By Yuri Cárdenas, as told to Evan Starkman
I’ve been living with chronic migraine for about 9 years, and it’s taken me lot of trial and error to learn how to get relief during a migraine attack.
The exact steps that work for me might not help someone else. Everybody with migraine disease is unique. The symptoms vary from person to person and even from one attack to another. It really takes experimentation, learning as much as you can about the disease, and, ideally, partnering with a certified headache specialist to find out what treatments and self-care techniques will help you.
My migraine attack is not the same as yours. But hopefully, you’ll find some help from the steps I take when I feel one coming on.
Take Abortive Migraine Medications Early
This is key, and it’s something I didn’t do enough in the past. Abortive migraine medicines can abort, or stop, a migraine attack. If your doctor prescribes one or more of them for you, it’s important to take them at the very first sign of an attack.
Currently, I take triptans, gepants, and NSAIDs for my abortive medicines. I try to limit them to no more than two to three times a week, because taking certain abortive meds too often can bring on rebound headaches. Sometimes the abortives don’t work or I’ve taken my limit. So I have a slew of rescue medications I can take if I need to. Rescue meds may not stop a migraine attack but can help ease my symptoms while the attack runs its course.
Migraine attacks can change over time, so the treatments that work for you now might not work later on. Find an abortive medication that works for you. Have rescue medication options, too.
Practice Self-Care Techniques
After I take my medication, I stop whatever I’m doing and get as much rest as possible. If I’m at home, I lie down in a dark, quiet room. If I’m somewhere else, I see what I can change about my environment to make it more migraine-friendly.
While I’m waiting for my abortive medications to kick in, I check on my posture and try to relax my neck and shoulders. I take deep, slow breaths into my belly to keep my body in a relaxed state.
Sometimes a warm washcloth over my eyes or on the back of my neck helps me relax. But if I’m overheated, which can happen in a migraine attack, I use a cold washcloth.
I practice mindfulness meditation to stay in the here and now. When my migraine attack causes physical pain, I use mindfulness to avoid getting lost in thoughts about it. I do my best not to get carried away in stories and meanings I place around that pain.
I also use an electrical nerve stimulation device designed to ease migraine symptoms. I put it on my forehead, and It helps me wait out the pain until my medication kicks in. It’s terrific for the worst attacks when the pain is excruciating.
Make Rest a Priority
If I don’t slow down during a migraine attack, it gets unbearable. We must take the time to let the attack pass when we can.
Pushing through a migraine attack is the worst thing I can do, but most of us have to push through an awful lot. When I do have to push through, I get as comfortable as possible and cancel any upcoming plans that I can.
We don’t want to cancel a plan, but it is so important to listen to our bodies and rest during a migraine attack. I strive every day to be more gentle with myself and accept that some things will have to get done later, and some I have to let go of.
Let Loved Ones Know How They Can Help
Sometimes when I’m in a lot of pain during an attack, I ask my boyfriend to put his hand gently on my back. Something about that is really calming for me.
I also helped him be aware of my migraine triggers. I’m very light- and sound-sensitive, so a while ago, I gave him a migraine checklist: “Are the lights down? Are any sounds low or off?”
Healthy Habits and Support
I’ve found that certain healthy habits and support are vital for me, whether I’m having a migraine attack or not.
It’s important to get some physical activity. I aim for about 15 minutes of gentle movement each day. You can ask your doctor what’s right for you.
I also take care of my mental health. A daily gratitude practice helps me do that. It can shift your perspective toward the things in your life that bring you love, joy, and kindness. No matter what's going on in the world, in your mind, or in your body, a daily gratitude practice is linked to reduced pain symptoms, anxiety, and depression.
I can’t recommend gratitude and mindfulness practices enough for those living with depression and anxiety, which are common among people who have migraine.
I also keep in touch with the people in my life who are loving and kind and accept my disease. That includes people I connect with through online support groups. There are dozens of migraine support groups on Facebook, each with hundreds to thousands of members.
Furry loved ones can provide support, too. My dog Katsu, who’s a trained assistance animal, brings me comfort, joy, and laughter every day.
Looking back, I wish I'd known early on that many people live with chronic migraine for decades, and that it would be a long road of trial and error to try to find relief. Most importantly, I wish I'd really accepted that my identity and self-worth are not based on my productivity. Along with gratitude and mindfulness, being gentler on myself is an ongoing daily practice. It’s like continuously readjusting to the body you’re in.
Yuri Cárdenas, migraine patient advocate, Oakland, CA.
American Migraine Foundation: “How Gepants and Ditans Complement Existing Therapies,” “Medication Overuse Headache,” “Comorbidities of Migraine.”
National Headache Foundation: “Abortive Drugs for Migraine.”
MigraineDisease.org: “Preventive, Abortive, & Rescue Migraine Treatments.”
University of Southern California: “Practicing gratitude can have profound health benefits, USC experts say.”
Anxiety & Depression Association of America: “Gratitude -- A Mental Health Game Changer.”
FDA: “Treating Migraines: More Ways to Fight the Pain.”