Wednesday, 20 Aug 2014 03:11 PM
By Nick Tate
Migraines are not simply bad headaches. For many of the 36 million Americans who get migraines, they can be debilitating — causing not just crushing pain, but also nausea, vomiting, sensitivity to light, or even a frightening blurring of vision and flashes of what appear to be bright lights.
Each year, Americans spend some $17 billion on migraine medication, outpatient services, doctor visits, and diagnostic services. Treatment typically includes a class of drugs called triptans, but they are expensive and don’t work for everyone. But health experts from the Montefiore Headache Center of New York say there is a better way to treat migraines without drugs.
Dawn Buse, a psychologist and director of behavioral medicine at Montefiore, tells Newsmax Health three scientifically proven techniques are as effective as medication in treating and preventing chronic migraines: biofeedback, cognitive behavioral therapy, and relaxation training.
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The key, Buse explains, is for migraine suffers to learn how to avoid what triggers their headaches and that includes managing stress levels that can lead to attacks.
“Someone with migraine has a sensitive nervous system that reacts to changes in the external environment or inside their body. Those can be changes in hormonal cycles, changes in the weather, actually, [or] changes in stress level,” she explains, in an interview on Newsmax TV’s Meet the Doctors program.
“So what we try and do is teach people how to really keep a calm and steady nervous system by keeping a healthy lifestyle. And there are three very well proven scientifically studied approaches that are non-pharmacologic, so not medicine. They are biofeedback, cognitive behavioral therapy, and relaxation training.”
- Biofeedback is a mental discipline that involves learning how to control the body’s functions, such as heart rate. With biofeedback, patients are typically connected to electrical sensors that help them receive info (feedback) about their bodies (such as heart rate). That helps them focus on making changes in the body, such as relaxing their minds and their muscles.
- Cognitive behavior therapy (CBT) is a type of treatment that helps patients understand that their thoughts and feelings influence their moods, behaviors, and ultimately their health. It is used to treat depression, anxiety, and addictions, as well as migraines. CBT therapists teach patients to identify and change thought patterns and behaviors that lead to stress, which can trigger migraines and other health problems.
- Relaxation training techniques — including meditation, yoga, or just making time for silent reflection or listening to soft music every day — aim to ease stress, which is linked to everything from cancer and heart disease, to chronic pain and migraines. As Buse explains: “When I say relaxation training I don’t mean just kicking back on the couch. Meditation can get you there, doing a guided visual imagery can get you there, yoga can do this. But basically we spend a lot of our lives in the fight-flight-or-freeze response — the activated stress response — and that is the sympathetic branch of the nervous system and when we’re in that activated response, people who are prone to migraine, people who have migraine, that might trigger an attack.”
Buse notes that stress is a key trigger for migraines, but the hormones and chemicals stress produces in the body can linger after a taxing event in one’s life.
“We actually found after someone’s been in a stressful period for a while and then the stress is over, many people will have their attack as they start to relax,” she says. “And what may be happening there is they’ve had these activated hormones and neurochemicals from the stress response for a period of time, that relaxes and again their body goes through a change, and then they have their attack.”
Brian Grosberg, M.D., a neurologist and director of Montefiore Headache Center, adds that migraines are caused by a brain disorder, which distinguishes them from the simple headaches that nearly everyone experiences.
“Migraine isn’t just a headache; [it] is a brain disorder where there are a number of events that occur that lead to a cascade of changes that occur in the brain,” he says. “Headache is one of the symptoms of a syndrome of a brain condition.”
A number of new treatments have become available in recent years, including painkilling drugs and botox, which the Food and Drug Administration has approved for treating people who have migraines at least 15 days a month, he explains. In March, the FDA also approved a nerve-stimulating headband — the so-called Cephaly device — to treat migraines.
But Dr. Grosberg adds that the best way to combat migraines is to identify what triggers them — including stress, alcohol, anxiety, certain odors, caffeine withdrawal, loud noises, bright lights, changes in regular eating, sleeping, drinking habits. A number of foods have also been linked to them, including chocolate, peanut butter, wine and other foods containing MSG and nitrates.
Both he and Buse stress that effective treatments often require a patient-centered combination of medication, lifestyle changes (to avoid migraine triggers), and non-medical approaches, including biofeedback, CBT, and relaxation training.
“No two people with migraine have the same exact type of migraine, and I think that’s the important thing to end up understanding that each [treatment] plan needs to be tailored to that individual,” Dr. Grosberg says. “It’s employing a multi-disciplinary approach — [including] non-medication, paying attention to lifestyle modifications, which are just as important as medication approaches.”
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