Migraines: triggers, links to mental health and how to manage them naturally

If you suffer from migraines, you don’t need to be told how debilitating they can be. Migraines are much more than a bad headache. They are a neurological disorder that can have an incapacitating impact on your daily life.

According to the Migraine Research Foundation, around 1 billion people worldwide suffer from migraines, making it the 3rd most prevalent illness in the world. And migraines don’t discriminate. Whilst women tend to be more prone, migraines can also affect men and even children.

Migraine symptoms

Migraine symptoms vary from person to person and even the same person can experience different symptoms across different attacks. Whatever the symptoms, they tend to stick around, lasting anywhere from a few hours to a few days. Aside from severe and intense headaches, migraines are often accompanied by symptoms such as:

• Sensitivity to light, sounds and smells
• Fatigue
• Dizziness
• Nausea & vomiting
• Numbness & tingling
• Sensory disturbances such as blind spots or flashing lights (known an migraines with aura)

Common migraine triggers

We know that there may be a genetic component to migraines but the exact ‘cause’ is not fully understood.

There are however some common lifestyle and environmental ‘triggers’ that are pretty well established and are frequently reported by migraine sufferers, as setting off a migraine attack. These include:

• Stress
• Sleep disturbance
• Intense exercise
• Alcohol
• Certain foods and additives
• Excess caffeine
• Caffeine withdrawal
• Fasting
• Skipping meals
• Dehydration
• Changes in weather
• Light, sounds and smells

There are also physiological factors that may play a role in some people, including:

• Menstrual cycle / hormones
• Inflammation
• Gut issues
• Nutrient deficiencies

As with symptoms, triggers can vary between different people and also what triggers an attack for you one day, may not on another occasion. This suggests triggers may be cumulative and it may take a combination of triggers to provoke an attack.

This is why it can be really useful to keep a diary. Tracking your diet, exercise, sleep, stress etc. alongside your attacks and symptoms can help establish any patterns and help you understand the particular triggers, or combination of triggers, that are personal to you.

This can help identify triggers that may not have occurred to you e.g., do they always tend to happen on a weekend when you don’t drink coffee, so could be a result of caffeine withdrawal? It can also help to debunk triggers you have convinced yourself of that don’t seem to be an issue after all e.g., that they always happen when you eat cheese (wouldn’t that be good news!)

Are migraine and mental health connected?

Migraines are painful, debilitating and can linger for several days so, it’s no wonder that your mental health may be affected if you suffer from migraines.

The American Migraine Foundation, found that people with migraine are five times more likely to develop depression than those without migraine, and a 2020 systematic review found that, on average, around 43% of migraine sufferers also had anxiety.

Interestingly, while migraines tend to affect women more than men overall, men who suffer from migraines seem more likely to also experience anxiety.

There are a couple of proposed explanations for the link between migraines and mental health based on factors we know are implicated in both;

Low levels of serotonin

Known as our ‘happy hormone’ low levels of serotonin are associated with depression and anxiety, but also with migraines due to serotonin’s role in regulating pain perception.

Fluctuating oestrogen levels

We know oestrogen is closely linked with our mood…think PMS, post-partum, peri-menopause! We also know that many women experience menstrual migraines suggesting it also plays a role in these.

Stress

This is one of the most well-established triggers for migraine, but stress is also a factor in depression and anxiety. This is linked to the fact that stress increases our cortisol levels which can throw our neurotransmitters, such as serotonin, out of whack.

So does migraine cause mental ill-health, or does mental ill-health cause migraine? Is it the chicken or the egg that came first?

As with most things, there is no one clear answer but the research tells us that it’s likely bidirectional, with each possibly contributing to the other. The good news with that is that by managing one, there’s a good chance it will have a positive impact on the other.

Tips for managing migraines naturally

As there is no one universal cause or trigger of migraine, there is no one, easy, silver bullet solution.

Knowing your personal combination of triggers is a good place to start but some common migraine triggers are not easily modifiable, and avoiding these may not be realistic. E.g. if changes in weather are a trigger for you, that’s not really within your control.

Becoming too focused on simply trying to avoid triggers may therefore not be particularly helpful and may actually contribute to increased stress……a well know migraine trigger!

My philosophy is always to focus more on what you can add in or increase rather than just on what you should avoid. Ensuring you’re getting the basics right in terms of general healthy lifestyle choices is a good place to start for migraine management:

Ensure a good intake of foods rich in nutrients and anti-inflammatory properties e.g. lots of colourful fruits and veggies, herbs, spices and healthy fats

Eat 3 balanced meals a day including quality protein, healthy fats and complex carbs to keep blood sugar levels stable and manage hunger levels

Keep yourself hydrated

Implement techniques and strategies to manage your stress levels

Aim to Incorporate 30 minutes of exercise into your day

Make sleep a priority! All of the above will be harder without adequate sleep!

Focusing on incorporating these tips, will by default mean you will be pushing out some of those common, modifiable triggers but via a process of inclusion rather than avoidance.

Do you need to dig deeper?

Some migraine triggers can be easy enough to spot, for instance, skipping meals or strongly fragranced candles. Others however are a little less obvious.

This is where testing can be really helpful in getting to the root cause of your migraines and potentially provide the missing piece of the puzzle.

If you are still suffering with migraines, even after removing or avoiding the obvious triggers and focusing on increasing healthy diet and lifestyle habits, there are two key tests I would recommend to help you dig a little deeper.

Hormones – because we know sex and stress hormones and neurotransmitter and nutrient levels can play a role. The hormone test I use is a urine test, done over 24 hours and at a certain point in your cycle. This gives an accurate picture of your active sex and stress hormones and their metabolites over the course of a day. It also provides information on neurotransmitters, melatonin and some B vitamins.

Gut – because research shows there is a possible link between gut health and migraine occurrence via the gut-brain axis. The gut test I use provides a comprehensive picture of overall gut health including microbial population, inflammation, immune and digestive function.

If you would like to find out more about these tests and whether they may be appropriate for you, please get in touch. I’d love to help you try and reduce or eliminate your migraines.