICAL DISEASE. I personally think it is really challenging to talk about emotions and migraines because of the stigma we are trying hard to eliminate. If Nathan’s answers aren’t helpful to you, I would just suggest looking elsewhere. I personally really like this article about “The Migraine Dirty Dozen,” 12 things not to say to people with chronic migraine: https://migraine.com/blog/the-migraine-dirty-dozen-things-not-to-say-to-a-chronic-migraineur/ It might be a helpful one to read and share with the people close to you. Hope this is of help, and feel free to reach out any time.
    -Lisa

  • clrickard
    3 years ago

    Very interesting article. As someone who has experienced migraines since I was a teen, I can see the connection to emotions. I don’t think in terms of them causing my migraines however I do realize they can be the “fuel on the fire” which can make things much worse if I don’t take steps to manage them. I used to have very unhealthy ways of coping with life – I call these “survival tools”. I was stealing alcohol from my parents at age 14 after figuring out my father was dying but no one told us. Luckily, basketball became my “LifeTOOL”. One of my best LifeTOOLS I call ‘Brain Dumping’ – everyday I set aside 5 minutes, maybe more depending on the day, take a piece of paper and just start writing. Don’t think about WHAT you’re writing – just write. Now MOST IMPORTANT: Don’t read what you wrote – just destroy it! The key is when we read it , we reload it back in our brains. It is also very different than journaling, which to me is meant more for ‘reflecting’. It doesn’t make problems of situations go away – it helps to release the pressure that builds up in us! I hope that is helpful for others!

  • Brooke H moderator
    3 years ago

    Hi Cirichard,

    Thank you for taking the time to share some of your experience and tools coping with migraine. I’m so sorry you had to deal with the loss of your father at such a young age with others around you not discussing the reality of the situation. I can only imagine how hard that must have been. It sounds like you’ve done a lot of work to find strategies that are healing and useful with the challenges of life. I really appreciate the suggestion of “brain dumping” writing and value you sharing that tool with the community! Please come here anytime for support.

    Best,
    Brooke (Migraine.com team)

  • chaselife
    3 years ago

    Dr. Feilze has it right on with me. I am very emotional now due to physical, mental and verbal abuse over 20 years. I was in fact silent till marriage with all but one migraine ( had no clue what it was, over studying for an exam). Migraine runs deep on mom’s side with her aunt taking her life once her devoted husband past. I find my outburst prior to migraine just pure acts of crazy, I have no impulse control, sarcastic or over the top stupid happy. Next day 3 day migraine. Dr says no help tried everything. This behaviour and pain has lost me family, my job, my last kiss ck at the can with a relationship. I fear sucide is my crown g glory. It keeps me going each day by giving me the control that at any time I choose I can kill myself. Have a plan, but live my puppy so much under 2 years. But pain has become unbearable with Dr only allowing Amerge, that’s it. Doesn’t work now. Seen Pysciatrists, neurologist, pain Dr. Told there is no more to do nor try. I don’t want sympathy, I just am done surrendering to a life I choose to live.

  • Joanna Bodner moderator
    3 years ago

    Dear Shade,
    I am happy that you took the time to comment and to reach out. It certainly sounds like you are in a very difficult and conflicted state of mind right now and we absolutely hear and feel for you tremendously. You are contending with so much. I understand that you have seen and spoken to many doctors, but PLEASE know that you’re not alone! We understand and know the physical and emotional pain migraine creates. We are always here to listen whenever you need support. If you don’t mind me saying this, I think an important article for you take a minute to read is “Creating a Suicide Safety Plan” and if you are in imminent danger, please call 1-800-273-TALK (8255) or visit their online live chat. Additionally, please know you can always contact the National Domestic Violence Hotline – 1-800-799-7233.

    Lastly, I know it may seem like you have tried everything, but PLEASE do not give up hope for better days ahead! I thought that these articles may provide you with some hope and encouraging thoughts.
    https://migraine.com/blog/tried-them-all/
    https://migraine.com/blog/breaking-through-the-darkness/

    Again, please know that we are always here for you. Never hesitate to reach out with questions, chat or even vent. Please keep in touch. We will be keeping you in our thoughts and sending you loads of good energy.

    Warmly,
    Joanna (Migraine.com Team)

  • Yamihere
    3 years ago

    I’ve had headaches for most of my life. I have Hashimoto’s disease which is certainly enough to deal with, and it can cause or trigger migraines. In fact all descendants of my maternal grandmother have it, but the severity varies and symptoms vary widely. Often a food that a Hashi’s patient ought not eat triggers a strong reaction (if I eat cheese, it’s a guaranteed migraine). Mom couldn’t breast-feed me, I couldn’t tolerate dairy, the only alternative was soy. 55 years later I find in research that being fed soy based formula increased the probability of Hashi’s symptoms as an adult by a significant per cent. But no one knew that then, and there weren’t other alternatives. After I was weaned, it was back to “drink your milk.” I was a self-reliant kid; if I had a headache, I took the aspirin from the medicine chest myself. I don’t recall that I ever told my parents how often I did that. But at age 12 I had a significant allergic reaction while staying with my grandmother: my lips and lower face were very swollen. My cousin drove me to the doctor (I held a book over my face, only my eyes showed), was given epi and benadryl and steroids and told I could never take aspirin again. Acetaminophen had just come on the market & my folks had to buy it so that I could keep self-medicating.

    I have had migraines in response to stress, usually the “let down” headache which hits after the emergency has been dealt with. I note those which occur when I have to deal with difficult people. I found “The Invisible Scar” website a couple of days ago, which VALIDATED what I’d always known but had no label. I can recall certain incidents when the emotional abuse describe on that site was taking place.

    So I wouldn’t rule out emotional triggers, but no way would I ever say migraines are “always” or “almost always” or even “frequently” triggered by stress/emotional issues. Each person is physically, emotionally and spiritually unique. And not every migraine sufferer has been tested for autoimmune disease or even for food allergies which exist without other co-morbidity. I believe that those possibilities should be explored, because if any food allergy is triggering some of the migraines, or thyroid treatment could alleviate some, the patient would certainly want to avoid it.

    And today I found two providers equipped to deal with all three issues: migraines, Hashimoto’s disease and psychotherapy. It won’t be cheap. But I will take money out of investments for this. I ask that all who read this and who pray that I will be able to get an appointment ASAP. For complicated reasons I need to get in to one or the other in the next twelve days.

    It can’t be coincidence that I found these two websites which led me to the website of those providers. I’ve been calling every psychiatrist in network for three weeks without success, and now my insurance must pay for anyone I find who will take me. And the doctors at these two clinics are triple board-certified: migraine/headache, neurology, psychiatry and have autoimmune disease MDs on staff. (And if they’re out of network, my insurance has to to eat it, which I confess is amusing to me at this point – they DESERVE to have to pay!)

    Please please pray for me to get in to one of these doctors.

  • Lisa Robin Benson moderator author
    3 years ago

    Hi Yamihere,

    Thanks so much for sharing your story. I believe a huge part of the power of this site is when people can share for others to read and learn from. I love how you say, “Each person is physically, emotionally and spiritually unique.” I wholeheartedly agree. I also agree that the autoimmune and comorbidity connection should be explored. I’ve been active in the migraine community for about five years now and, though of course I likely encounter the worst cases, a lot of people I converse with have found other health issues, or food sensitivities, etc. and once those are dealt with it can help improve their migraines. That’s why I am always doubtful if someone has tried “everything” because there’s a never-ending list of things to try and investigate.

    It sounds like you are at what will hopefully be a positive turning point in treating your Hashimoto’s and migraine, and I am wishing you the best. I would love if you check back in and let us know how it all goes.

    I’ll leave you with a few articles in case they may be helpful to you:

    Because you mentioned “The Invisible Scar” : https://migraine.com/blog/early-childhood-trauma-increases-risk/

    Information on thyroid diseases and migraine:
    https://migraine.com/blog/migraine-triggers-and-co-morbidities-thyroid-disease-part-2/

    Be well,
    Lisa

  • madihwa
    3 years ago

    In terms of emotions causing migraines, generally I don’t get upset easily. However there is one type of emotional upset that will cause my very worst possible migraines. I’ll describe what happened. I had ordered some books from B&N which had not come but which they insisted had been delivered. So I’m on the phone trying to straighten this out. Just before I finally figure out how they screwed up which took a lot of time, I felt something in my head shift and I knew I was in trouble. It took me 6 months to get rid of that migraine. Now my husband handles all my phone problems.

    Nothing has ever worked on my migraines except Fiorinel with Codeine. I open the capsule and divide it in half into 2 empty capsules. I used to put it into 3. My migraines have, thank god, improved from what they were several years ago. I also have an allergy to wheat (gluten) which can bring on migraines but they’re not as bad as the ones caused by overwhelming tension or stress which, thank god, I seldom experience.

    I really doubt that there is a migraine personality but I wouldn’t be surprised if a person’s personality could be affected by constant migraines. Migraine sufferers often become suicidal. With reason.

  • DonnaFA moderator
    3 years ago

    Hi Madihwa, it’s wonderful that your husband is so helpful in helping you avoid triggers. I’m also reay glad to hear that you’ve had some improvement over the years.

    Thanks for being part of the community! -All Best, Donna (Migraine.com team)

  • Tammy Rome
    3 years ago

    I think that linking migraine to somatization is treading into dangerous territory that sounds a little too much like “migraine personality”. Can emotional states heighten the perceived suffering of someone with migraine? Of course. However, to even suggest that migraine may have an emotional root cause is alarming. That kind of thinking can set migraine research and treatment back 50 years.

  • Lisa Robin Benson moderator author
    3 years ago

    Hi Tammy,
    That’s interesting about the HPA axis. I’m assuming that had to do with trauma in many cases?
    I agree that it’s hard to pin down exactly what Dr. Fieles opinion is considering it does seem like he backtracks. Personally, I have found no emotional triggers with the exception of the “let-down” migraines, though I know we are all different. I’ve also observed others who have been told their migraines are due to stress or emotions and actually had another life-threatening illness that the doctors did not think or know to look for. I think therapy may be helpful for some at least in coping, but do worry about labeling migraines as significantly emotional too soon. It’s a tough balance to strike.
    Lisa

  • Lisa Robin Benson moderator author
    3 years ago

    Hi Madihwa,
    I’m sorry to hear they disrupted your happy life–I very much understand that. Thank you for your comment and I’m really glad to hear you’re doing better!
    Lisa

  • Tammy Rome
    3 years ago

    Correction: HPA axis stands for hypothalamus-pituitary-adrenal axis. Sorry, my spell check took over.

  • Tammy Rome
    3 years ago

    While there is some new evidence that changes in the HPA (hypothalamus-pituitary-amygdala) axis related to early or long-term stress may be a migraine trigger, it is most certainly not a cause of migraine. His final comments appear to back-track many of his early comments. In his closing comment, he admits that emotions are a “significant piece” in solving the migraine puzzle. That may be true for migraine patients who are otherwise unresponsive to medical treatment and have been referred for cognitive-behavioral therapy. However, this is not representative of all migraine patients — only the most severe and intractable. One would certainly understand how unsuccessful treatment of migraine over a lifetime would have an impact on emotional/mental health. It is my opinion that in most cases any emotional relationship to migraine is secondary to migraine itself and not causal or contributory.

  • madihwa
    3 years ago

    I agree, it’s ridiculous. I’ve had migraines since I was 13 and I’m 73 now. I live a comfortable worry-free life. I don’t have to do anything I don’t want to do–every day. I am the most relaxed person around. So why do I get migraines? Fortunately they’re much better than they were several years ago. Thank God! They had me feeling suicidal they were so bad! And when your life is as good as mine, you certainly don’t want to leave it!

  • Lisa Robin Benson moderator author
    3 years ago

    Hi Tammy,
    I agree, though Dr. Feiles acknowledges in the beginning the medical nature of migraine, I would not have chosen the word “somatization.” I’m wondering if you can take a look at the last question I asked him and give me your own thoughts on a good way to keep the dialog open on emotions while not furthering the years-old stigma we’ve had to deal with.
    Lisa

  • Tamara
    3 years ago

    Thank you for this, I really needed it this week. I have fought with depression because of these chronic migraines and it gets really really hard sometimes to handle. I was starting to do better and was able to pinpoint that I get the bad thoughts and crying right before a migraine starts but it does go away when it finally releases. And that was great …. for the two weeks when I got a break between attacks but the last two weeks or so have been attack after attack so my mood starts to spiral downwards and becomes harder and harder to come up from.

    I’m missed more time from work this week because of not mentally being able to handle it than the pain. And then I feel very very guilty that I’m letting my boss down because I don’t even hav a migraine and still not working … and it triggers pain. Such a viscous cycle.

    So an reminder that migraines and mood are related and it’s ok to be having problems is a help. Thanks!

  • madihwa
    3 years ago

    Find a doctor who will give you real painkillers. It’s the only thing I’ve found that works in the 50 years that I’ve had migraines. I’m very careful with the medicine. My doctor knows this. In fact I cut the pills in half.

  • DonnaFA moderator
    3 years ago

    Hi Tamara, we’re so glad that you found the article uplifting. Please know that you’re not alone and we are here to share support and information. Be gentle with yourself. -Warmly, Donna (Migraine.com team)

  • Joanna Bodner moderator
    3 years ago

    Hi there Tamara,

    Thanks so much for sharing such a heartfelt response to this article. I am so sorry to hear how difficult it is for you to manage as can be for so many as well during the phase leading up to the attack. While I realize you certainly sound like you have your emotions and thoughts under better control once the attack subsides, I just want to be sure you have spoken to your doctor or someone about this? It’s important that you get the support that you deserve! Not only from doctors, but counselors, therapists, family, friends, etc. I always like to share this article as one of our contributors discusses breaking through the darkness as it may provide you with a bit of hope. – https://migraine.com/blog/breaking-through-the-darkness/

    Also, please know that you are not alone and that we are here to support you and understanding what you are going through, but if you EVER need immediate help due to thoughts of harming yourself, please NEVER hesitate to reach out to – http://suicidepreventionlifeline.org/. I would also recommend reading this article which may provide you with some comfort as it discusses the importance of creating a safety plan – https://migraine.com/blog/suicide-safety-plans/.

    Thanks again for your comment & especially for being part of our community. We are always here for you!

    Warmly,
    Joanna (Migraine.com Team)

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