How can we deal with stress to empower ourselves against migraine?


Stress is a common trigger for migraine, so it’s important to learn to manage it appropriately with techniques like biofeedback, cognitive behavioral therapy, and practicing mindfulness.


“The last ‘S’ is stress management. That's tough because I can't go into my patients’ lives and eliminate stress. So obviously this isn't about eliminating stress, but this is about teaching strategies to be able to cope with stress. To cope with roadblocks that occur in life. I really rely on my colleagues in psychology and their therapy as far as teaching these techniques to patients. These include biofeedback, cognitive behavioral therapy, relaxation techniques, practicing mindfulness. These are all ways that patients can empower themselves, just in their lives in general. We know that these are the things that can be helpful to make those lifestyle changes for migraine management and migraine prevention. Again I really talk to patients a lot about pain behaviors versus life behaviors. A pain behavior is when you have a stressful event in life and you then become victim to it. Whereas, a life behavior is when you say, ‘OK, this has occurred, I'm stressed, I need to take a moment, do some breathing exercises, and then re-engage.’ So those are the keys for managing stress and recognizing that stress is a common trigger for migraine. For someone who has the neurobiological disorder of migraine, it's even of utmost importance to make sure they can manage their stress appropriately.”


Stress can trigger migraine. Biofeedback, cognitive behavioral therapy, relaxation techniques, and practicing mindfulness can empower us against stress. If stress occurs, take a moment to do some breathing exercises and re-engage.

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Amaal J. Starling, MD, FAHS, FAAN

Mayo Clinic, Arizona

Dr. Amaal J. Starling is an associate professor of neurology at the Mayo Clinic College of Medicine. She joined the Mayo Clinic in 2012 and is currently a consultant within the Department of Neurology. Dr. Starling received her medical degree from the Drexel University College of Medicine in Philadelphia. She completed a transitional year residency, a neurology residency, and a headache fellowship at the Mayo Clinic College of Medicine in Scottsdale, Ariz.

Dr. Starling is an active member of numerous migraine advocacy organizations, including the American Headache Society (AHS), the American Migraine Foundation, and the American Academy of Neurology (AAN). She is also involved in events supporting migraine, including Headache on the Hill, Miles for Migraine, and the Alliance for Headache Disorders Advocacy. Dr. Starling is currently serving on the AHS Board of Directors and is the chair of the AHS Advocacy Committee and a member of the AHS Diversity, Equity, and Inclusion Taskforce. Dr. Starling has been the recipient of numerous awards, including the AHS Above and Beyond Award for Service, Manfred D. Muenter Award for Excellence in Clinical Neurology, the AAN Annual Meeting Residency Scholarship, the 2012 Spirit of Mayo Clinic Award, and the Mayo Brothers Distinguished Fellowship Award.

Dr. Starling has authored numerous peer-reviewed publications and abstracts related to her fields of interest, which include migraine, concussion, post-traumatic headache, neuromodulation, and telemedicine. Dr. Starling’s hope is that her research and advocacy will advance care for people with migraine, post-traumatic headache, and other headache disorders. She envisions a future in which all people with headache disorders receive personalized, effective, and well-tolerated treatment options to improve their quality of life.

Interviews from Amaal J. Starling, MD, FAHS, FAAN

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