“Recognizing triggers, preparing a treatment plan,
and anticipating the changes in advance will
give your teenager the best tools to keep
his or her migraines managed.”
Paying attention to the above-mentioned triggers and their
role in headache may be helpful. For instance, a teenager
who suffers from migraine exclusively on weekends may do
well to avoid oversleeping.
Naturally, the college environment will be less structured
than it was at home. Meals will be less nutritious, sleep
patterns will be irregular, and classes and roommates will
pose new demands. Stress, both good and bad, is perhaps
the most common trigger for migraine, and will be an inevitable part of adjusting to the new pressures of college.
It is important, then, to work closely on the triggers your
teenager can control – like staying well-hydrated (with at
least 2 liters of non-caffeinated fluid daily), eating regularly
with balanced meals, maintaining an exercise regimen, and
avoiding caffeine-overuse (no more than 200mg caffeine
daily, about 2 regular cups of coffee), and known food and
alcohol triggers.
The prospect of a roommate may be tricky. While sharing living space with a peer is a unique social opportunity
in the college experience, it also means giving up some
control of the environment. Freedom from the above
triggers and access to a dark, quiet, snore-free, scent-free
surrounding when migraines do occur may not always be
available. Roommate housing options vary widely. Options
allowing for some degree of private space, like multi-unit
suites with shared common space, may be feasible for some
migraineurs. Although, for those who suffer more frequent
and/or severe headaches, any shared situation might be untenable and teenagers may opt for a single room allowing
them exclusive control of their space. A physician’s note is
usually required, and it is best to make this request early.
Even with optimal lifestyle management- avoidance of
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HeadW ise ®
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Volume 4, Issue 4 • 2015
triggers and an ideal roommate situation, occasionally
migraines will inevitably occur. Having a plan in place
before your child leaves for college is essential to tackle this
situation. You should share the headache diary with your
child’s physician months before leaving for college. If there
has been a recent change in your child’s headaches, your
physician may decide to run tests to exclude underlying
medical problems (such as anemia and thyroid dysfunction). If the headaches are being inadequately treated, this
is an opportunity to try alternate rescue medications. Additionally, if headaches are frequent (usually above 5 days
per month) or intrusive, there may be a role to initiate a
preventive regimen. This usually involves prophylactic
medication, but other options may include specific vitamin
supplementations, addressing comorbid mood disorders,
biofeedback training, physical therapy, and acupuncture.
These preventive strategies raise the headache threshold
and make it harder for the brain to generate headache – the
goal being to decrease the migraines’ frequency, severity,
duration, and/or improve response to rescue medication.
These medicines take around 6 weeks to take effect, and
finding the correct regimen may require trial and error, so
it is important to begin working with your physician on
this plan as soon as possible.
With the transition to college come new challenges for
those with migraine. Teenagers prepare with standardized testing and rigorous applications, but planning for
migraine care is just as important. Recognizing triggers,
preparing a treatment plan, and anticipating the changes
in advance will give your teenager the best tools to keep his
or her migraines managed in the background, and allow
him to be fully present in the college experience. HW