Compounding Effects of Trauma With Headache Diseases 

I want to have a tough conversation today. Adverse childhood events (ACEs) affect 61% of Americans, and 16% of adults have experienced four or more.¹ Adverse childhood events (there are ten on the list) range from abuse to neglect to household dysfunction. I want to bring attention to the insidious compounding effects for those of us who have trauma along with headache disease. While I have a genetic predisposition to migraine and cluster disease, I will always wonder what role trauma has played in the severity of my diseases.

The impact of ACEs

When you experience Adverse Childhood Events (ACEs), you learn to live in a state of high alert, which is exhausting. The polyvagal theory explains flight or fight but also includes the freeze response.² These responses keep people from experiencing calm and safety in their lives they need to restore and revive. Speaking from experience, this vicious cycle is exhausting. And not to forget, there are adverse adult experiences as well that lead to similar responses. I find navigating the memories, and my body's reactions to them, challenging as they often seem difficult to manage. Managing headache diseases can trigger my trauma responses, making it even more difficult to get my footing to manage.

The impact of headache disease

The emotional toll of headache disease is real. The brutal pain and the plethora of symptoms can stop a person in their tracks. When the disease isn't well managed, there can be a tendency for symptoms to worsen. A person with high episodic or chronic migraine often experiences high levels of disability, and quality of life is out the window. Experiencing cluster headache attacks day after day, cycle-after-cycle is brutal. Experiencing chronic cluster headache where there is never a day that I can forget my daily management routine, and the beast doesn't send pain signals to remind me he is ready to pounce is exhausting. It also leads to the polyvagal fight, flight, or freeze theory. Experiencing this level of pain day after day, trialing medication after medication and doctor appointments where patients often leave feeling unheard and frustrated takes a huge toll on a person's quality of life.

Adverse events and headache disease

Combining the toll of headache disease with the trauma of adverse life events (experienced as a child or an adult) can feel insurmountable. As a person who experiences both, I feel I have compounded guilt and shame. When my pain ramps up or goes on for days, my mind goes to dark places, assuming the things I learned in abuse are true (things like it's my fault, I asked for it, and I wanted it). I wonder why I cannot just "get over it," and I don't ask, "Why me?" because as a person who has experienced abuse, I have been told countless times, "I deserve it." Over the years, I have worked on these issues, and I'm still a work in progress. I have found some resources that have helped me learn to manage better.

Tips to manage the emotional toll

• Mindfulness - In the book "The Body Keeps Score" by Bessel van der Kolk, I learned how PTSD/C-PTSD (complex PTSD) affects the body.³ I searched for the answer and felt so confused when the answer pointed toward mindfulness activities. However, I'm beginning to experience mindfulness through restorative yoga and other resources I've found from The Danielle Foundation's Resources for Migraine Management class. I'm coming around to the idea and realizing its value.⁴
• Acceptance - I have been in therapy for over 20 years. Each therapist I've seen has a different perspective and insight to offer. Sometimes I focus more on the C-PTSD/PTSD and other times more on the chronic pain conditions, and other times it's about the devastating effect of both on relationships. Overall, I am beginning to have hope for the future by learning to accept my past and present.
• Finding joy/gratitude - Despite the pain and the emotional tolls, I am determined to enjoy life, which looks different for each person. I have two teenage girls who are amazing humans. I have fur babies that are always nearby. I love visiting water, whether it's a lake, the ocean, or a waterfall - having these experiences and soaking them up into my being helps me survive the dark times better.
• Grounding techniques help get me through the really bad moments. It might literally go from day by day, hour by hour to minute by minute. The simple grounding technique I use is:
  • 5: Acknowledge FIVE things you see around you...
  • 4: Acknowledge FOUR things you can touch around you...
  • 3: Acknowledge THREE things you hear...
  • 2: Acknowledge TWO things you can smell...
  • 1: Acknowledge ONE thing you can taste.