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Ever feel like stress hits you in different ways and your migraines follow suit? Let's unpack why.
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Welcome to the Migraine Heroes podcast. A podcast for people living with chronic migraines,
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years of pain, misunderstanding and no answers. I'm Diane Ducarme and I've helped more than a
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thousand people reduce the burden of migraines and feel more in control. Each episode brings
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you grounded insights into what your body might be asking for and what can truly help. Before we dive
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in, a quick reminder. Over the past few weeks I've been personally holding our 90 minute migraine
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sessions and once again I've seen how powerful it is when someone's migraine finally begins to make
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sense. There's a shift that happens in those conversations. You can feel it. Clarity settles in,
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the uncertainty softens and from there real change becomes possible. These sessions are
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offered at no cost for anyone who reserves before end of March. If you've been considering it or
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waiting for the right moment, this might be it. Click on the link in the show notes or download
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the Migraine Heroes app, complete your Getting Started steps and you'll see how to reserve your
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session. Now take a deep breath and let's dive in.
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In this episode you will learn why not all stress is created equal and why identifying the type of
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stress matters more than you think. How each of the five core stress types activates different
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systems in your brain and your body influencing your migraine response. A simple at-home grounding
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technique that helps interrupt stress signals before they trigger pain. Stay with me till the
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end because at the end of this episode you will learn a simple self-inquiry exercise to decode
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which stress is most triggering your migraines and how to respond to it differently. Let's start
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gently. Stress is not one thing and neither are migraines. If you've been told just to manage your
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stress more times than you can count, it makes sense if that phrase now lands like a dismissal
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rather than help. Because when you're already trying, sleeping when you can, holding your life
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together, showing up for work or family while your nervous system is on edge, being told to try harder
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can feel very cruel, especially when the migraines still come anyway. And what often gets missed is
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this. Stress isn't a personal failure, it's a biological load and your brain doesn't experience
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all stress the same way. The work is not about becoming calmer in some abstract way, it's about
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learning your nervous system's language, recognizing the specific stress signatures your brain reacts to
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and slowly restoring a sense of safety and balance piece by piece. That's not a quick fix,
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but it's a path forward and you don't have to walk it alone. So the five types of stress we're
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exploring today are threat, loss, role, moral and uncertainty. And they each have been studied across
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psychology, neurology and trauma research. They each activate unique neurobiological pathways
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and emerging science is showing they may contribute to migraines in different ways.
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Let's break them down. First, we have threat stress. Think. Your body perceives danger, a car swerving,
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a raised voice, a violent memory. The brain's amygdala and hypothalamus activate the hypothalamic-pituitary-adrenal
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axis, flooding your system with cortisol and adrenaline. This fight-flight
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activation can create a hypervigilant brain state, which is a known migraine trigger. And according
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to Dr. Peter Gadsby, heightened activation in the brainstem and hypothalamus precedes
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many migraine attacks, both areas influenced by perceived threat. The second type of stress
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is completely different. It's the loss stress. Here we're talking about grief, we're talking about
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death, we're talking about divorce, lost dreams, even subtle identity shifts. The nervous system
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experiences this more as a collapse than an alarm. And yet the immune system often ramps up
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inflammation. Chronic loss stress is associated with elevated cytokines and changes in serotonergic
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signaling, both of which have been linked to migraine episodes. Loss can also shift pain
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perception, lowering our threshold. The third type that we have is role stress. And role stress arises
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when you carry heavy responsibility without the power to change your situation. So think parenting,
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caregiving, work pressure. The key here is chronic tension. Functional MRI studies show role-based
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stress activates the dorsolateral prefrontal cortex, which when overburdened, reduce top-down
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control of the pain matrix. It's like your brain is trying to stay organized but there's no relief.
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And the fourth kind is moral stress. This is when your actions or inactions go against your core
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values. So think staying silent about abuse, being complicit in injustice, working in systems that
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harm others. The stress is existential and research shows it activates the anterior cingulate cortex,
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a brain region involved in emotional conflict and pain amplification. And so for people with
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migraines, moral injury may increase pain sensitivity even when there is no physical
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threat. And then we have the uncertainty stress. Uncertainty is the feeling of not knowing. Test
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results, life changes, a waiting game. What's fascinating here is that the uncertainty often
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produces greater stress responses than known threats. A study in Nature Communications found
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that uncertainty heightened amygdala activation more than receiving a known negative outcome.
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And this anticipatory anxiety can trigger migraines through over-activation of pain
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expectation circuits, especially in those with high interceptive sensitivity. So when we say
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stress causes migraine, what we're also really saying is chronic dysregulation in one or more
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of these brain pathways is alighting the fire. In traditional Chinese medicine, stress is not one
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thing. It's an imbalance, movement. And each of these five types of stress can be understood as
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affecting different organ systems and emotional domain, disrupting the flow of qi, of life energy,
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in very different ways. So let's go through each of these five and see how they impact different
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systems. The first one, the threat stress, is impacting kidney and bladder meridians. Threat
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invokes fear, which traditional Chinese medicine associates with the kidneys, the organ system that
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governs survival energy and the adrenals. And so prolonged threat is going to deplete the jing,
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the core essence, which can manifest as chronic fatigue, hypersensitivity, and headaches that feel
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deep and draining. The second type, the loss stress, is going to be a lung and large intestine
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system stress. Loss relates to grief governed by the lungs. When grief is unprocessed, it's going
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to create stagnation in the chest and head. The qi cannot descend, as said in the classics.
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Headaches here feels like a dull pressure or fog, often worse with sighing or during the fall season.
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The third, the roll stress, is more linked to the liver and gallbladder. The liver in traditional
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Chinese medicine is responsible for smooth flow of emotions, energy, blood. Roll stress disrupts
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this flow, leading to liver qi stagnation. And this is the classic tension headache with tight
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shoulder, irritability, and pain that moves or pulses. The moral stress influences the heart and
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small intestine system. The heart houses the shen, your spirit. And when your actions conflict with
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your values, the shen becomes disrupted, leading to insomnia, palpitations, and headache that feel
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hollow with emotional unease. An Asian text describes this as the spirit leaving the head
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unanchored. The fifth one, the anterogen distress, is going to affect the spleen and stomach system.
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So worry or overthinking weaken the spleen, which governs digestion and transformation,
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and this leads to dampness and heaviness, especially in the head. Migraines under
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uncertainty often come with digestive symptoms and are worse after eating or during transitions.
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And so I find absolutely fabulous because the West has mapped exactly the East. The West has
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found five different types of stress and has unknowingly organized them completely around
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the East and how the East perceives stress as acting on different systems. And so I find it
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a coincidence, but an absolutely remarkable convergence of the two systems. In the East,
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there's an old saying that goes, the body whispers what the mouth cannot speak. Now,
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what actionable advice can I give you for today? Today, if this is you with stress in your life,
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I want you to take five minutes to ask yourself, what type of stress is most present in my life
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right now? I want you to name it. Is it threat? Is it loss? Is it role? Is it moral? Is it
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uncertainty? If you don't remember, feel free to listen to this episode again. They're done
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short on purpose to really help. So try to find which one it is and then try to find which system
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it dysregulates. And then ask yourself, what would safety look like? Write down one micro action you
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can take to restore balance. Even noticing the pattern is the beginning of healing. And remember,
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every small step you take moves you closer to freedom. You are powerful,
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you are resilient, and you are no longer alone. Keep rising, migraine hero.
