CBT for Migraine
Adding medications can help with the physiological and changing medications can reduce the side-effect source of depression. What should you do about the situational and fatigue aspects of depression and migraine? Cognitive behavioral therapy (CBT) may be the best answer.
Research and real-world practice has found CBT to be beneficial for a number of issues, diseases and disorders. People with depression, anxiety, type-2 diabetes, autism and migraine tend to do quite well with CBT treatment. Luckily, CBT is widely available in number of settings. Many counselors, social workers and psychologists are specifically trained in CBT.
CBT is based on the idea of the cognitive triad. The cognitive triad is a triangle with thoughts, feelings and behaviors at each point. This illustrates the idea that thoughts, feelings and behaviors are all influence and are influenced by the others. If you have feelings you do not like, you must try to change your thoughts or behaviors. If you have behaviors you do not like, you must modify your thoughts and feelings. Feelings tend to be the most difficult to change because they are challenging to access directly.
A cognitive behavioral therapist will look at aspects of your cognitive triad to look for beneficial adjustments. Consider this example for the interaction between your depression and migraines:
- Thoughts – My migraines will never get any better. My depression will never get any better. My symptoms have been terrible for weeks. Nothing is ever going to change.
- Behaviors – Staying in the house, no contact with friends, only watching TV on the couch, eating poorly and sleeping sporadically
- Feelings – Depressed, anxious, frustrated, irritated, angry, hopeless, helpless
You can see in this example how each aspect impacts the others. A therapist can help you find an appropriate intervention that involves changing a thought or a behavior.
- Cognitive options: Depressed thinking is polarizing and exaggerated thinking. It is based in a world of good or bad, wrong or right, all or nothing. A way to improve your thinking can be as simple as paying attention to your word choice. Odds are that using words like never, always, must, should and phrases like have to and need to will make depression worse. Search for shades of grey and exceptions to the rule. Use words like sometimes, often, might, occasionally and could to begin changing the flow of depression. It may seem like a small difference, but you think to yourself constantly. Small changes yield big results with repetition. Saying, “My migraines might get better” offers hope and objectivity.
- Behavioral options: If you do not eat well, sleep well and have contact with supports in your life, depression and migraines will not improve since fatigue will be more of a negative presence. Changing your behaviors are an easier option because it is more measurable and observable. Can you contact some trusted supports to bring you healthy foods? Eating better will improve sleep and energy levels. Can you find motivation to exercise when symptoms are low? Exercise will help with mood, migraines, energy, sleep and appetite. Behavioral options are limitless. There is always something you can do to improve your symptoms.
When you complete cognitive interventions, you will feel better and be more likely to complete behavioral interventions. The same is true with completing behavioral interventions. If you can work on changing your thinking and changing your behaviors, you will feel amazingly well and your therapist’s job will be much easier.
If you want to limit the impact of migraines and depression in your life, follow the system outlined above. Acknowledge symptoms and sources to gain information. Pursue medications that show high benefit with low side effects. Try some therapy. A clinician well versed in CBT will be able to teach you the skills to change your thinking and change your behaviors. You may not be able to end your pain, but you may be able to feel happier and more hopeful.