New research suggests that it’s the “comedown after the craziness” that can trigger a migraine.

In a small study at the Montefiore Headache Center in New York City, 17 migraine patients kept headache and stress diaries for 30 days. Researchers found that migraines were nearly twice as likely to occur within 6 to 18 hours after a sharp drop in stress – as opposed to the anxious period itself.

Said Dr. Richard Lipton, codirector of the Montefiore Headache Center, “Migraines didn’t occur when participants were getting ready for the big test or finishing a big deal. It’s after they take their test or close the deal that they feel terrible.”
And, surprisingly, stress levels themselves were not linked with migraines, but, rather the size of the shift – from feeling crazed to feeling suddenly calm or relaxed that brought on the symptoms of migraine, including nausea, or a stabbing sensation in a specific spot on the temple or behind the eye.

“I have said for many years to patients: be boring – a little grief regularly and no excesses,” wrote Dr. Peter Goadsby, a migraine researcher at the University of California, San Francisco. “It is silly advice since it would make life less interesting, although it is in keeping with the study findings.”

The “let-down” phenomenon associated with headaches has been known for several years. However, Dr. Lipton said this is the first time it’s been quantified. It’s likely caused by a deactivation of the body’s stress response. One of the stress hormones, cortisol, dulls pain, so when cortisol levels fall, migraine pain sets in.

Montefiore psychologist Dawn Buse suggested migraineurs pace themselves when they know it’s going to be a busy or emotional week. “When you’re cramming, take breaks even if you don’t think you have the time,” she said. Walking outside into the sunshine for a few minutes may help. And, free smartphone apps like GPS for the Soul can remind you to take some breaks, and pull back – so you don’t pay for it later……. Boston Globe 3/27/14

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