"All things in moderation" is a wise motto for all of us, but especially for those who suffer from painful migraines.
These skull-crushing headaches can be debilitating and last for days, confining a person to a soft bed in a darkened room.
"It's a pretty disabling headache," said Dr. Lawrence Newman, director of the Headache Institute at St. Luke's-Roosevelt Hospital in New York. "It has an effect on your kids, co-workers, family and friends. They all suffer."
Many doctors believe migraines are the products of a genetic disorder that makes one person's brain more sensitive to certain stressors that other people would barely notice — like missing a meal or a rainy day. More than 26 million Americans suffer from the neurologic disorder, according to the American Medical Association
But recognizing migraine triggers can help ward off a painful migraine headache, and doctors recommend keeping a detailed diary of what foods, events or activities trigger a migraine. These triggers are different for everyone, Newman said, but there are also some classic ones to look out for, including diet, weather or sleeping patterns. All of these triggers can disrupt normal serotonin levels in the brain, which serve the purpose of stopping a migraine before it starts.
Migraines can be treated, and some of the newer drugs, like triptan, which stabilize serotonin levels in the brain, have been shown to decrease the pain and sensitivity associated with migraines.
Overall, any change to the body's status quo is the largest factor in triggering migraines. The best way to combat these changes is to stick to a routine that includes plenty of sleep, moderate exercise, a healthy diet and time to relax.
"Migraine people don't like change, they like sameness," said Dr. Joel Saper, founder and director of the Michigan Headache and Neurological Institute. "Any change of the norm, any stress to your system, and your body will produce a headache."
On the following pages, you will find some of the more common aspects of your life that contribute to migraines — and how you might be able to lessen the frequency of these crushing headaches.
The biological events that precede orgasm can bring on migrainelike headaches, Saper said. Increase blood flow through dilated vessels, tensed neck and body muscles, heavy breathing and changes in serotonin levels in the brain can all trigger a migraine.
Such headaches may even occur after running, lifting weights or other kinds of physical exertion and exercise.
"If people got active, jumping around and all that other stuff," the result could be a migraine, Saper said.
This problem is actually more severe for men than for women, according to Dr. Steven Silberstein, director of the Jefferson Headache Center in Philadelphia, and past president of the American Headache Society. An orgasm may ease a painful headache for some women, while it may bring on a migraine in a man.
"One of the best-known triggers [for migraines] is menstruation," Silberstein said.
This is because hormone levels in women's bodies fluctuate dramatically during this time. Changes in the levels of two hormones in particular — estrogen and progesterone — can bring on migraines.
These hormones also change during pregnancy, and postpartum women can be especially prone to having migraines due to rapidly falling levels of estrogen.
"Estrogen stabilizes the brain from pain," Silberstein said. During pregnancy a woman may not experience headaches. "Postpartum the levels fall, and you get headaches again," he said.
Perhaps the phrase "'tis an ill wind that blows no good" originated because storms can literally make some people sick.
No one knows why some people react more strongly to weather changes than others, but changes in air pressure, such as before a heavy rain or snow, can trigger migraines.
Seventy percent of migraine sufferers experience migraines during changes in air pressure systems, according to Newman. This includes changes in altitude and traveling between humid and dry climates.
It may not be that "early to bed, early to rise, makes a man healthy, wealthy and wise." Rather, it may be that sticking to a consistent sleeping schedule is what is worth striving for.
Getting too little or too much sleep disrupts normal bodily rhythms and can trigger a migraine. Sleeping irregular hours can also interfere with normal eating patterns, causing blood sugar levels to rise and dip when they should not.
Going to bed and waking up at the same time every day, even weekends, is critical. After a late night out, doctors recommend waking up at your normal hour, eating breakfast and taking a nap later in the day.
What you eat — or don't eat — can have a profound effect on how you feel. Additionally, there are a host of chemicals in food, both natural and added, that can trigger migraines. Sensitivity to these ingredients can vary widely from person to person.
Saper recalled one patient who reported terrible headaches each morning and was totally baffled by the cause. Eventually, the patient figured out that the glass of milk he drank each night before bed was the reason behind the migraines.
Other, more common dietary triggers include monosodium glutamates (MSGs), chemicals used to add flavor to food; nitrates, used to preserve and add color to meats like bacon and hot dogs; and tyramines found in aged cheeses and red wine. Even chocolate and oranges, foods otherwise known for their antioxidant properties, contain chemicals that can trigger a migraine.
Red wine is a particularly well-documented trigger, as they are known to bring about migraines in many people.
People who suffer from migraines are known to be very sensitive to sensory stimuli, particularly bright lights and loud noises. Bright, fluorescent or flickering lights can be very painful to someone with a migraine.
Some times, in these cases, staying in bed is the only thing that feels comfortable.
In fact, this has been a contentious issue among migraine sufferers who prefer gentler, incandescent light bulbs, due to the recent push to use environmentally friendly fluorescent lighting.
Stress seems like the cause for many diseases, but it can be particularly injurious to migraine sufferers.
"Migraineurs don't have any more stress than anybody else. They just can't handle it as well," Silberstein said.
In addition to tension, the letdown period after a period of stress can bring on a migraine because of the quick shift to a new, less intense physical and mental gear.
For example, Newman said that when someone prone to migraines finishes a large project at work and submits it, "wham, they get a headache."
Silberstein advised taking some quiet time out of each day for yourself.
"Meditate, pray, whatever, but give yourself some time every day to just relax."