Why Do the Holidays Trigger More Migraines?

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Getting up the outdoor decorations before it’s too cold, putting up the tree, enjoying the celebration of lights, celebrating with family and friends, baking cookies, wrapping gifts, hosting and attending parties, expressing faith—ah, the holidays! These romantic, magical elements of Christmas often fall short and prove exceptionally difficult for migraine sufferers, since they expose every potential trigger for many.

Think for a moment—stress levels are much higher, we are exposed to many of the foods and drink that can trigger an attack, and we don’t tend to stay in our normal sleep patterns: “periods of high stress and poor sleep increase one’s risk of having a migraine more than either one of these alone” (Newman).

Stresses/Triggers: If we remember that migraine results from a brain that is very sensitive to even minor deviations in our normal routines, we can better identify and understand the numerous triggers at this time of year:

• Food and Drink: In 2020 we won’t be attending or hosting parties, but we are still exposed to more food and drink triggers than at any time of year: “Commonly reported food triggers of migraine include red wine, processed meats, chocolate, nuts, and aged cheeses” (Newman)
• Taking on Too Much: Living with migraine often makes getting through our normal days difficult. Add to that, gift purchasing, decorating, baking, sending cards, making phone calls to those you cannot be with, juggling work and the holidays, and cooking more. Additionally, this year, we have to send packages to those we typically would see. Also, we want to volunteer our time and money to those who have lost their income through the pandemic. All of these tasks, while inherently good, lead to a loss of control, increased stress, less sleep, relaxation, and exercise—all of which easily lead to migraine attacks.
• Loss and Grief: The holidays are typically times of family and friends, but they also bring front and center those whom we have lost, who are no longer with us. The emotional roller-coaster of the holidays is dangerous for a migraineur.
• The Winter Darkness: Increased darkness, less light can lead to depression and Seasonal Affective Disorder (SAD)
• Sensory Overload: The varied fragrances (candles, Christmas trees, and flowers) associated with the holidays, the many lights and sounds surrounding us, trigger attacks for many migraine sufferers whose brains are hypersensitive to smells, lights, and sound.

COVID and the Holidays:

This holiday season is more difficult than most. We may not have to cope with the stress of juggling family and friends for gatherings, but the very fact that we cannot be together is painful. The stress of isolation, being unable to carry on with family traditions and rituals is distressing and emotionally draining. We are forced to find alternative ways to get gifts to those with whom we typically exchange, and we still can’t experience the joy of watching them open their gifts. We cannot gather for social and office parties, times we typically let down and enjoy one another. We cannot hug the people we love and care about. These are additional factors contributing to migraine during the 2020 holidays.

Let-Down Migraines:

Yesterday morning, I had to get up at 5 a.m. (not my usual time) to give a presentation at a conference on Zoom that originated in the United Kingdom. I had worked for two days on a meaningful PowerPoint and accompanying notes to present. I hadn’t slept well, fearing the technology wouldn’t work, and, then, as I feared, just as I was prepared to start, the connection for sharing my PowerPoint failed, and I was left to talk my way through the presentation for 35 minutes. (I was actually proud that I didn’t get too flustered and didn’t start sobbing.)

Shortly after, I could feel my neck pain start in “that spot,” and by early afternoon I was completely swept up in a full-blown attack.

This kind of migraine, one which comes after a stressful event or experience, is common during the holidays. We may get through the chaos of the holidays and think we have survived, only to be struck after: “In the first six hours of reduced stress, a person’s risk of getting a migraine increases by nearly five times (Smyres).

While researchers aren’t certain about the cause of let-down migraine, the theory is that while the hormone Cortisol acts as a sort of shield during stressful periods, the levels drop once the stress is released, leaving us open to a migraine attack (Smyres).

How Can We Help Ourselves During this Season?

While becoming more aware of some strategies to minimize our risk of migraine, we know all of these suggestions are “easier said than done.” Here are some reminders to keep in mind throughout the holidays:

• Stay on your sleep schedule.
• Don’t deviate too much from a healthy diet: stay away from your food triggers.
• Minimize alcohol intake.
• Build in time for you—relaxation, yoga, reading, meditation, physical exercise.
• Pay attention to your body and your moods.
• Avoid over-planning and multi-tasking
• Be kind to yourself when you suffer a migraine attack, one which might prevent you from completing a task or doing all you had intended.

Guilt of Migraine

According to Dr. Berk, a neurologist and an Assistant Professor at the Department of Neurology and Division of Headache Medicine at NYU Langone Health, in his article “A Migraine Specialist on Coping with Migraine During the Holidays,” migraineurs often suffer from guilt associated with experiencing migraine during the holidays and must work to realize they are blameless in having to sometimes put their health first.

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Paula Kamen, in her wonderful essay “Down the Rabbit Hole,” reminds us when she quotes Dr. Vincent Martin’s explanation of migraine triggers:

You’ve got this nervous system that’s overreactive to both your internal and your external environment…The more stress you have, the more headaches you get. You might eat the wrong foods; you might drink too much coffee…weather changes might bother you…It’s as if in this particular nervous system every change in the environment actually provokes a headache. And that’s a system that you live with and I live with, and it’s just a very sensitive type of headache (Kamen 19).

During this very unusual holiday season that is 2020, try to take a deep breath, take care of yourself as best you can, absorb the real meaning of your holiday, and do your best to stay in touch with those you love and care for.