The holiday season presents a distinct challenge for people with headache and migraine. Stress is a reliable trigger of migraine attacks — and, wonderful though the holidays are, they make for a uniquely stressful time of year. In this supercharged 2020 year, stress promises to play even more of a starring role than usual.
“There are so many unknowns around what our celebrations are going to look and feel like this year,” says health psychologist Caryn Seebach. “That adds to the anxiety people are already experiencing,” reeling from the twin collective traumas of the Covid-19 pandemic and a tense U.S. election. People are on edge: Anxious, angry, homebound and hurting. Relationships have been strained this year. Full-on family clashes have taken place. “And in the middle of all that, now it’s, ‘What does a Zoom holiday dinner look like?’” says Seebach.
To protect against headache and migraine attacks this holiday, it’s important to understand the stresses that trigger you, as well as how to reduce those stresses. Doing so will set you up for a healthier holiday you’ll be more free to enjoy.
Physical stresses that worsen migraine
The migraine brain thrives with consistency and pushes back against change. But the holiday season yanks us out of the consistent, well-paced routines that help protect against migraine. Sudden, drastic changes to our nutrition, hydration, sleep and exercise can pave the way to a migraine attack.
Common holiday stresses include:
- Getting off schedule. With so much time spent planning, shopping, cleaning, cooking, entertaining, traveling, socializing, and attending events, you’ll inevitably be thrown way off of your usual schedule.
- Too much activity. The holidays cram a lot of activity into a short time, requiring extra energy that you may not have. Pushing yourself beyond your physical limits is a recipe for a migraine attack.
- Holiday excess. Too much food, too many sweets, too much alcohol, staying up too late — in the spirit of holiday overindulgence, it’s easy to lose touch with your body’s migraine stability zone.
How to manage physical stress for migraine this holiday
Get good sleep. If there’s one thing you can keep consistent during the holiday season, make it your sleep routine. Try to maintain a sleep schedule close to your usual by not sleeping in too late and — perhaps the harder part — going to bed around your usual bedtime. Look at it this way: Being the first to head upstairs will be worth it when you awaken feeling ready for more fun instead of feeling rotten.
Have a game plan for maintaining balance. Plan to compensate for a migraine stressor by doing something that will give you migraine protection. For example, if you already know that during the holiday you enjoy eating sugary sweets, which reduces migraine threshold, set aside extra time for your movement routine, to raise your threshold back up again.
Know your own “hard stops.” No one knows your migraine triggers better than you. If you reliably get migraine attacks after drinking brown liquor, or being around ambient noise, or staying awake past midnight, know when to draw the line for yourself.
Emotional stresses that worsen migraine
Holidays are an emotional roller coaster. “The expectation going into the holidays is that you’re going to feel only amazing and joyful and good. And most people don’t,” explains Dr. Seebach. “The holidays also put a spotlight on any type of grief, loss, guilt, frustration, and feelings of ‘I’m not where I want to be.’” Processing such emotions is difficult; experiencing them while under pressure to be jolly is even more so.
Common emotional issues around the holidays include:
- Loss and sadness. If you’re grieving the death of a loved one, their holiday absence makes the pain more acute. Loss also takes many forms. “It doesn’t have to be the loss of a person. It can be the loss of a family dynamic, or a tradition, or of health,” says Seebach. Whatever the source of your loss, the holidays become a reflective time.
- Guilt and shame. People tend to take stock of their achievements as the new year approaches. If you didn’t accomplish the things you’d hoped this year, due to migraine or any other reason, you may dread seeing people over the holidays and fear their judgments. Worse, you can turn those judgments against yourself.
- Changing relationships. As people change with time, so too do relationships. It can be a challenge to see loved ones as they currently are — rather than as they once were, or as you imagine them to be — and the holidays bring that contrast to the forefront. The pressures of 2020 have ramped up those dynamics further.
- Wintertime blues. Depression rates climb this time of year, when holiday stress and seasonal affective disorder converge. People are also prone to post-holiday sadness as the cold and dark of winter sets in and the calendar is empty. Covid-19 may exacerbate that feeling, with colder weather limiting our opportunities to get outside and socialize.
How to manage holiday emotional stress for migraine
Build self-awareness through mindfulness practice. Handling emotional stress begins with being able to recognize it in the first place. When you learn to tune into your body and mind, you can more easily pick up on your stress warning signals. Start now with a simple breathing exercise of between one and three minutes each day. This practice will serve as your secret holiday weapon in at least two ways:
- Preparing for a stressful situation. If you’re about to head into, say, a difficult conversation, notice your physical sensations. If you’re sensing stress signals (e.g. jaw clenching, tensing shoulders, knuckle-cracking) take 30 seconds to recalibrate. Take a few deep breaths, roll your shoulders back, and relax any tightening muscles. Doing so lowers your stress response and thus raises your migraine threshold a little higher.
- Recovering from a stressful situation. An acutely stressful experience creates a fallout effect in your body afterward: a parasympathetic crash that can bring on a migraine attack. After a stressful situation, give yourself at least five minutes to recover with a meditation or a body scan.
Know your own tendencies and have a game plan. Do you tend to overextend yourself to meet others’ needs, at your own expense? Do you tend to get angry around the holidays? Do you tend to numb your feelings with emotional eating? Our own habits often lead us down unhelpful paths. Once you identify your own holiday tendency, make a plan for handling it.
Say “no.” Migraine is sensitive to your overdoing it, making you especially vulnerable this time of year. As an act of self-compassion, learn to judiciously say “no.” This can be difficult for many people, but try to release yourself from guilt. You’re honoring yourself and your own boundaries; if someone else is disappointed or upset, those emotions are not yours to take on or make better.
Set boundaries. Think about your situational “hard stops.” Where might you overextend yourself this holiday, in ways that make you vulnerable to physical or emotional health consequences? There are two variations to consider:
- Situations that will overtax you physically or emotionally
- Situations that will compromise your values
The second is as important as the first, says Seebach. That could mean avoiding difficult conversations about conflicting ideologies. Or it could mean avoiding a gathering altogether. “If you know you’re going to get into an argument with a family member, because it’s happened time and time again, and there’s no way to come out of it self-preserved, this is your time to say, ‘That’s not going to work for me,’” she says. “I’m all for connectedness, but not at the expense of personal health and happiness.”
Get back to basics. Covid-19 is forcing us to take a step back from our usual celebrations. Use it as an opportunity to rethink how you might like to celebrate — and give yourself permission to simplify. Says Seebach, “Often, when you’re trying to make the perfect meal, and make sure everyone around you is happy, and attend every event, you miss the moments that are happening all around you,” like the joy on kids’ faces as they open gifts, or the taste of hot chocolate, or the sound of voices joined in song. “These tiny moments are what bring out the joy of the holidays. What detracts from the joy is when you’re trying to chase a feeling instead of experiencing the feeling.”
So in the name of good health, ask yourself: What does the spirit of the holidays mean to you? If you could design a simple, meaningful holiday around that spirit, what might that look like? Then grab a pen and start to make a plan for your happy, healthy holiday.