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Sometimes, the worst part of migraines isn't the pain, it's the fear of when the next
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attack will strike.
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Migraine Heroes is a podcast for chronic migraine sufferers who've seen countless doctors with
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Learn how to reduce your migraine attacks without endless medications or constant sacrifices.
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Hello, I'm Diane Ducarme.
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I've helped over 500 people break free from migraine, even after suffering for up to 60
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My mission in life?
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To bring this relief to a million people, using a unique blend of Eastern medicine and
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In this episode, you will learn why anticipatory anxiety is so common in migraine and how
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your brain wires it in.
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What science reveals about the vicious loop between fear and attack frequency. And Eastern
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strategies for calming the fear of the next and restoring resilience, like the teaching
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of the two arrows.
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Let's talk about anticipatory anxiety, the fear of your next migraine.
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If you live with migraines, you know the feeling.
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A scanning of your body for signs, a tension in your chest, a fear of making plans because
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you don't know if the pain will crash in.
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It's like living with a shadow that follows you everywhere.
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And people I work with mention at times a little ghost that almost follows you and threatens
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Science confirms this is real and actually measurable.
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A 2021 study in the Journal of Headache and Pain found that up to 40% of chronic migraine
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patients report significant anticipatory anxiety, the dread of the next attack, even on pain-free
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This anxiety is associated with higher attack frequency and poor quality of life.
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Neuroimagining studies show why.
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A 2017 review in Cephalalgia explains that migraine brains have hyperactivity in the
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amygdala, the fear center, and dysregulation in the prefrontal cortex, the calming center.
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So that means your brain literally over-anticipates threats and under-delivers reassurance.
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And to that, the concept of allostatic load, the cumulative burden of stress.
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A 2018 paper in Pain Reports found that migraine patients who live in a constant fear of next
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attack actually carry higher cortisol levels and greater inflammatory markers even outside
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In other words, the fear itself becomes a biological trigger.
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So here's the vicious cycle.
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You experience a migraine, you dread the next one.
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That dread activates your nervous system, stress hormones rise, the increased stress
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lowers your migraine threshold, and bam, a new migraine arrives, reinforcing the fear.
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The medical community now calls this the preictal anxiety.
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Anxiety in the window before an attack.
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Some researchers argue it's not just psychological, it's a prodrome symptom of migraine itself,
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wired in the disease process, and I think I align with those.
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So if you've ever thought, am I imagining this?
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The answer is no, the fear is real, it's wired in your brain's migraine circuits.
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Through my work, I've seen that people live in a constant state of alert.
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Often these are people who experience childhood trauma growing up with strict or demanding
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parents, being put up in charges of siblings, acting as mediators in their parents' divorce,
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or protecting one parent from the other in abusive situations.
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In these cases, the vagus nerve becomes trained to stay on guard, scanning for threats, and
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holding the body in a perpetual state of tension.
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Yesterday, in an anxiety group called Migraine Heroes, we explored these themes together,
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and so many beautiful and invulnerable stories surfaced, each showing how early survival
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strategies can evolve into a hyper-alert state in adulthood.
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At Migraine Heroes, when we work with food, our goal is to bring nourishment to the vagus
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nerve while removing toxic inputs that feed inflammation, and this helps the system begin
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to relax while also helping people recognize the defense mechanism they've relied on
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for years, mechanisms that now often manifest as migraines.
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You see, the gut-brain axis is bidirectional, but so is the emotion-to-gut axis, and what
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lives in the mind also lives in the body, and what lives in the body also shapes the
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And by addressing both together, we've discovered just how far we can take people in their healing
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journeys, and that is something truly powerful and joyful.
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And in so many ways, this is what I mean when I say you are no longer alone at the end of
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This is happening. We are coming, and we're coming to help.
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In Buddhist teaching, there's a powerful metaphor known as the two arrows.
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Now, before I explain the teaching of the two arrows, I want to be clear that this comes
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from Buddhism, not from me, and while I don't disagree with it, and in many ways it aligns
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with what Western science says also, I've come to appreciate something important.
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Every story, every brain is unique.
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The way each of us feel pain, receives pain, and responds to it is different.
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Pain levels and pain resistance can vary enormously from one person to another.
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So, back to Buddhism.
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In Buddhist teaching, there's a powerful metaphor known as the two arrows.
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The first arrow is the unavoidable pain itself, whether it's a migraine, an ache, or an
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The second arrow is the suffering we add on top, the fear that it will get worse, the
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judgment that it shouldn't be happening, the tightness and resistance we wrap around
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That second arrow often hurts more than the first, at least in Buddhism.
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One practice is to gently sit with the pain and watch it like a wave.
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Notice how it rises, peaks, and falls.
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Pain is really rarely static, it shifts in intensity, location, texture.
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By observing without judgment, you discover that the sensation is not an immovable wall,
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but a moving tide.
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You don't have to like it, but you don't have to fight it either.
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When you practice this, something softens.
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The body no longer braces against the pain with extra tension, the mind no longer spins
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with dread about the next movement.
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What's left is simply the first arrow, still difficult, but lighter, cleaner, and less
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And with less resistance, now the nervous system has more space to begin its own natural
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In traditional Chinese medicine, fear and worry are linked to the kidney and spleen
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The kidneys are the root of life force.
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When fear is chronic, kidney qi becomes depleted.
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This creates a sense of fragility and heightened reactivity.
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The spleen governs thought and digestion.
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When overthinking takes hold, spleen qi weakens, produces dampness.
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The dampness then clouds the head, leading to heaviness, fog, and migraines.
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The dampness can wrap around the kidney and make the kidney weaker.
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What's striking is that traditional Chinese medicine doesn't separate anxiety from the
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It sees them as two sides of the same disharmony.
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Fear of the next attack weakens the body, and the weakened body becomes more vulnerable
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Ayurveda echoes this.
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Anticipatory anxiety is seen as a vata imbalance.
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Vata, the dosha of movement and nervous energy, becomes aggravated when routines are unpredictable
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and the mind races into the future.
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An aggravated vata makes the nervous system hyperactive, exactly the environment where
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What's important here is this shift in mindset.
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Eastern medicine doesn't treat anxiety about the next migraine as irrational.
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It treats it as an early signal, a sign that your energy is unsteady.
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And by listening to it, you prevent the attack instead of punishing yourself for being afraid.
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And here's something you don't often hear.
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One of the strongest antidotes to anticipatory anxiety isn't just relaxation.
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In traditional Chinese medicine, the kidney, water, and heart, fire, are linked in what's
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called the controlling, or ke, cycle.
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Water restrains fire, and fear, the kidney, keeps joy, heart, in balance.
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But when fear is excessive, it over-controls fire and smothers joy.
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This is why prolonged fear can manifest as anxiety, timidity, or even palpitations.
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The heart is not allowed to shine.
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Pathologically, if the kidney yin is too depleted, it fails to anchor the heart's fire.
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The result is that fear and agitation coexist, leading to restlessness, racing thoughts,
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The person feels both drained by fear and consumed by the heart's unchecked fire.
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In the West, we don't describe this in terms of elements, but we see the same truth.
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Joy can act as an antidote to fear.
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When you deliberately cultivate joy through laughter, gratitude, connection, you shift
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your nervous system out of the fear's grip.
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Joy lifts and warms the heart, counterbalancing the cold weight of fear.
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Where fear constricts and isolates, joy expands and connects.
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And in this way, the wisdom of both East and West converge.
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Joy doesn't erase fear, but it dilutes its power and allows your heart to keep beating
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And so, a 2019 study in Frontiers in Psychology found that positive-effect moments of genuine
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joy reduce migraine frequency and intensity, independent of stress.
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It's not just about lowering anxiety.
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It's about creating a buffer of resilience.
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A stand-up comedy.
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For the English speakers, I love Jack Whitehall, I highly recommend, and Michael McIntyre.
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Great antidotes on a very stressful day or stressful night.
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Now, as always, I am not suggesting by any stretch of imagination that preventing the
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anxiety around migraine attack is as simple as watching a stand-up comedy show.
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What you're living with is incredibly hard.
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Every single day, you show up to the world carrying an invisible disability, one that
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society is still completely ill-equipped to recognize, to address, or even to show compassion
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So what I'm saying is that when you gather these small pieces of wisdom and practice
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all together, over time, you can begin to retrain how your body responds.
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And that, to me, is nothing short of extraordinary.
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This is exactly what we do every day at Migraine Heroes, with the commitment to bringing positive
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impact and change to the lives of a million people.
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And remember, every small step you take moves you closer to freedom.
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You are powerful, you are resilient, and you are no longer alone.
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Keep rising, Migraine Hero.
