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Migraine: Risk factors and what you can do

There’s no outright cure for migraine, but there are steps you can take to prevent a migraine. Knowing what can trigger your attacks and changing any lifestyle habits that worsen your condition can help improve your quality of life.

Migraine is a complex neurological disorder that causes moderate to severe headaches, usually on one side of the head. Other symptoms include light and sound sensitivity. About one in four people with migraine experience aura, a symptom that makes people see flashing lights or zig-zag lines.

Migraine is a common condition: Nearly one billion people experience migraine globally at some point in their lives. This does not make the condition any more comforting, however. Migraine attacks can be very debilitating and may last anywhere from four to 72 hours. People who have chronic migraine can experience 15 or more migraine attacks per month.

Who Is Most at Risk?

Anyone can get migraine, but some groups of people experience this condition at higher rates. Risk factors include:

  • Age: Migraine is most prevalent among adults between the ages of 30–39. You can get your first migraine attack as early as your adolescent years and during puberty. It’s rare for people older than 50 to experience their first migraine attack at that age. Migraine typically develops much earlier. 
  • Family history: Migraine may be linked to genetic factors. People who have a family history of migraine are three times as likely to experience migraine than those who do not.
  • Sex: Women are about three to four times as likely to experience migraine than men. Changes in hormones, primarily estrogen, can trigger migraine attacks for people assigned female at birth. 

Certain health conditions can increase your migraine risk or make you more prone to chronic migraine. These conditions include

  • Diabetes: A disease that makes it difficult for your body to turn glucose (sugar) into energy
  • Dyslipidemia: A condition that causes high levels of LDL (“bad”) cholesterol  
  • Hypertension: Having high blood pressure 
  • Obesity: Having an excess amount of fat in your body 

Some mental health conditions and other neurological conditions commonly co-occur with migraine. It’s important to note that these conditions do not cause migraine. People with migraine may also have one or more of these related conditions. 

Related conditions include:

  • Anxiety disorders: Anxiety-related conditions like generalized anxiety disorder (GAD) can co-exist with migraine.
  • Bipolar disorder: Bipolar disorder causes recurring cycles of mania (mental state of emotional highs) and depression (mental state of emotional lows). More than half of people with bipolar disorder can also experience migraine attacks.
  • Depression: Anywhere from 28.5% to 36.3% of people with migraine also have clinical depression or major depressive disorder.
  • Epilepsy: This neurological condition causes seizures. People who have epilepsy may also have migraine.
  • Sleep disorders: The two most common sleep disorders you might experience with migraine are insomnia and sleep apnea. Insomnia is an inability to fall or stay asleep. Sleep apnea causes breathing to stop and restart while sleeping.

Genetics 

Genetic factors can increase your risk of migraine. You are three times as likely to develop migraine if you have at least one family member with a history of migraine than those without. More than 50% of people with migraine have a family history of the condition.

Some types of migraine have a closer genetic link. A child who has at least one parent with familial hemiplegic migraine has a 50% chance of developing the same condition. This rarer form of migraine causes symptoms along with muscle weakness.

Genetic testing isn’t part of the standard procedure when diagnosing migraine. Collecting genetic information and learning about your family history can help inform a healthcare provider about your condition and options for treatment. 

How To Reduce Risk

There’s no outright cure for migraine. Understanding your triggers, making any necessary lifestyle changes, and following your treatment plan can reduce how often you have a migraine attack. 

Track and Avoid Triggers

Migraine triggers look different from person to person. Your triggers depend on how your body reacts to certain environmental factors. These triggers can include but are not limited to:

  • Bright or flashing lights
  • Loud noises
  • Medications
  • Missing meals
  • Overuse of painkillers 
  • Physical exhaustion, or overexerting your body 
  • Stress and anxiety
  • Strong odors 
  • Tobacco use
  • Weather changes

Some people have dietary triggers. These foods and drinks may include:

  • Aged cheeses
  • Alcohol
  • Caffeine (or caffeine withdrawal) 
  • Cured or processed meats, such as bacon or ham
  • Dark chocolate
  • Yogurt 

One way of tracking your triggers is by keeping a journal. You may find it helpful to keep a running note on your phone. Logging your environmental triggers and keeping track of what you’re eating can help you and a healthcare provider understand what to stay away from to prevent a migraine.

Dietary Choices 

Your dietary choices can influence the severity and frequency of migraine attacks. Making subtle but helpful changes to your dietary habits can help prevent a migraine.

Preventative dietary choices include:

  • Choose whole-grain foods to increase your fiber intake
  • Drink enough water, which includes nine cups per day for females and 13 cups per day for males
  • Eat fewer foods that are highly processed or high in salt or sugar 
  • Include fresh fruits and vegetables in your diet
  • Limit your alcohol intake, particularly of red wine
  • Make sure to eat at consistent times every day and do your best to not skip meals 
  • Reduce how much coffee you consume to less than two cups per day 
  • Steer clear of any dietary triggers 

Exercise

Physical overexertion can be a migraine trigger, but getting regular exercise can help reduce the frequency of migraine attacks. Some evidence suggests that aerobic (cardio) exercise has several benefits that can improve migraine symptoms and prevent attacks.

These benefits include:

  • Boosts heart rate 
  • Eases anxious feelings and depressive moods
  • Improves sleep
  • Reduces stress 

Exercise sometimes requires a bit more effort and motivation. You may try participating in organized sports or exercising with a loved one or gym partner on days when you’re feeling less than motivated to work out.

Start small and slowly increase your workouts if you don’t work out regularly. Try not to go over your limit, especially if you’re first starting with an exercise routine. Overexertion can have the opposite effect on your condition. 

The important thing here is to find what works for you. Migraine prevention isn’t a one-size-fits-all plan. It’s OK to take time to learn more about your body and triggers. Reach out to a healthcare provider for advice if you need help learning more about exercise options that are right for you.

Manage Stress 

Learning how to manage stress is often a personal journey. Not all stress management strategies will work for everyone. 

Here are a few techniques that can help get you started:14

  • Be mindful about not overbooking yourself
  • Do deep breathing exercises
  • Keep up with activities and people that you enjoy
  • Make time for self-care 
  • Meditate for 10–20 minutes per day 
  • Practice yoga 
  • See a mental health specialist 
  • Stretch your body 
  • Write and reflect in a journal 

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