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Key points
- People with migraine often demonstrate remarkable resilience to unexpected disabling migraine attacks.
- Letting go of guilt about attacks can help you better manage migraine.
- Select a limited toolbox of migraine management strategies that work for you.
- Instead of worrying about what you "should" be doing, focus on what works for you.
Do you want to be more resilient to life's constant uncertainty? I would recommend taking a cue from people living with migraine disease.
People With Migraine Subvert Stereotypes
There is a cultural perception that people with migraine are fragile.
They just can't deal with stress. They are too sensitive.
Our scientific language even promotes this stereotype; we often describe the brain systems of people with migraine as hypersensitive. And when we bring this concept back out into real life, this perpetuates the cultural perception of people with migraine as being too sensitive, inappropriately sensitive, and basically, not resilient.
But this perception couldn't be further from the truth.
People with migraine are an exceptionally resilient group. Migraine is most prevalent during the busiest time of life, when people are juggling school, work, and building and raising a family, all while managing unpredictable and severely disabling attacks.
So how do they do it? How do people with migraine continue to lead full and productive lives while struggling with one of the leading causes of disability worldwide?
I have learned two particularly important lessons about living a resilient life in the face of hardship from my patients with migraine.
1. Don't take responsibility for things one doesn't control.
Our research has demonstrated that thinking a lot about why migraine attacks occur and who controls them is not often adaptive for people with migraine. Of course, it's not helpful for people with migraine to believe that only chance or fate can control the onset and course of a migraine attack. But it turns out that the belief that you are personally responsible for the onset and course of migraine attacks is not helpful either.
For people with migraine disease, migraine attacks are just a part of life. Prevention strategies can reduce the frequency, but they will still happen sometimes. And beating yourself up for things that are just a part of life isn't helpful. People with migraine who are resilient tend to have this understanding: Migraine attacks are just a part of life, and I am not to blame when I have a migraine attack.
2. They develop and revise migraine action plans ahead of time.
We have never had as many strategies to both prevent migraine attacks from happening and treat migraine attacks when they occur as we do right now. We have devices that stimulate your nervous system in half a dozen different ways. You can take medications and nasal sprays early during an attack to stop it.
We have injections that you or your doctor can give you every few weeks to a few months to help control how often your migraine occurs. And increasingly, we have behavioral strategies to reduce how often attacks occur, including biofeedback and sleep improvement, stress management strategies, as well as emerging evidence on diet and exercise.
But sometimes, having too many tools in your toolbox can be a problem and can interfere with your ability to be resilient in the moment. People with migraine who are the most resilient carefully choose the pieces of migraine management that are the most effective for them and that work best in their lives. It is literally impossible to follow all of the advice out there for managing migraine.
There are only 24 hours in a day. And people with migraine learn early on to be selective about the advice they try to implement in their lives. The purpose of health and wellness activities is to free up more time for you to live your life, not to take over your life.
Self-efficacy is your confidence and your ability to accomplish a task effectively. By being selective about the strategies they use to manage migraine, people with migraine can build their self-efficacy for overall migraine management.
For example, some people have no problem remembering to take a pill every day. For others, that's a difficult task. So they may choose a monthly injection instead. Neither strategy is right or wrong. The question is, which of these builds my self-efficacy for migraine management?
The same thing is true for lifestyle strategies. Although many doctors recommend reducing stress, and my own research has found that stress reduction is a key component of migraine management for many, stress is highly dependent on external variables and may be difficult to change during certain times in our lives. Research has shown that not every person has a link between stress and headaches. Therefore, although many people with migraine have found stress management to be very useful for migraine disease, it is not going to be an important part of every person's toolbox.
Similarly, clinical trials have demonstrated that improving sleep quality can reduce migraine symptoms. However, it is pretty difficult to improve your sleep quality when you're a parent of young children. So, even though your poor sleep quality during that time of life may be contributing to your migraine, that's not feasible during that time.
To Build Resilience, Banish the "Shoulds"
People with migraine build resilience by cutting through the constant messaging about what they should be doing to find a small, tailored set of tools that can help them reach their migraine management goals.
