Migraine Detective: On the Trigger Case

If you are new to migraine, having been recently diagnosed, or have had migraine for years and are ready to change your relationship with the condition, you might think of yourself as a detective trying to solve a mystery. Getting to the bottom of such a complex case will be demanding and time consuming but it will be well worth it in the end.

What is the migraine mystery?

What is the mystery? Learning our migraine triggers. Why is this important? Because the more knowledgeable we become about what causes our attacks, the better armed we will be to prevent and treat them. With some tracking, we become clear about which triggers set us off, when, and why. Also, with careful sleuthing, we learn which of our triggers are avoidable (food, drink, bright lights) and which are not (weather, hormones).

Although it can be an irritating practice, keeping a migraine/headache diary/journal is a great way to start uncovering patterns between pain and triggers.

How do I use a journal to identify triggers?

Consider dedicating a solid window of time to solving this mystery, perhaps 8 to 12 weeks. Find a good blank diary/journal to use that feels good to write in. During this time, track all potential triggers. Think of each trigger as a potential suspect who needs to be investigated and interrogated. There are MANY triggers out there, unfortunately. Use this list to brainstorm. Be sure to include food, drink, sleep, weather patterns, hormonal shifts, encounters with strong smells, stress, anything unusual like sickness (sinus, colds), or use of unusual medication. Also track the level of pain each day using a number scale (0=no pain, 10=worst pain ever). Be as thorough as possible. It is of course important to be specific in your record keeping on the day of a migraine attack, but it is just as important to record each day, so you can look back to the day before a flare up to check for triggers.

Some migraineurs keep a diary like this every day. It works for them as a terrific way to stay conscious about the dynamics between life and migraine. Many migraine specialists ask patients to do record keeping to review daily pain and medications taken. This documentation helps them better understand the progress of their patient. Regardless of whether or not we choose to continually document our pain and triggers, doing so for even a short time can tell us a lot about our migraines and how to avoid attacks.

Everything's documented, now what?

Once there is enough data from the diary/journal to analyze, take some time to look for patterns. Are there certain foods or drinks that caused an attack? Perhaps caffeine or sugar? It will serve you to learn with some specificity what gets your migraines going. When analyzing weather, for instance, a rise in barometric pressure is a trigger for some, while for others it is a drop. For others still, it's simply the change in pressure that is the problem. When looking at hormonal triggers, some women get a migraine on the first day of their periods, some on the last day. There are hormonal fluctuations (progesterone and estrogen) that rise and fall which could account for these migraines. Looking for patterns to learn which hormone might be your specific trigger could be helpful in choosing birth control, for instance.

How can we avoid those triggers?

Once we have carefully investigated each trigger and gained real clarity about what causes our attacks, it is time to consider how to avoid those triggers. If sugar and caffeine showed themselves as potential triggers, the next step would be to cut those things from our diet to see if we experience an improvement. When it comes to those unavoidable triggers (weather, hormones), we then think carefully about how to track those things in order to learn how and when to take medication preventatively to increase our chances of avoiding an attack.

There are so many migraine triggers in this world that we can sometimes feel under attack and as if we are victimized by migraine. Solving the mystery about our triggers can help us feel that we are asserting and reclaiming some control over the condition.

Have you tried tracking your migraine patterns? Have you had any success in discovering your triggers? Share with the rest of us below so we can learn from each other!