Can Psychotherapy Help with Chronic Migraine?
Chronic migraine affects an estimated 1 to 2 percent of people globally and is often linked to stress or lack of sleep. It is diagnosed when an individual experiences 15 or more headache days per month, which can be significantly disabling and have profound emotional effects.
Although chronic migraine has a neurological root cause, incorporating talk therapy into the treatment plan has proven beneficial for some individuals in managing the condition.
Talk therapy, also known as psychotherapy, can help reduce stress levels and manage related conditions such as depression, anxiety, or insomnia. It involves engaging with a licensed professional to better understand and cope with stress, pain, and even personal emotions and beliefs.
For many people with headache disorders, a combination of medications and complementary treatments, such as talk therapy, provides the best results in reducing the frequency and severity of headaches. Psychotherapy can be particularly effective in managing the mental health impacts of chronic migraine and may help reduce the number of migraine attacks for some individuals.
According to the American Migraine Foundation (AMF), 30 to 60 percent of people with migraine report fewer headaches after starting relaxation techniques, biofeedback, or cognitive behavioral therapy (CBT). For those who utilize relaxation or biofeedback therapy specifically, the AMF reports a 45 to 60 percent reduction in headache frequency and severity.
Benefits of Therapy
Talk therapy offers numerous benefits, including preventive measures, and can help you:
- Manage pain response to chronic migraine
- Reduce stress associated with the condition
- Change your mental outlook
- Improve sleep
- Learn relaxation techniques to help prevent migraine onset
Depression, anxiety, and stressful life events are risk factors for chronic migraine, making mental health care a priority for those diagnosed with the condition. Since stress can trigger a migraine and migraines can cause stress, learning to manage stress is a vital strategy that talk therapy can help you develop.
What are the Mental Health Impacts of Chronic Migraine?
Migraine symptoms can leave you bedridden or unable to complete daily activities, and these can include:
- Moderate to severe head pain
- Throbbing pain
- Nausea and vomiting
- Dizziness
- Sensitivity to light, sound, and smells
- Disturbances in visual, motor, or other sensory functions, known as auras
Such severe symptoms can significantly impact mental health, especially when chronic migraine lowers your quality of life.
According to an estimate from the American Migraine Foundation (AMF), people with migraine are five times more likely to develop depression than those without this condition.
Individuals diagnosed with chronic migraine may also experience symptoms of anxiety, such as excessive worry, fear, or irritability. Some might constantly worry about when the next migraine attack will occur or feel helpless about their symptoms.
Others may feel frustrated by the substantial impact chronic migraine has on their lives.
At times, feelings of depression can mimic common migraine symptoms, including:
- Insomnia
- Loss of appetite
- General discomfort
A lack of control over the condition can further contribute to feelings of depression, encompassing:
- Fatigue
- Loss of interest in previously enjoyed activities
- Changes in sleep or eating habits
- Feelings of sadness or hopelessness
What Kind of Talk Therapy is Best for Chronic Migraine?
Various types of talk therapy may assist in managing chronic migraine. While some individuals rely on medication to address the mental health impacts of the condition, others might benefit from therapy alone or in combination with medication. No single approach works for everyone.
Cognitive Behavioral Therapy (CBT)
CBT can be particularly beneficial for those looking to manage stress or alter responses that may contribute to anxiety and depression. This common form of talk therapy helps you become aware of negative thinking patterns and understand how your thoughts and beliefs influence your behavior.
A small 2019 study found that CBT could benefit people with migraine, and more research is currently ongoing for migraine-specific CBT. During CBT sessions, you work alongside therapists to learn how to view difficult situations more clearly, which can help you respond more effectively.
Relaxation Therapy
Relaxation therapy is another option for chronic migraine sufferers and can offer similar benefits to CBT. It directly addresses stress, a key trigger for migraine symptoms, by calming the nervous system through techniques such as deep breathing or guided visual imagery.
Relaxation therapy can be practiced with a trained therapist in an office setting, which is helpful when you’re just getting started, or independently using smartphone apps or online videos.
Biofeedback Therapy
During biofeedback therapy, you are connected to machines that measure various involuntary physiological responses, such as skin temperature or muscle tension. You receive real-time information about these changes and may observe visual cues to understand your physical stress levels.
According to the American Migraine Foundation (AMF), this can help you modify your reaction to stress or initiate preventive strategies, such as hand warming. The National Headache Foundation notes that people with chronic migraine may experience the following benefits from biofeedback therapy:
- Fewer migraine attacks
- More stability in the nervous system between attacks
- A greater sense of control over migraines
Biofeedback therapy is usually conducted in physical therapy clinics, medical centers, and hospitals.
Getting Started with Therapy
Speak with Your Primary Doctor
Your first step toward beginning therapy should be speaking with your primary care physician. Sharing your needs, concerns, and symptoms is crucial in identifying a potential treatment plan. A primary care physician can also refer you to a trusted therapist.
Make sure to advocate for a referral if you believe therapy would help you manage your migraine symptoms.
Consider your therapy goals, such as reducing anxiety or learning relaxation techniques. This can help both you and your primary doctor determine the most suitable therapy for your needs. It might be beneficial to find a therapist with specialized experience in working with individuals who have chronic pain.
Consider Costs
Before starting therapy, check if it’s covered by your health insurance or company benefits, and try to select a psychologist or other mental health provider within your network.
You can also reach out to local hospitals for assistance in finding a provider.
For lower-cost options, consider seeking a therapist who is in training at a center or university, as they work under the close supervision of licensed mental health professionals.
There are also online therapy options available that may be more affordable than traditional therapy.