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What if the moments before your migraine are actually fueling the next one?
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In this episode, we unpack how anticipation is reality.
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Migraine Heroes is a podcast for chronic migraine sufferers who've seen countless doctors with no
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results. Learn how to reduce your migraine attacks without endless medications or constant sacrifices.
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Hello, I'm Diane Ducarme. I've helped over 500 people break free from migraine,
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even after suffering for up to 60 years. My mission in life? To bring this relief
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to a million people using a unique blend of Eastern medicine and Western science.
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In this episode, you will learn how your fear of the next attack can actually trigger the next
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attack. Practical strategies to interrupt the anticipation loop so you can regain control over
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your body and of your migraine cycle. And why combining an Eastern medicine mindset
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with Western neuroscience gives you a whole new pathway out of the fear spiral and into freedom.
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Stay with me till the end because understanding what's happening in your brain gives you power
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to change it. Migraine is far more than occasional head pain. Between attacks, you may still be
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living in a state of alert, of waiting, of expectation, what we call the fear spiral.
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Research is showing that this anticipatory state isn't harmless. It influences the next attack,
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the inner attack burden, and keeps you locked in a cycle. For example, a recent overview shows
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that the inter-rectal phase, so the time between migraine attacks, carries substantial burden,
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hypersensitivity, cognitive and emotional load, anxiety about the next attack.
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Now, an interesting study came out in 2021 by Karazhan and her team, and they asked an important
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question, are some of the things we call triggers actually early warning signs from the brain
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itself? In other words, maybe it's not that coffee, stress, or certain foods cause the migraine,
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but that your brain is already shifting in migraine mode and you're simply noticing those
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signals. So okay, here I'm not sure I like it because it's also accusing someone of self-triggering
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the migraine, and I think we need to be very careful with that language. That being said,
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when I reflect on this, the gut-brain axis is bi-directional, meaning that your brain
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communicates with your gut and your gut communicates back here with your brain.
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And in the Eastern world, there's also an emotion-to-gut axis. Emotions will influence
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your gut and your brain, and vice versa. And in the West, we have seen this notion in the
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vagus nerve being damaged on children who have been abused. So in the West, we also know that
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emotions play a critical role when it comes to health. And so how you perceive a trigger can
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technically influence your experience. And when I was reading this initially, I was a bit against
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it or I didn't like the way it was formulated. But when I reflect on it, I'm also reflecting
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on our app and I'm genuinely reflecting on our app as I'm preparing for this podcast. And
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while we let people know of fast and slow triggers inside the app, we never put emphasis on them.
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And I think there's two reasons for that. Number one is they will go away. So over time,
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a trigger shouldn't be a trigger. It's a reflection of an imbalance inside of the body.
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And so there's no need, number two, to obsess with those unless, and there's an unless,
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they are part of your day to day. And so I find that from my perspective, the way I find it most
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useful, this part of the app, that it's an aha moment of sometimes someone saying, oh, I take
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this food every day or I have that habit every day. It can be protein powder that they take every
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day. It can be a flat white, a cafe latte that they take every day. It can be kombucha that they
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take every day, a liter that they brew. And all of these will cause the migraine. So from that
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perspective, it's interesting, but it's not interesting from the moment it becomes an
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obsession because it should go away. And so when you look at the food podcast, they will teach you
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things that are important to avoid in your day to day and having them occasionally is not harmful.
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And so of course, even more interesting, they found that the fear or avoidance of those sensations
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like tension, cravings, or fatigue might actually amplify the process, making the nervous system
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even more reacting. And yet another study by Griffin et al found that 72% of migraine
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attacks were preceded by premonitory symptoms like fatigue, difficulty concentrating,
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which could all be interpreted as early warning signs of the brain heading into an attack mode.
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And so the hypothesis on how anticipation keeps the migraine alive is that when you begin expecting
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a migraine, you shift into a hypervigilant state. Your nervous system is primed for threat.
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You know, it's coming. And that means heightened sensory sensitivity, increased the stress hormones,
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cortical excitability. And look, I'm saying this with a lot of gold in my voice. Like this is
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awful. I mean, absolutely awful. Especially if you know that the migraine is going to hit
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every single day at a specific time of the day is just unbearable, absolutely unbearable. So
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bear with me. I'm trying to just explain and give you a few tools that may help you observe
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yourself in those moments of fear. The second hypothesis on how that anticipation keeps the
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migraine alive is that the brain may misinterpret some of the early signs like mild sensory changes,
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ache behind the eyes, mood changes as full-blown impending attack. So your emotional system is
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going to react. The anxiety increases and you may withdraw. You may avoid activities and this
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avoidance and anxiety heighten the nervous system activation and may lower your threshold for the
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next attack. So over time, that's going to create a kind of feedback loop, attack,
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relief, anticipation, hyper-vigilance, stress system attack. And that's a fear spiral.
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And that's a spiral that we try to break literally. In the new version of the app,
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we're releasing an emotion management section to just really help you get out of that loop
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because then the foods can do their job and we can undo some of the underlying imbalances.
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And so this means that you do not just want to treat the attack when it comes,
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you want to intervene earlier in this anticipatory phase before full activation happens.
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Recognizing that the waiting itself is active and that your body is doing work in those
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anticipatory hours, days, opens a new frontier for relief. So you'll want to monitor, you just
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want to observe, how do you feel when you anticipate a migraine? What are your habits
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of avoidance and hyper-vigilance? What are the emotional states that is in between these times?
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Because these are not passive, they're just really part of the cycle. And by doing this,
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you can start to break the loop. Now, this is another interesting study I came across as I
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was doing this research. And it's a study that looks at how the brain of some with migraine
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responds to rewards and losses. And they found that when people with migraine expected a reward,
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say something good was about to happen, their brains lit up just like everyone else.
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But when they actually received the reward, that final moment of satisfaction,
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a specific part of the brain called the right inferior frontal gyrus, didn't activate as
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strongly. In other words, the anticipation of pleasure was there, but the follow-through,
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that ability to fully feel and enjoy the reward, seemed muted. And I find it a fascinating glimpse
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into how migraines isn't just about the pain, can suddenly shape how your brain experiences joy,
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motivation, and relief. Such as if the joy itself was listened. And I find it interesting because
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when we work with people, and that over time they have fewer migraines, they say that they
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actually started seeing their life more in colors. And that's exactly what people describe. And that's
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why the app and the logo are a little bit more bright in colors. And we thought, how bright can
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we go? And I think with the years, we'll go brighter. We're still quite muted, but we go
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brighter because that's what we want back for you in your life. I genuinely mean it. I personally
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find it's quite fascinating because it's like this too can be reversed. And so for you, for today,
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what I'd like you to take out from this podcast is when you know the pain is going to come,
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because this is the time of the pain, just accept it. Don't fight it. Try to accept it like a naughty
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friend that is coming to visit and try to make you experience the pain in a safe way. Take something
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that makes you feel safe. Just observe the pain and don't attach too much emotion to it. Just let
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it go. Let it pass and hold on to what makes you feel safe. And we've seen that when you start
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to do that, you can start to gently break that cycle. More on this in other podcasts. And remember,
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every small step you take moves you closer to freedom. You are powerful, you are resilient,
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and you are no longer alone. Keep rising. My Green Hero.
