You’ve probably wondered how to prevent migraines if you’ve ever dealt with an attack. Migraines can be debilitating, leaving a person with unrelenting pain for a few hours or even several days. Using reliable migraine treatment and management techniques at the first sign of symptoms is key for coping with the condition. However, migraine-prone people can also identify triggers and try to wind up with fewer migraines overall.
First, it’s helpful to understand what a migraine is. “We recognize migraine as a brain disease,” Cynthia E. Armand, M.D., assistant professor of neurology at Montefiore-Einstein and fellowship director and founder of the Holistic Migraine Lecture Series at the Montefiore Headache Center, tells SELF. During a migraine, overactive nerve cells in your brain send signals to your blood vessels that cause a cascade of hormones and other brain chemicals. This process causes swelling and pain, according to the Cleveland Clinic. “Once the nerve signaling gets going, it’s a difficult thing to stop,” Dr. Armand says. Migraines cause a span of symptoms including throbbing pain, nausea, vomiting, and sensitivity to light, sound, and smell. Some also come with auras, or sensory disturbances, that can cause things like blind spots.
“Avoiding migraine attacks can be challenging,” Matthew Robbins, M.D., neurologist at Weill Cornell Medicine and New York-Presbyterian, tells SELF. “Some attacks can be clearly triggered by lifestyle factors, but attacks can also happen spontaneously with no trigger at all.” Luckily, he adds, “there are a lot of safe and effective preventive treatments available that can reduce how frequent and severe the attacks are.”
Although migraines can manifest in different ways, the following advice may help you manage your migraines.
1. Keep a migraine diary.
One of the most common migraine triggers is emotional stress—which we’ve all had plenty of lately, thanks to things like the pandemic and political climate. But other things like caffeine, alcohol, certain foods, hormonal changes, sleep deprivation, weather changes, bright lights, skipped meals, or dehydration can trigger migraines. And that list is not complete. Triggers vary from person to person, so it’s important to learn what yours are and talk with your doctor about how to manage them, Dr. Armand says.
The best way to anticipate when a migraine might be coming on is to track your triggers and symptoms. “Tracking helps establish patterns and can put you more in tune with your body so you can know when to expect a rough patch,” Dr. Armand says. Obviously, it’s not a perfect science, but it’s an easy thing that can help you better avoid migraine pain.
You don’t need to do anything fancy—simply use an old notebook, or even keep it in a notes app on your smartphone. Here are a few things you’ll want to think about when journaling, according to the University of Michigan Medical School:
- Your food and beverages
- Time of your meals
- Exercise schedule and routine
- Weather conditions
- If you’ve experienced any stressful events or strong emotions
- Your migraine symptoms and when they occur
- Your menstrual cycle
2. Develop a schedule.
Being proactive about developing a daily, consistent routine can help you better identify, avoid, and manage triggers, Dr. Robbins says. Every individual’s routine may look different, but a schedule could include: developing consistent sleep habits, being physically active three times a week, drinking water every hour, eating three meals every day, and scheduling a virtual friend date on Friday nights. Of course, sticking to a schedule is not always easy, particularly during the COVID-19 pandemic when work can seep into your personal time and when it seems like we’re all dealing with curveball after curveball. You may find it helpful to set reminders on your phone or to create transition rituals (these are habits that help you ease from one state of mind to another). For example, you could stretch for 15 minutes before bed to help signal the end of your day.
Your schedule may evolve as you identify your biggest triggers. For instance, if you notice that you get more migraines when you go to bed later than normal, then sleep may be a potential trigger. You can tweak your schedule until you find what makes you feel your best. If you know that anxiety leads to your migraines, then scheduling time for grounding techniques or breathing exercises can help you get a handle on your stress and ultimately minimize that trigger.
3. Learn the signs of an impending migraine.
“The earlier a migraine attack is treated the better chances are of the treatment working,” Dr. Robbins says. Fortunately, there are some early signs that a migraine could be on its way.
The most common are premonitory or prodromal symptoms, Dr. Robbins says. These symptoms are often subtle and may include mood changes (depression, irritability, hyperactivity), diarrhea or constipation, drowsiness, and food cravings, according to the Mayo Clinic. They can occur one to two days before a migraine hits, and about 40% to 60% of people with migraines experience them.
About 20% of people with migraines may experience aura about an hour or so before an attack. Auras can include flashes of light, blind spots, and other vision changes, or tingling in your hand or face. They can also be verbal, causing speech or language problems. Rarely, an aura can make your limbs or one side of your face weak.
4. Act as soon as you notice any migraine symptoms.
You can reduce the severity of your migraines by acting as soon as you notice any of these signs (journaling can also help you monitor prodromal symptoms), according to the University of Michigan Medical School. Some pharmacological treatments help decrease your symptoms when you take them during the first signs of a migraine, according to the Cleveland Clinic. People with severe migraines may benefit from taking daily medications that reduce the frequency and severity of their episodes, the Cleveland Clinic also says.
You can also try to reduce as many triggers as possible if you know a migraine is coming. For example, if things like specific foods, dehydration, and stress trigger your migraines, then you can do your best to pay close attention to your diet, drink more water, and practice relaxation techniques as soon as you experience prodromal symptoms. (If you want to meditate but don’t know where to start, this article can help.)
Although you have less time to react to auras, you might be able to mitigate some of the discomfort by relaxing in a quiet, dark room if possible, according to the Mayo Clinic. The organization also recommends placing a cool cloth or a wrapped ice pack on your forehead or at the back of your neck if you can. Of course, there are times when you can’t just take a break. You can only do what you can to avoid triggers and manage migraines to the best of your ability.
5. Focus on what you can control.
“What we’ve been going through this past year is so unpredictable in nature and it’s not a good time for people who have migraines because it is an unpredictable brain condition,” Dr. Armand says. To make the thought of a migraine less stressful, and put yourself in the best position to handle an impending attack when you feel it coming, Dr. Armand suggests really focusing on the things you can control. Come up with a plan for how you can manage your migraines when faced with unpredictable events. This will be really specific to each person, she says, but for example, this could mean outlining what you’ll do if you get a migraine while you’re working from home with kids who are in school remotely. “You can establish strategies like a signal that means it’s quiet time at home or having family members lined up to help,” says Dr. Armand.
Also, if you have a primary care doctor, neurologist, or headache specialist as a resource, ask them to help you get a plan in place for when a migraine is creeping up or hits full force. “We call it a migraine action plan, and it’s important because having a plan helps reduce the stressor of perhaps getting a migraine,” Dr. Armand says. “Migraines are unpredictable, so you want to focus on what you can control versus what you can’t control,” she says.
Even though migraines are painful, getting familiar with your particular triggers and symptoms, focusing on establishing good habits, and having a plan can help you manage the condition now and into the future.
“I would encourage anyone whose life is disrupted by migraine to seek care proactively as we have excellent treatments, and the American Migraine Foundation is a wonderful source to find a specialist and to seek out vetted information about migraines,” Dr. Robbins says.