How Therapy Can Help With Migraine

This is where therapy comes in: It can act as a way to disrupt the negative feedback loop between these associated conditions.

“Therapy can be helpful for people with migraine as they identify stressors, set goals to make changes where possible, and utilize stress reduction techniques they learn,” says Brooke Wacker, a psychiatric mental health nurse practitioner with Mindpath Health in Ocoee, Florida.

Stress can be a major trigger for headaches, and that can include migraine headaches. This is important to note, because people with migraine are often told that their headaches are “just stress.”

Stress, while not always the main trigger, certainly can lead to headaches, though of course, triggers are unique to individuals and not everyone experiencing stress will develop a headache or migraine episode.

On the flip side, “Depression and anxiety increase the stress response within the body, and this can cause inflammation which can trigger migraine,” says Wacker.

Migraine also has the potential to lead to depression. According to Wacker, migraine and depression both can:

• Make it difficult to get out of bed
• Make it difficult to complete both work and personal tasks
• Cause a person to miss out on social interactions

“It has been noted that the more frequently someone experiences migraine headaches, the more depressed they can become. It has even been linked to an increased risk of suicide,” Wacker says.

What’s more, the anticipation of a migraine headache can lead to anxiety, which may ultimately lead to a migraine episode.

“Migraine can trigger anxiety for someone by making them feel unwell and worry about whether they will be able to do their daily routine, work, and take care of things at home,” Wacker says.

Helping people identify and cope with stress is one of the primary reasons psychotherapy — talk therapy with a trained mental health professional such as a social worker, licensed therapist, psychologist, counselor, or psychiatrist — can be beneficial for people with migraine.

• Identifying general life stressors
• Creating coping skills and strategies for stress
• Navigating a full life with a chronic condition like migraine
• Better pain management through mindfulness or reprocessing

Besides psychotherapy there are a number of approaches that people with migraine can use to “retrain” their brain.

Behavioral Therapies

Behavioral therapies can help many people manage migraine pain by changing their thought processes.

There are a few therapies to help break this cycle:

• Cognitive Behavioral Therapy (CBT) CBT teaches ways to identify negative thought patterns and shift them in a more positive direction.

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• Mindfulness-Based Stress Reduction (MBSR) According to research, this standardized program of small group classes incorporating mindfulness training and yoga can lessen migraine frequency, as well as improve overall quality of life and lessen the disabling quality of chronic pain.

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• Pain Reprocessing Therapy (PRT) PRT uses psychological techniques to retrain the brain to interpret and respond to bodily signals in a way that can help lessen chronic pain.

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Biofeedback

Biofeedback uses insights into your body’s stress response as a tool to help you manage migraine pain.

• Frontalis The muscle in your forehead used when frowning. Is likely to tighten when you’re under pressure.
• Masseter Responsible for jaw tightening; also known to stay clenched during moments of anger or frustration.
• Trapezius Connected to your shoulders; may tighten in response to anxiety or fear.

Relaxation Therapies

According to research, therapies and practices focused on relaxation and deep breathing are successful because they allow the sympathetic nervous system to relax and activate the parasympathetic nervous system.

It is useful to practice relaxation techniques regularly so you’re prepared should you begin to experience migraine symptoms.

Kaplan says that opting for a professional with experience in holistic work would be highly beneficial.

Or, if you’re already seeing a neurologist, ask if they have mental health staff or a headache specialist.

Before meeting with a mental health practitioner, consider what you’re hoping to get out of the sessions: Is it dealing with the stress that triggers migraine attacks, receiving work or school accommodations, or navigating the depression and anxiety that surrounds your chronic illness?

Regardless of what the end goal is, be open to communicating honestly with your therapist, and advocating for what you need.

Does Insurance Cover Therapy for Migraine?

While various forms of therapy appear helpful in living with migraine, access is often very limited. If you have health insurance, your provider can tell you which practitioners and how many sessions are covered by your plan.

Many therapists don’t accept insurance because of low reimbursement rates, but some charge on a sliding scale, meaning the fee per session is based on your income.

To find therapy you can afford, look for community service agencies or mental health clinics in your area that offer lost-cost visits or sliding-scale payments. You can also ask your headache doctor or primary care physician what mental health resources they’re aware of.

A comprehensive treatment plan for migraine typically includes medications and lifestyle modifications as well as therapy.

Medication for migraine can be acute (used during migraine attacks) or preventive (taken regularly to stave off attacks).

If you’re not already seeing a doctor about your migraine, that’s a first step. You can begin with your primary care provider, who may refer you to a neurologist or headache specialist. If you have insurance, the carrier will determine if you need a referral or if you can search for a specialist on your own.

There are resources on the American Headache Society website and the National Migraine Foundation website to help you find board-certified providers.

If you’re new to migraine treatment or medication, some of your symptoms may improve once you begin. But if you’re also experiencing depression or anxiety, especially in a way that affects your day-to-day, then it may be time to consult with a mental health professional.

• Therapy is a powerful tool for reducing migraine symptoms and addressing related depression and anxiety.
• Psychotherapy, behavioral therapies like cognitive behavioral therapy (CBT), biofeedback, and mindfulness training can help treat migraine and related mental health issues by addressing the body’s response to stress.
• Therapy and medication can support each other in alleviating migraine symptoms.