Searching for a cure for your migraines can make you want to bang your head against the wall. Most preventive meds were originally developed to treat other conditions (like depression or epilepsy) and can have unwanted side effects—if they have any effect at all. As a result, many migraineurs (yes, it’s a word) experiment with treatments. That’s what Lisa Jacobson did for 25 years, during which time she figures she endured some 9,000 migraines. Slowly, through painstaking trial and error, and with constant vigilance, she tweaked and refined her strategy—until, three years ago, her daily head pain disappeared. For months. Now when the occasional migraine strikes, she knows how to manage it. We asked Jacobson, 58, founder of the support site The Daily Migraine, to share what she’s learned.
1. Your Journal Is Your Bible
Years ago, Jacobson’s neurologist advised her to track her migraines. “One day I looked over my journal and noticed that all my migraine-free days occurred on vacation,” she says. “My doctor agreed it probably meant stress was a key trigger.” Jacobson still relies on her diary to identify triggers, as well as figure out her most effective remedies.
2. Stress Is Enemy Number One
“There are direct connections between parts of the brain that control emotion and the pain pathways activated during a migraine, which means that stress, anxiety, and depression can bring on attacks,” says Rashmi Halker Singh, MD, a neurologist at the Mayo Clinic in Phoenix. When Jacobson feels overwhelmed, she practices deep breathing or does a 30-second meditation. If she starts getting a migraine, she retreats to a dark room. Some migraineurs are prescribed antianxiety medication or cognitive-behavioral therapy to cope with stress.
3. Drugs Can Help, But There’s No Magic Pill
If a headache feels imminent, Jacobson retaliates with a triptan. These stopgap prescription meds, like Imitrex, Maxalt, or Zomig, bind to serotonin receptors that are found in the pain pathways responsible for migraines, explains Halker Singh. When Jacobson takes one at the first sign of an attack, it reliably gives her 24 hours of relief. But using triptans too frequently can cause rebound headaches, so she limits herself to two a week.
4. Turtlenecks Are a Migraine Don’t
For Jacobson, getting too hot is a trigger, so she always dresses in layers she can easily remove. “I own probably 20 cardigans, in every color.”
5. It’s Okay to Wear Ice Packs on Your Head
One of Jacobson’s warning signs is a feeling of pressure behind one eye; she’s found that when it hits, putting ice on her head can stave off the pain. She teamed with a friend to develop the Migraine Hat, a snug beanie with compartments for ice packs.
6. Nothing Tastes as Good as a Clear Head Feels
Jacobson doesn’t consume aged cheese, sugar, white flour, alcohol, or MSG. “I think eating whole, unprocessed foods has made me less prone to migraines,” she says.
7. Normal Is Worth Celebrating
“I try not to worry when the next migraine will hit and instead revel in every moment without pain,” Jacobson says. Bonus: Choosing to feel grateful instead of on guard helps keep stress—and pain—at bay.
8. Not Just a Headache
A migraine is a neurological disorder that is largely inherited and characterized by overexcitability of specific areas of the brain.