Behavioral Medicine Clinical Services

Behavioral Treatment of Headache and Migraine

There are quite a few reasons why someone who suffers from headaches or migraines could benefit from seeing a psychologist. A review of the existing research showed that cognitive-behavioral therapy and relaxation techniques lead to a significant reduction in headache activity ranging from 30 percent to 60 percent. Ultimately, the reason would be so that you have fewer headaches and get back to living life like you want.

There are misconceptions about the behavioral treatment of headaches. One is that meeting with a psychologist says that the pain lacks a physical cause. None of us wants an encounter that might suggest our pain is not real. Psychologists understand that there is a physical basis to headaches and migraines. Psychologists are involved in the treatment of headaches and migraine because they can offer effective strategies for the management of this pain. They also know patients suffering from headaches or migraines are often in a vicious cycle. It is clear that pain is real and causes stress, tension, anxiety, or depression which in turn causes more pain. For the sufferer it can be very helpful to discuss all this with someone familiar with pain.

Who Might Benefit?

Headache sufferers who experience stress as a headache trigger

Stress is the most common headache trigger. Stress can cause change in the brain that makes it more likely you will have a headache. Stress can also make a headache last longer and make it feel more painful. People who feel over-stressed also don’t do as well with the rest of their lives when they have a headache. This impact affects time with family and friends, leisure activities, home chores, work, or school. Although everyone experiences stress, everyone does not handle stress in the same way. Stress can’t be completely avoided. Learning to better deal with stress can help you have fewer headaches. Stress management training is designed to break the pain-stress cycle. Use of relaxation techniques is one very common coping strategy for managing stress. Relaxation techniques reduce muscle tension and anxiety, increases self-control and leaves a person feeling better. The psychologist will present different forms of relaxation and encourage daily practice.

Headache sufferers who have problems taking medication as prescribed

Many patients have trouble sticking to the medical treatment recommended. This leads to inadequate management of their headaches or migraines. There are many reasons why people do not take headache or migraine medications including high cost, limitations on pill quantities imposed by health insurers, concerns about negative side effects, and safety concerns for pregnant women.

Other times, headache patients may take their medication too often leading to medication overuse headache. How do you know if it’s too often? Health care providers have concerns if you are taking any abortive or symptom relief medication (either over-the-counter medications such as ibuprofen or acetaminophen or prescription medication such as triptans or opioids) more than 2 days a week. Talk with your health care team about your use of acute drugs. If using acute drugs too often, expect, work with your health care provider to create a plan on how to prevent overuse. Patients find that using behavioral treatments make this process easier and more successful.

Headache sufferers with lifestyle factors or exposure to triggers that exacerbate their headaches

There are other issues in your life that influence your headaches and their impact. These include problems with sleep, unhealthy eating habits, lack of exercise, tobacco use, or high consumption of caffeine. In addition, triggers such as light, smells, allergens, noise, and weather can bring on migraines. The psychologist can help you come up with strategies to cope with these triggers. Research has shown that making changes in these areas help to reduce the intensity, duration, and frequency of headache. The psychologist can work with you on making these changes in a step by step manner.

What Should I Expect from My First Visit with a Psychologist?

The psychologist wants to understand how headaches or migraine affects your life. You will be asked questions about the history and nature of your headaches and migraines. There will be questions about past treatment attempts. There will be a focus on how headaches or migraines currently affect your work, relationships, home life, and leisure activities. The provider may ask you to fill out some questionnaires in advance to best understand you.

Cognitive-behavioral therapy (CBT) teaches you how to recognize and cope with headache triggers. It helps to understand how thoughts and behaviors affect symptoms. You and the psychologist will set specific treatment goals together. The chief goal is to exchange sick time for wellness time. You can spend the exchanged time enjoying yourself, staying healthy, managing triggers and stress thereby minimizing headaches.

Treatment may focus on any or all of these:

  • Wellness Activities (Healthy Sleep, Physical Activity and Eating)
  • Relaxation Strategies and Stress Management Techniques
  • Managing Headache Triggers
  • Modifying Thoughts to Make Them More Adaptive and Beneficial
  • Pacing of Activities

Make an Appointment

Behavioral treatment is meant to empower you to act in your own best interests. Choosing comprehensive treatment helps you manage the difficulties in the many areas of your life that have been influenced by headache. If you are ready to approach the management of your headache or migraine in a new way, pursue behavioral treatment by calling 401-793-8770 for an appointment.