If only there was an easy answer to this. Migraines certainly have a medical presentation, considering the headaches, and all of the symptoms that can come with migraines. But for many sufferers, migraines may be as much a product of emotional history, as of bio-chemistry.
I think it’s important to start this post by acknowledging that nobody knows the cause of migraines, and no one has the cure. It isn’t like an infection, where a doctor hands you an antibiotic and says to take this for two weeks and you’re probably good after that. Migraines are a mystery to the medical world, and presents quite differently from one person to the next. While more is being learned all the time, at this point, there is no one identified universal migraine source across the board.
There are many medications that are used to try to either prevent or abort migraines. But for many migraine sufferers, these have little, to no effect (and even for those who are helped by them, this is often only to a point). This isn’t to, in any way, diminish how important the role of medicine and the medical component is to the migraine picture. But for many people, there’s an area of their migraine picture that medicine doesn’t seem to reach. This begs the question if there may be more to the total migraine picture than the medical side can address on its own.
I have written extensively on the role of emotional, relational , and psychological history as relevant in non-organic, chronic migraines, and how certain types (and combinations) of psychotherapy can help for people who have not seen significant results through various medical approaches.
I often receive contact from people who struggle with chronic migraines, and generally their words are positive, acknowledging that these posts have helped them start into the process of understanding their own emotional history, and wanting to work further through life issues that could be contributing to their chronic migraine environment.
But sometimes, I’m contacted by people who are simply looking for a way to discredit the emotional impact on migraines. There are people who try to suggest that my interest in the emotional/relational side of migraines must mean that I reject western medicine, or that I must base my work on archaic methods of practice, or that I think migraines are “all in your head”.
I think for many migraine sufferers (and I have my own migraine history, so I’m not an outsider to the reality of migraines), it’s scary to imagine the answer isn’t black-and-white, and that the answer doesn’t solely lay in the medicine, even if medicine can also be very helpful and necessary as part of the healing process.
Are migraines based ONLY on emotional history?
No, I don’t believe that migraines are purely a product of emotions. Some people are fortunate enough to have very concrete and specific triggers for their migraines, and when they avoid these triggers, they are otherwise fine. But, I have found these cases to be the vast minority of the migraine population.
Migraines are an incredibly individual event. Many people have different symptoms, and different triggers. The mechanism of migraine is not one and the same across the board. What many migraine sufferers don’t always know is that triggers often work in combination, slowly setting the stage internally (the Internal Migraine Environment) for an attack. Sometimes, a trigger can be presented and cause no noticeable effect; and sometimes, if the internal environment is primed, that trigger will put someone over the threshold and trigger a migraine. This is part of what makes understanding the source of migraines so complex.
While some triggers can be concrete, migraine researchers (such as the work of Dr. Dawn Buse, and Dr. Gretchen Tietjen, as well as others) have witnessed the impact of emotional and relational history in the internal structure of migraines. This does not mean that migraines are “all in your head”, or that migraines are something you’re causing, and doesn’t mean to suggest that your suffering is your fault, by any means.
The Mind-Body Connection
People don’t always take the time to reflect on how emotions can impact the body. For two very quick examples: when you feel fear, your flight or flight response takes over — which includes chemical changes in your body, you may feel tension, a surge of energy, less able to relax, your stomach may churn, etc. This all comes from the emotion of fear. The body responds.
Or, if you are stressed, cortisol is released. You may end up feeling a headache, or stomach ache, back pain, tension, or other symptoms, when stressed.
These are clear examples of how our bodies respond internally and chemically to emotional states. Who knows what other chemical reactions in the body and brain took place when growing up, and what your brain may produce more or less of in response to ongoing (and often unconscious) emotional events in the present.
Why are non-medical professionals involved in the migraine conversation, if migraines have a medical presentation?
As long as the source of migraines remains a mystery, it’s impossible to say why they happen — and clearly, as described above, bio-chemistry can shift as a response to external (emotional) stimuli. So, the question remains, what causes the bio-chemical changes for each person that leads to a migraine?
Many alternative practices have been effective for people (acupuncture, homeopathic remedies, naturopathic, yoga, etc.), in addition to western medicine, when trying to solve the migraine puzzle.
When adding psychotherapy to that list, this allows a person to examine their own mind-body connection. There is over a hundred years of literature on how stored (dissociated, repressed, suppressed) emotions can result in physiological responses. This isn’t a new concept. Unfortunately, viewing migraines as a black-and-white medical issue ends up blocking off possible answers and remedies that could help relieve their struggle.
Again, this by no means rejects the importance and relevance of western medicine, and how much it can and has helped people with migaines. This isn’t meant to dismiss all of the current research and advancements in western medicine. Western medicine certainly has helped me, and without it, I’d be worse off. But we can’t ignore that there may be more to the puzzle for people who continue to struggle, even after trying almost everything the western medical field has to offer.
The advancements in understanding of emotional health, as well as emotional health treatments, should be considered along side of the advancements in medicine. People generally tend to have a higher probability of success when they utilize a team approach to combat migraines — a neurologist to oversee the medical area, and then exploring the various other options to combine with it.
Whether or not we want to face it, emotions are a trigger for many, and often times people may not be aware of how this plays out for themselves (for example, if someone functions in a high level of stress or anxiety on a daily basis, they may be so used to this that they’re not conscious of how this is impacting them).
The question isn’t whether migraines are medical or emotional — it’s what are the (combination of) sources fueling your migraine environment?