Migraines are a real pain – can hypnotherapy help?

Most people have suffered from a headache at some time in their lives. Usually, the pain is mild and a couple of painkillers is often enough to block out the pain so that normal life can resume. However, migraine headaches are quite different. Sufferers quite often have to stop what they are doing and hide away in a darkened room until the worst of the episode passes.

The pain from a migraine can feel like the temples are going to explode. some people say the pain is like a garden rake scraping over their eyes and head. Some have said that their head feels like a balloon that is overfilled with air and is about to burst.

Many migraine sufferers get a feeling of being washed out and drained of energy after an attack, looking pale and feeling tired for a day or two after an episode.

Migraine has been recognised as a medical condition for centuries. Unfortunately, it is a complex disorder and medical science is not able to offer definitive reasons why some people suffer from the condition. We know that as many as 20% of the population are affected, with women three times more likely to experience migraine than men.

Thankfully, migraine attacks are not life threatening, although to many sufferers the condition can seem like the end of the world. One of the biggest problems with migraine is that you can never really predict when an attack will occur. A person could be driving, going off on holiday, about to pick up the kids from school or about to go our for a meal with friends when the dreaded migraine strikes.

The sequence of events

Research has helped us to understand what happens during a typical migraine. Some people notice that they yawn a lot more in the hours leading up to an episode while others say they have lots of energy. Some crave certain foods. These unusual signs may be experienced a few hours before a migraine comes on, or they can be experienced a day before.

Migraine headaches can be classed in two different ways; with aura and without aura. The ‘classic’ migraine usually starts with some sort of visual disturbance, referred to as an ‘aura’. About 25% of sufferers know that a migraine is starting because they notice a disturbance in their vision. Many of my patients say their ‘eyes go funny and out of focus’ or they see ‘zig-zag lines’ that move across their eyes. Some people say they have blind spots in their vision.

The aura stage of migraine can last from a few minutes to an hour or more. This stage is usually followed by the first signs of pain in the head.

The ‘common migraine’ is when there is no aura. The attack starts with a headache, which quickly develops into a thumping pain in the right or left side of the head.

Most people experience other symptoms during the early stages of a migraine. Speech many be affected, with difficulty forming words. Some people have a tingling sensation in their fingertips, which often spreads up their arms. Many people experience tingling in their tongue.

One of my patients told me that he suffers from about five migraines each year and they all follow exactly the same pattern. They start with a visual disturbance that lasts about 20 minutes, followed by difficulty speaking. He gets tingling in his fingers and tongue and then the headache starts, mild at first but it quickly develops into a thumping pain in either his left or right temple. He feels completely drained for the next 24 hours.

Similar symptoms to a stroke

Some of the symptoms of migraine can be frightening, particularly the speech problem. Often referred to as ‘migraine babble’, this part of the migraine cycle is one of the most noticeable signs that a person is experiencing something untoward. Speech problems, or transient aphasia, probably occurs when blood vessels over-dilate, which is thought to be the main cause of migraines. Different parts of the brain are affected by over-dilation, which partly explains why many people get these unusual symptoms.

Understandably, some people are afraid that their migraine is a symptom of a stroke. The good news is that there is little evidence to suggest that a stroke is more likely to occur during a migraine. A stroke is when a blood vessel in the brain in either blocked so that oxygen is prevented from getting to brain tissue, or that a blood vessel bursts inside the brain. Migraine is neither of these two things.

Trigeminovascular theory of migraine

So what causes a migraine?

The answer to this question is not an easy one. For many years, it was believed that over-dilation of blood vessels in the brain caused migraine pain. However, over-dilation doesn’t quite explain why the attack occurs.

Research has shown that electrical changes that go across the brain are linked to the early stages of migraine, particularly the aura effect. This wave of electrical activity is quickly followed by what is called ‘spreading cortical depression’ and it is during this phase that constriction of blood vessels occurs. Studies have shown that as the waves of spreading depression pass over the brain there is a drop in oxygenation of that segment of the brain. Thankfully, the drop in oxygen levels doesn’t last long, only until the wave of electrical energy passes over. This could explain why some of the symptoms that migraine sufferers experience are similar to those of a stroke victim.

There is also evidence of brainstem activation at the beginning of a migraine, and there is strong evidence that migraine is linked with abnormally excitable neurons in the trigeminal nerve. In summary, something may trigger abnormally excitable neurons to fire, which causes a wave of electrical energy to pass over the brain, resulting in constriction of blood vessels and a drop in oxygenation.

What excites the neurons?

So, what causes the over-excitement of these neurons? Various things can do this, including low magnesium, abnormal calcium channels or inherited brain chemical abnormalities.

Regardless of the scientific pathology, it is generally accepted that migraines are started by ‘triggers’. Some people are more susceptible to certain triggers than others. But the story about triggers is complex too. A person exposed to one of their known triggers might not be enough to start a migraine. For example, red wine is thought to be a common trigger. A person who is susceptible to red wine may drink a glass every day for a year and never have a migraine. We know that more than one trigger is usually needed.

I often talk about ‘tipping the balance’. Imagine if red wine is one of your triggers. You might drink a glass with no effect. However, if you had a glass of red wine on an empty stomach after driving a long journey following a few days of lack of sleep or sleep disturbance, you may have tipped the balance and, hey presto, a migraine is triggered.

All of those things mentioned above can be triggers. I classify triggers in nine categories: lack of food, specific foods, sleep disturbance, stress and anxiety, exercise (not enough or sudden bursts), long travel journeys, changes in the environment (lighting, noise), neck pain, and hormonal changes in women.

Three or four of the above occurring together may be the root cause of a person’s migraine. That is why it is such a good idea to keep a migraine diary. Whenever I have a patient who needs treatment for migraine, I always ask them to keep a diary so that we can discuss their habits and lifestyle at their first appointment.

Can migraine be treated?

Some people are prescribed preventative medication by their GPs. These can have varying degrees of success. Beta-blokers, serotonin antagonists and tricyclic antidepressants are common drugs that are known to help migraine sufferers. However, they can take more than three months to start working and they often have unwanted side effects.

A popular relief medication that is available over the counter are tablets that contain sumatriptan. Taken as early as possible whenever a migraine is noticed, this medication can help reduce the effects of an attack and, in some people, they can shorten the episode.

But medication is not the cure, it is merely a sticking plaster to help relieve the symptoms. To get to the root cause of migraine another approach is needed. One very successful therapy is hypnosis. Treating and preventing chronic migraine headaches with hypnosis is a cost-effective alternative to drugs. Hypnotherapy doesn’t just help relieve the acute symptoms such as pain, it can also help stop migraines completely, by looking at the underlying reasons why migraines are occurring.

Two uses of hypnotherapy to treat migraine

There are two uses of hypnotherapy in the treatment of migraine. Firstly, self-hypnosis is a technique to help patients deal with the pain when an attack does occur. Teaching self-hypnosis can be a wonderful alternative to using painkillers. Patients are taught how to induce a deep state of relaxation whenever a painful headache comes on. Some of my patients say that 20 minutes in a self-hypnotic state usually takes the pain away completely.

Secondly, and more importantly, is the use of hypnotherapy as a way to treat the underlying cause of migraine. Stress and anxiety are two of the most common triggers of migraine and so it is important to treat these properly. A migraine is the body’s way of telling us something is wrong. It is something abnormal. However, the conscious mind might not be able to understand exactly what is wrong. I will talk about the conscious and subconscious mind in later posts.

Hypnotherapy is a gentle and powerful way to reach into the subconscious mind to understand why migraines are being triggered. There is a reason why people have migraines. Neuroscience can help explain the ‘what’ but it cannot fully explain the ‘why’. The subconscious mind has most of the answers but it is only accessible through deep relaxation and through hypnotherapy. By discovering the underlying reasons for migraine, the patient can be helped to eliminate them completely.

I hope you enjoyed this brief insight into migraine headaches. I would love to hear your stories about migraine and how you manage to cope with this debilitating condition.

Check out my podcasts on http://www.ahelpinghand.biz

 

 

 

 

 

Stress or pressure – is there a difference?

Stress or pressure

We often hear people talking about being under “stress”. Tight deadlines at work, colleagues who can be a little tetchy, and that damned IT system playing up again can all result in people complaining and saying ‘I’m stressed out today’. Well, generally speaking, they are not ‘stressed’. Actually, they are under “pressure”.

There is an important difference between pressure and stress. Someone who is suffering from stress will certainly know about it, because they will have needed help to sort themselves out. But more on that later. Firstly, let’s talk about ‘pressure’.

Pressure is good for us. Pressure helps the body to prepare for the ‘flight or fight’ response. Our brain wants to keep us safe so whenever it senses danger it releases chemicals into the body. I refer to this as ‘pressure events’ that trigger a response.

What is a pressure event? Well, it is anything that the brain detects as danger, or put another way, something that the brain detects as abnormal. Imagine sitting quietly at lunchtime, sitting in a comfy chair while enjoying a sandwich from Marks & Spencer. Someone creeps up behind you and shouts BOO. Almost immediately your brain will respond. You heart rate will go up, your arteries will dilate a little, your breathing will increase and your pupils will dilate too. All of this will happen in less than one second. Your brain has sensed danger and has put you on a state of readiness to react. But, you are not under stress. You are under pressure.

Brain and body arousal

Without getting too scientific, the following sequence of events follow a pressure event. The pre-frontal cortex of the brain senses something is abnormal. An immediate response is made through the Hypothalamus Pituitary and Adrenal System (the HPA axis). A special hormone is released, called the corticotropin-releasing hormone (CRH).

The pituitary gland comes into action at this stage and it releases adrenocorticotropic-releasing homones (ACTH) into the blood system. ACTH acts on the adrenal cortex and tells it to release cortisol. The adrenal system then releases adrenalin into the blood system, while insulin is produced in the pancreas to convert some glucose into glycogen, just in case the body needs a blast of energy.

And all of this happens because someone said BOO!

The point I am making here is that the brain will react to pressure. Sometimes, pressure is because of an external event or sometimes it is simply because we think something. When we get angry at a person the brain sees this as a pressure event and, again, releases all those chemicals.

Pressure on a daily basis is good for us. It tests the central nervous system and it gives it a good workout. We might experience over 100 pressure events every day. Think about it. The driver who cut us up this morning, the coffee machine that delivered a latte instead of an Americano and the MD who failed to read the report that you spent last night preparing. These are all pressure events. And, they are good for us. Well, maybe not the MD one – that is just downright annoying!

Crossing the line

Now then, I want to explain something that I call ‘crossing the line’. Imagine a line drawn in the sand. The line is just out of reach of the tide. Imagine placing a brand-new ipad on the sand just above the line, on the dry side. You sit back and watch the tide come in. You know that it will ebb and flow as it gets nearer and nearer to the line, but you know that the usual tide never quite reaches the line in the sand, so your ipad is quite safe.

One day, an unusual event occurs. The tide comes and goes as usual but you start to worry because the ebb and flow is getting faster. Something is wrong today. Suddenly, a vast tide comes up, crosses the line and drenches your brand-new ipad. It is damaged beyond repair.

The line in the sand is analogous to pressure events. When pressure bobs about inside our brains it can come and go nicely, without causing too much harm. However, when pressure events start to come more frequently, and pile on top of one another, there comes a point when the line is crossed. That is the stage when pressure changes to stress.

With most people, crossing the line is a major and serious stage. Most people will never be able to get back below the line again, not without proper help. Their symptoms will continue to manifest as irritability, sleep disturbance, eating disorders, compulsive behaviour and a whole load of other things.

Antidepressants and therapy

Crossing the line is when normal everyday pressure turns into a serious medical condition. At this stage, a person will be in much need of help. It is far from impossible to get back to normal again, but it will take time and patience. Depression is a very common symptom at this stage. A person suffering from stress should visit their GP, who will more than likely prescribe medication, often antidepressants. One of the most common types of antidepressant are the Selective Serotonin Reuptake Inhibitors (SSRIs). These help to sort out the chemical imbalances in the brain.

Why does a chemical imbalance occur in an otherwise healthy brain? Well, the answer is simple really. Remember the story about BOO? All those chemicals that are released each time we have a reaction to a pressure event need to disperse. If pressure is under control and we are not subjected to too much pressure, the flood of chemicals can fairly easily dissipate and be converted into chemicals that can pass out of the body. However, when these chemicals reach an amount that overwhelms the brain and body, the balance within the brain can be disturbed. We need medication at this stage to sort out the imbalance.

Something very important though is that medication on its own is not always enough. Medication will definitely treat the symptoms but they rarely fix the cause. Cause and symptoms is something that I will mention a lot in further posts and podcasts. Suffice to say for now is that symptoms will always appear because something is wrong. The cause of the problem needs to be fixed and this is where counselling and therapy come in. Hypnotherapy is an excellent technique for delving into the brain to access the cause of the problem. Find the cause and the symptom will disappear.

Check out my podcasts on http://www.ahelpinghand.biz