Migraine Management Could Be Enhanced with Mindfulness

University of Mississippi psychology professor Todd Smitherman partnered with Elizabeth Seng, of Yeshiva University, in a study published in the Journal of Behavioral Medicine. Their findings conclude that employing mindfulness techniques may not take away migraine pain, but they can help people learn to enjoy their lives again.

“We can improve people’s functioning by changing the way they approach their pain,” Smitherman said. “Getting people to deliberately engage in activities and other things they care about in their life helps improve their functioning, even without changing their headaches.

Todd Smitherman

“It is important to know that the goal of these mindfulness techniques is not to reduce symptoms. Symptom reduction is great if it happens, but the real intention is to improve people’s functioning.”

Migraines are one of the most common forms of disability in the United States and are one of the most common neurologic conditions worldwide, with some 1 billion people suffering from chronic headaches.

Alongside pain, light sensitivity and nausea, one of the most common results of migraines is missing out on important life activities, Smitherman said.

“Migraines affect your functioning in the world,” he said. “How many days have you missed school or work because of headaches? How many important events have you missed because of headaches? To what extent is it interfering in your ability to function?”

Migraine symptoms can occur up to 48 hours before pain begins, so people who experience migraines must constantly be aware of their bodies, Seng said. Seng is an associate professor in Yeshiva’s Ferkauf Graduate School of Psychology and research associate professor in the neurology department of the Albert Einstein College of Medicine.

This hyper-awareness can translate into fear and avoidance, which stops people from engaging in activities.

“People with migraines have to keep two things in mind at the same time,” she said. “On the one hand, we want you to be aware of everything happening in your body all the time so you can be aware when a migraine is coming, but also, we don’t want you to be hypervigilant and overthinking.”

Seng and Smitherman’s research examined how often a person who experiences migraines engaged in activities that were important to them regardless of their pain level, both with and without using mindfulness techniques.

The study found that people who used mindfulness techniques, such as meditation, were more likely to engage in activities than those who did not.

Elizabeth Sing

“With mindfulness, it’s an attention regulation technique where you can attend to the current moment – not the past or the future – and be aware of all of the sensations that your body is experiencing, but you’re not classifying them as good or bad,” Seng said. “You’re able to let them be what they are.”

These results could be in part due to stress and anxiety’s relationship to migraines, she said. Although stress does not inherently cause migraines – migraines are a separate neurological condition – it is easier for a person who is experiencing anxiety to trigger a migraine, Seng said.

“Any person can get a migraine if they have enough disruptions,” she said. “But for people with anxiety and migraine disease, it doesn’t take as much disruption to cause a migraine.

“Not every person has stress as a major contributor to their migraine and not every attack is stress-related, but stress is an important factor for migraine management.”

Mindfulness is a proven method of stress management, meaning it can help people who experience migraines better prepare and prevent an attack.

Mindfulness may not erase migraine pain, but it could help people live more fulfilling lives without the fear of pain, Smitherman said.

“If we focus exclusively on symptoms, we’re missing the boat,” he said. “These acceptance treatments are giving us another tool in our toolbox for how to improve people’s day-to-day functioning.

“There’s this notion that mindfulness is not scientific, not evidence-based, but that’s what I think is cool about this study: we’ve shown that it works. And it’s something people can do on their own.”

This material is based upon work supported by the International Headache Academy Research Award, the U.S. Department of Health and Human Services, the National Institutes of Health, National Center for Advancing Translational Sciences award no. UL1TR001073, the U.S. Department of Health and Human Services, the National Institute of Neurological Disorders and Stroke award no. K23 NS096107 and the Yeshiva University’s Hollander Seed Fund.