The 4-Step Guide to Stress Management for Migraine

Stress and migraine fuel each other. Eighty percent of people with migraine report stress as a migraine trigger. What’s more, living with migraine is stressful, leading to more attacks. Stress, unfortunately, is inevitable. However, the way we cope with stress is something entirely within our control — which is why learning ways to manage stress is crucial for life with migraine.

Stress management for migraine involves exercises that strengthen the nervous system’s ability to dial down its stress response. These brain-training exercises involve tuning into your inner experience to better understand the way you think, feel, and act. We call that self-awareness.

Every time you practice self-awareness, even for a minute or two, you strengthen a positive neural pathway. It’s like doing a tiny bicep curl for your brain. Before you know it, you’ll be flexing a new muscle! However, when starting a self-awareness practice to reduce migraine, it can be hard to know where to begin.

We’ve done the hard work for you. The Care Tuner app lays out four different approaches to self-awareness, all proven to reduce stress. No matter where you are in your life with migraine, these four strategies give you options to help you improve.

#1: Get mindful

A major source of stress comes from the mind’s tendency to skitter in all directions. It ruminates on events of the past. It flits into the future to somehow foresee what lies ahead. It concocts “what if” and “worst-case” scenarios, writes to-do lists, and generally dives down rabbit holes that take it farther and farther away from the here and now. The antidote to the spiraling, stressed-out mind is a strategy called mindfulness. 

Mindfulness means being fully present in the moment, on purpose, without judgement. When you live with migraine, this ability to focus becomes a powerful way to promote calm and dial down pain, even during an attack.

Try our “Breath Awareness” activity:

• • Open or close your eyes for this exercise, whichever is most comfortable. You need not be in a quiet setting. This breathing practice is useful for whenever you need to carve out a moment of peace.
  • Listen to our guided audio. It will walk you through focusing on the flow of your breath, giving you a respite from the thoughts, emotions, and urges tugging at your mind.
  • Start with one minute of daily practice. With time and repetition, Breath Awareness will become easier, allowing you to practice for longer periods of time.
  • Be patient with yourself. The goal is to slowly build up to 20 minutes of self-awareness practice a day, total.

Get mindful with the “Breath Awareness” activity.

#2 Get meditative

With your new understanding of mindfulness, you’re now ready to move into the formal practice of mindfulness: meditation. Regular meditation has been shown to reduce the intensity, frequency and distress of headache and migraine.

Many people fear they “can’t do meditation” because they can’t clear their mind. Fear not. Meditation is not intended to clear the mind! It’s really about how many times you’re able to notice your thoughts drifting, then bring your awareness back to the present — whether that’s 10 times per session or 10,000 times. With practice, the mind will calm and your attention will wander less. Meditations that focus on a specific intention can be particularly useful to rein in your attention, especially when your thoughts are swirling.

Try our “Defusion Meditation” activity:

• • Find a quiet setting with limited distractions. If practicing this meditation for the first time, it will be easiest when your mind is calm. With ongoing practice, this meditation will help you when you’re feeling anxious, stressed, or feel your thoughts racing.
  • Listen to our guided audio. Because we have a tendency to fuse with our thoughts and accept them as fact, this will help you step back from your thoughts and neutrally observe them. 
  • Practice this meditation at least two times this week. 
  • Be patient with yourself. The goal is to slowly build up to 20 minutes of self-awareness practice a day, total. 

Get meditative with the “Defusion Meditation” activity.

#3 Get relaxed

Yet another approach to stress management moves its focus to the body. Do you clench your jaw when under stress? Raise your shoulders by your ears? Crack your knuckles? Breathe shallowly? The unconscious patterns of a body under stress sends signals to the brain that it’s under threat, which can set a migraine attack in motion. But recognizing and easing physical tension through relaxation training can disrupt those signals to help improve headache and migraine.

In relaxation training, the goal is to pay attention to your breath or muscles so that you can home in on areas of physical tension, then relax them. 

Try our “Body Scan” activity:

• • Find a quiet setting with limited distractions. Relaxation will eventually help you most in times of stress, including during a migraine attack. But it’s helpful to start out in times of low stress, until it becomes second nature.
  • Listen to our guided audio, which will walk you through systematically scanning the body for signs of tension and using the breath to actively let it go.
  • Practice at least three times this week. Consider trying right before bed to support quality sleep. 
  • Be patient with yourself. The goal is to slowly build up to 20 minutes of self-awareness practice a day, total. 

Get relaxed with the “Body Scan” activity.

#4 Get emotionally regulated

This last strategy moves its focus to our emotions. The migraine brain likes consistency and balance, and emotions are no exception. The more we can cope with difficult emotions through emotion regulation, the calmer the migraine brain. Studies suggest that poor emotional regulation either makes us more susceptible to migraine, is the result of migraine, or both.

In emotion regulation, you learn to recognize your emotions and assess whether their intensity matches the situation, so you can react appropriately. It helps you step out of negative and rigid thought patterns that are intertwined with strong emotions, which can exacerbate migraine. A good place to begin is by learning to notice when you’re falling into such “thinking traps.”

Try our “Emotion and Thinking Traps” activity:

• • Identify the primary and secondary emotions you feel. The main emotion is the source of the thinking trap. The second emotion intensifies the experience.
    • • Examples: anxiety, frustration, pessimism, cynicism, disappointment.
  • Identify an automatic negative thought that is related to those emotions.
    • • Examples: “What if I have a migraine when I’m out and can’t get to safety in time?”; “I’m just being dramatic and need to push through the pain.”
  • Identify which thinking trap your automatic thought falls under.
    • • Examples: catastrophizing, negative judgments, fortune telling, mind reading.
  • Write your answers on our chart. Be compassionate with yourself as you do so. 
  • Once you are comfortable with identifying your emotion and thinking traps, use our “Thought Map” activity to help develop more helpful patterns.

Get emotionally regulated with the “Emotion and Thinking Traps” activity.

Choose Your Next Step to Improve Your Migraine

You have the power to reduce migraine, starting with managing your stress. The personalized plan within your Care Tuner app is ready to help. You’ve got this!

1. 1. Get mindful with the “Breath Awareness” activity.
   2. Get meditative with the “Defusion Meditation” activity.
   3. Get relaxed with the “Body Scan” activity.
   4. Get emotionally regulated with the “Emotion and Thinking Traps” activity.

Good luck! We’ll be with you every step of the way.