A Guide to Surviving the Holidays with Dr. Elizabeth Seng

Gearing up for any holiday is not an easy feat for the normal person. Tack on migraine disease and things get even more challenging. With increased stress loads, scents of cinnamon and peppermint everywhere and dodging triple the triggers - how can we get through it without succumbing to an attack!?

Well, I've got you covered. I had the opportunity to speak with Dr. Elizabeth Seng, a clinical health psychologist, Excedrin head pain expert, and research associate professor at The Saul R. Korey Department of Neurology at the Albert Einstein College of Medicine in the Bronx, N.Y. Dr. Seng offered up some wonderful advice on how to stay happy, healthy and migraine-free during the holidays.

Managing holiday stress

Jaime: First, I’d like to thank you for taking some time out to talk about holiday stress and managing migraine. Holiday seasons can be very stressful for someone living with migraine (and those who don’t!). What advice can you offer on how to stay happy, healthy and migraine-free during the holidays?

Dr. Seng: It's important to make sure you know what headache type you have. Having the right diagnosis and treatment plan will make managing your specific head pain much easier, especially during the holidays. Also, migraine attacks tend to happen around disruptions to daily schedule. Try to keep your regular schedule as constant as possible during the holidays – so your sleep, exercise, and eating routine should remain consistent.

Coping with holiday pressure

Jaime: Personally, I need to begin preparing for the holidays days in advance to avoid triggering an attack. The pressures of putting together the perfect holiday dinner or getting all of the shopping done can create increased stress and feelings of being overwhelmed. What are some of your suggestions for coping with those issues?

Dr. Seng: Preparing in advance is a good idea. Taking the stress out of getting everything done at once can help eliminate added stress burdens. People with migraine are more sensitive to changes to their environment. Take more time to get the same number of things done.

When migraine takes you out of the game

Jaime: There are times when a migraine takes me completely out of the game, and I cannot participate in the joys of the holiday the way I had hoped to. What are your recommendations for anyone who may have to take a backseat to the festivities?

Dr. Seng: According to these Excedrin survey results -

  • 87% of migraine sufferers have had to miss an important event due to a migraine.

You can still spread the holiday cheer over smaller less stressful events. Don’t consolidate your holiday into one day.

  • 76% of sufferers have been left feeling frustrated due to missing out on life events because of a migraine.

Have family and friends prepared for when you may have to sit out of an event – I am making a decision to take care of myself; I am taking the time to feel better.

  • Nearly half said they very often feel misunderstood by non-migraine sufferers after skipping an event due to migraine pain.

People in extended family don’t see your daily struggle so they are less prepared for when you can’t come to an event; have an advocate (close family member) to explain to other family members what you are experiencing. Plan to talk to other family members at other times – set up a phone call or video chat using Skype or FaceTime when you can't be there physically.

Managing holiday triggers

Jaime: Moderation is always key. For many living with migraine, sugar and alcohol are big triggers. There is an abundance of sweet desserts and alcoholic drinks like eggnog during the holidays. What are the best ways to indulge without triggering an attack? Or, if they are just not an option, what are some alternatives?

Dr. Seng:

  • Food triggers could be the situation surrounding the food itself – eating late, i.e.
  • Keep disruptions to a minimum.
  • Plan ahead and use a food diary/food calculator to plan a balanced diet – load half of plate with vegetables/salad, ¼ with turkey, ¼ with carbs.
  • Don’t drink coffee with your apple pie if you never drink coffee in the evening.
  • Don’t drink more alcohol than you normally drink.
  • Be careful of food that may contain alcohol.
  • Ask if there is any alcohol or caffeine in the food.

Traveling with migraine

Jaime: Many people travel during the holidays to be with family. Traveling is a major migraine trigger for me, especially air travel. How could someone with migraine who has to travel make the best out of their trip without winding up in severe pain or dealing with disabling symptoms?

Dr. Seng: In an ideal world you would choose flights that do not disrupt your sleep schedule – avoid early flights. During land and air travel, we eat different foods and at different time frames. Try to eat the same kinds of foods around the same schedule. Pack foods and snacks you normally eat to keep your eating schedule intact. And stay hydrated!!! Carry a water bottle with you. Plan ahead and keep an empty water bottle with you and fill it up throughout the day.

Avoiding after-holiday migraine

Jaime: Finally, after getting through an exciting, fun yet stressful event many people often experience what is known as a “let-down migraine”. What are some of your suggestions on how to best avoid being stuck in bed after the holidays?

Dr. Seng: The brain is very sensitive to stress hormones. Try to keep a low level of stress as possible throughout the holiday season and daily life. Practice deep breathing and taking time to check in with yourself to see if you need to slow down.

About Dr. Elizabeth Seng

Dr. Elizabeth Seng is a clinical health psychologist and Excedrin head pain expert. Dr. Seng is a Research Associate Professor at The Saul R. Korey Department of Neurology at the Albert Einstein College of Medicine in the Bronx, N.Y. Dr. Seng's research is broadly focused on improving management of migraine and painful conditions through modifying behaviors, thoughts, and lifestyle factors. Her current research focuses on improving treatment of migraine and other painful conditions by 1) developing and evaluating various behavioral strategies to improve migraine and pain management, 2) describing and evaluating methods to improve in-the-moment decision-making regarding adherence to medication and lifestyle recommendations, and 3) identifying modifiable factors associated with higher disease-related disability in these clinical populations.

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