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Running on Fumes

March 14th, 2009

A while back I wrote a… um… post (rant?) about how stress is not a Migraine trigger (officially) but… why does it seem that way to us so frequently?  The International Headache Society calls stress an aggravating factor, in other words, it’s not considered a trigger, but a factor that can make us more susceptible to our triggers, perhaps lower our threshold to be triggered into a Migraine.  As far as I’m concerned, the jury is still out on this question.  Given that hormonal fluctuations are one of the biggest triggering factors, (such as the hormonal fluctuations that give women menstrual Migraines and increases or decreases in Migraines around menopause), and given that our bodies react to and cope with stress by release of stress hormones (cortisol and epinephrine, among others), I’m betting research will eventually show that changes in stress hormone levels play a role in triggering Migraine attacks.

I’ve spoken with Teri Robert, author of Living Well with Migraine Disease and Headaches, about this topic.  Teri makes several good points – the level of stress in our lives may be largely out of our control, while individual triggers may be in our control.  Therefore if we focus on stress, we may be focusing on something we can do little about, rather than on something we can change.  And, if we blame stress we may be missing other triggers that being stressed makes us forget.  Do you sleep well, or enough, when you are stressed? Do you eat well, regularly, or enough? Do you overdo it on caffeine?

As so often happens, I had a chance recently to be my own guinea pig for these speculations.  I was given a rush project to complete over a weekend, and my world became all about getting it done.  It took me back to college, law school, and my early days as a lawyer, when a project could take over everything, and sleep, food, everything else would go on the back burner. It’s not a mode of operations I have used much in the past decade, and clearly not one that is good for me, but boy was it familiar!

On the second day of the project I woke up early after not enough sleep, my head full of the research I had to do.  I whizzed through getting my son off to school, and whatever I had to do of my morning routine, and was at my desk and deeply immersed in legal research before nine in the morning.  I was alert, turned on, and my mind was moving fast.  I was drinking more coffee than I usually do, and I noticed I had little appetite, and less tolerance for taking the time to eat, or rest.  I don’t know exactly when I noticed, but I could see it coming.  I was definitely pushing myself beyond normal endurance limits, and I could actually feel the point where the stress hormones took over.  When I was 25, I could run like that for several days without triggering a Migraine.  Now I could feel the lurking heaviness around the margins of my mind, crowding right in on the heels of my adrenaline high.  I caught myself before I lost much sleep, or skipped many meals, or propped myself up on much more caffeine than usual.  I forced myself to stop and rest, and although I couldn’t nap with all that caffeine in my system, I did lay down and do relaxation exercises, and I did manage to avoid the Migraine I felt threatening.  My hat is off to Teri for good practical advice, because if I was busy blaming the stress, I could not have attended to the triggers in this way.

I realize I’m not telling you a tale of a Migraine, but of a Migraine averted, and that’s good news. That’s actually another post, for another day, and I’ve written others on the theme – you can push those triggers back at times, and stopping and relaxing can do it. That’s why I offer relaxation teleclasses and recordings!  But if I hadn’t been so aware, and hadn’t had that tool; if my Migraines weren’t managed to the degree they are, I would have had a Migraine that day. In fact, I had one at the end of the project, three days later!

So, was the stress itself a trigger, one in the stack, with the lack of sleep, insufficient food, and excess caffeine? Was the stress an exacerbating factor that made me more vulnerable to the effects of the other three triggers? Or was the stress the producer of the stupidity that made me willfully expose myself to those triggers, the very things I so carefully manage my life to avoid? What do you think?

– Megan

Dashboard image courtesy of Winstonavich/Winston.

Tags: International Headache Society, Migraine management, Migraine triggers, relaxation practice, stress management, Teri Robert
Posted in Managing | Comments (4)