Dealing With Anxiety and Migraines
Counselor Eric Patterson and migraineur Sarah share their thoughts on anxiety and migraines.
Eric's Tips for Living With Migraines, Anxiety, and Isolation
Migraines hurt. Sometimes, though, the fear of the next migraine hurts even worse. As a migraine sufferer, you worry about your migraine triggers, where you will be and what you will be doing when the next one hits.
You stress over the potential for embarrassment and other perceived risks. What if I am in a restaurant with friends and I become nauseous and vomit? What if I am driving and I lose control of the car? Over time, the anxiety in you builds. The reasonable concerns develop into distorted views of yourself, your illness, and the world around you.
Anxiety and migraines frequently go hand in hand. Studies show that as many as half of all people with migraines also have an anxiety disorder.
Anxiety disorders usually involve irrational or excessive fears and worry. People fear embarrassment, physical injury, or death. Anxiety is a tricky opponent — it tries to convince you that worrying makes things better and that staying safe is the most important thing. People with high levels of anxiety will isolate because being alone in their house is the only way to feel safe.
How to Beat Anxiety
Of course, being confined to your home only increases anxiety. When you isolate you cut yourself off from your supports and your comfort zone gets smaller. Don’t let anxiety push you to isolation. Here are some tips to manage anxiety:
- Prevent – You cannot control migraines — you can only manage them. With anxiety, prevention is possible. It begins with you taking an honest look at your thoughts, feelings, and behaviors. If you notice you are worrying more, feeling anxious more or to a higher degree and leaving the house less, take action. Anxiety does not stay the same — it always gets worse unless you take steps to challenge it.
- Positivity – Anxiety works by emphasizing the risks of the situation and downplaying the positives. It will be your job to uncover the positives of the situation or event. Anxiety builds with “what if?" questions, so answer back with the realistic likelihood of that happening — or a simple “so what?"
- Plan – The best way to challenge anxiety is by making behavioral changes. Go and do things even if they make you feel anxious. You know migraines are unpredictable, so make back-up plans as well. This way, if you cannot make the Friday night movie with your friend, plan for a Sunday lunch.
- Prepare – If the time of your outing is approaching, take an inventory of how you feel. Doing some deep breathing, progressive muscle relaxation, or autogenic training will reduce your stress and anxiety and you will be more likely to combat the anxiety that is trying to keep you at home. Find routines and rituals that make getting out the door easier.
- Persist – You will have difficulties, but if you continue working towards your goal you can find success. If you surrender to anxiety, isolation becomes a real risk. Stay the course and realize that what you are fighting for is extremely valuable.
If migraines lead to anxiety and anxiety leads to isolation, working hard to notice and contest anxiety in its early stages is crucial. Remember the five Ps listed above. If you cannot find success on your own, consider the sixth P: psychotherapy. A therapist is trained to help you reduce stress and anxiety, ensuring that the best you is available to be seen and appreciated by others.
Sarah's Experience With Anxiety and Migraines
For me, the worse my anxiety is, the worse my migraines are. This perpetuates a cycle and is difficult to treat. However, recognizing that anxiety is a trigger allows me to try to slow or stop it in hopes of slowing or stopping a migraine attack.
Recognizing anxiety as a trigger allows me to try to avoid or address it as it rises. When I feel my anxiety rising, I control my breathing, meditate and remove myself from any anxiety-filled situation.
I visualize my heart slowing down, focus on slowing my breathing and focus only on what I can control. Quality sleep, a clean diet, and lowered stress help in prevention.
Knowing that my anxiety triggers a migraine actually raises my anxiety. The anxiety of getting a migraine causes me to become more anxious, causing more migraines, perpetuating a cycle. Addressing the anxiety before and immediately is important in avoiding the cycle.
Social Situations
I find that social situations make my anxiety rise for a variety of reasons. Simply leaving the house raises my anxiety some days.
Did I pack my medicine? Will I have to leave early? When I come home will I be triggered? What if I get a full-blown attack while I’m out?
How will I be able to leave if I feel a migraine rising? What if I need to lay down? How can I make a quick exit without answering questions, avoiding judgement, and not causing attention upon myself?
Once I’m out, I have a list of triggers that goes through my head, which makes me anxious.
Will the lights be too bright and my migraine light sensitivity can't handle it? Will the noise be too loud? Will I need to speak louder?
What foods will be served and what is in each option? What if there is no food?! Will there be water I can drink? Will I be sitting or standing?
Judgment always gives me apprehension. Will I be told that I look good and I must be feeling good? Should I explain how I really feel?
Will I be told I don’t look good and understand that I’m not hiding it as well as I thought? What if I have to cancel going? Will the host understand? Will the guests talk about how I’m absent and all their wild accusations about my health and their assumptions of it?
If an event is particularly important, I have anxiety as it approaches and get anxious about missing it. I have missed so many important days in people’s lives and it really frustrates me.
I think of myself as a good friend and family member and hate that it’s not in my control to show support for others. Missing an event not only brings up all the judgment feelings again but also saddens me that I’m forced to miss wonderful times because of migraines.
Medications
As I said, not having my medication with me causes anxiety. But the medication itself actually causes me to worry.
Medications give me bad side effects. If it’s listed on the long list of side effects, I get it — plus more. Taking medication often makes me feel worse in different ways than the reason I am taking it.
A new medication brings new concerns. An old medication brings realistic views and anxiety of the side effects that I had in the past and fear that they will return again.
Taking medication correctly also makes me worry. To begin with, treating my migraines correctly can be tricky. I can only take certain medications at certain times, so many times a day, week or month.
Along with that, I can’t mix some medications with others. I am always so cautious not to overmedicate or give myself reactions for differing medications. It’s a fine line to walk.
The medications I’m on are not always easy to take, and I tend to throw up my pills. I take the pill to relieve my migraine, and a few minutes later I’m in such pain that I’m sick.
Now what? Do I take another? Do I wait to see if this one is in my system and will kick in? What do I do now?
I take an injectable for the immediate relief of knowing that the medication is staying in my system. But injecting myself is not an easy task — I have my husband inject me but am unable to tell him the directions.
He is a pro at this point, but I can’t tell you how many times I’ve sat there waiting for him as he reads every word of the medication “pamphlet" — which might as well be called a book.
While I’m sitting there with a full-blown migraine, my anxiety rises waiting for the injection. The injection hurts and gives me a horrible rush that makes my heart race, my skin crawl and sometimes spikes my migraine.
I eventually get relief, but struggling through the worse-before-better stage is always anxiety-ridden.
Post-Migraine
Once I have had a migraine I feel quite uneasy about it coming back. Going through such pain is so scary and knowing it will return makes me walk on eggshells in fear.
I am constantly surveying my surroundings and how I feel. It doesn’t go away since my migraines don’t go away.
I hate feeling out of control and that’s exactly what migraines and anxiety are. So, like I said, I control what I can. I breathe, I stay calm, and I prepare myself the best I can.