Exploring the Impact of Mindfulness and Meditation on Migraine

0:00 [Music]
0:04 all right natania you should be able to
0:07 um share as well and also when it it’s
0:09 it’s your turn all right so what are we
0:11 going to talk about tonight um all kinds
0:12 of things related to to mindfulness and
0:14 meditation and natana and I had a tough
0:17 time really kind of narrowing this down
0:18 so we want to make sure we leave some
0:20 time at the end so really IT addresses
0:23 all of your needs and questions but
0:24 we’re going to you know review a little
0:26 bit of migraine what a treatment plan
0:27 looks like kind of Define in a little
0:30 bit the difference between mindfulness
0:32 and meditation maybe cover some myths
0:34 and misconceptions and where this fits
0:36 into a treatment plan and then really we
0:38 want you know participants to Come Away
0:41 with some helpful tools that you can
0:44 integrate into your daily life whether
0:46 you are somebody who lives with migraine
0:49 um has a family member or a loved one
0:51 with migraine it it can be relevant to
0:53 all okay so I know this seems probably
0:56 redundant but what is migraine there’s
0:58 so many misconceptions I think that are
1:00 out there that it’s nice to touch on it
1:02 so this is a neurological disease I
1:06 think it’s important to call it that to
1:07 gives it you know the validity that it
1:10 deserves um a lot of people struggle
1:12 with um stigma and misconception around
1:16 migraine so we need to recognize this
1:18 and use the right language it is largely
1:20 an inherited or genetically influenced
1:23 disease so many of you may have had a
1:26 parent with migraine or a child with
1:28 migraine um the way some of the ways
1:31 that I describe this is that individuals
1:33 with a a m with migraine and this
1:36 migraine brain have this increased state
1:39 of almost responsiveness or hyper
1:41 excitability that goes on with their
1:43 brain um and when you think about um you
1:47 know getting to that threshold where you
1:49 may be triggered into an attack somebody
1:51 else could be exposed to all of the same
1:53 things and that wouldn’t happen for them
1:55 if they they don’t have migraine so the
1:57 brain really behaves in a different way
1:59 than those who do not have migraine
2:02 amplification of sensory stimuli
2:04 so light and visual input auditory smell
2:09 um these things can become very very
2:11 pronounced and and often overwhelming
2:14 ultimately there are a whole spectrum of
2:16 symptoms we’ll touch on this a little
2:17 bit um and neurological disturbances so
2:20 it is not just a headache um and can be
2:23 quite different for for everyone and
2:25 even for each individual they may have
2:27 different dayss with different symptom
2:29 types
2:30 migraine is also very common so we know
2:35 that prevalence globally is sometimes
2:37 kind of estimated around 12% it’s
2:39 certainly over 10% in Canada it does
2:41 disproportionately affect genetically
2:44 born females so about 25 to
2:47 26% um and children also experience
2:49 migraine so sometimes this seems
2:51 surprising to people but about 10% of
2:53 children and it really can impact people
2:55 throughout their whole life uh I myself
2:57 live with migraine as well and certainly
3:00 can’t really remember a time that I I
3:02 didn’t have
3:03 symptoms um now it’s always nice to kind
3:07 of put it relative to other things so
3:09 when you look at migraine relative to
3:11 some of these other things that I think
3:12 we all would agree are are commonly
3:14 discussed and often you know get a lot
3:17 of attention paid towards treatments and
3:20 management but it really exceeds things
3:22 like diabetes asthma low back pain so
3:26 it’s it’s very prevalent and
3:28 unfortunately there’s still a lot of
3:29 Improvement uh that we need to do in
3:32 terms of managing it well so migraine is
3:36 not just a headache I think probably
3:39 anyone that’s here knows that and wants
3:41 to shake their head when anybody says
3:43 that um it’s certainly not caused by
3:45 poor self-care and this is I think you
3:47 know something natana and I talk a lot
3:49 about Wendy as well that there is this
3:51 pervasive misconception there um it is
3:54 not cured by hydration you can’t just
3:56 drink a glass of water or it’s not
3:58 caused because you’re not drinking
3:59 enough stress reduction or medication so
4:01 we’re not curing migraine our aim is to
4:04 really live as well as we can and have
4:07 the best quality of life and as little
4:09 Interruption to our function um it’s
4:11 certainly not a representation of
4:14 somebody’s strength or ability to cope
4:17 um and it’s not the same for everyone uh
4:19 so there can be fluctuations in
4:21 frequency and severity and the whole
4:23 constellation of symptoms which I think
4:25 can also make it very hard and isolating
4:27 because somebody may have my M but it
4:30 could have very little impact on their
4:32 life and and they may have that bias
4:35 towards somebody who lives with chronic
4:37 migraine and has other impacts so um it
4:40 does make it a little bit challenging
4:42 impact and disability so I have a very
4:44 strong interest in you know work focused
4:47 on advocacy and and reducing stigma um
4:50 and recognizing the impact of migraine
4:52 and ultimately trying to improve access
4:55 to good care for individuals with
4:57 migraine some of these statistics
5:00 here um that are are quite you know I
5:04 think sad when you see them but are the
5:06 result of some large um studies some
5:09 done uh US population based and
5:11 internationally but 50% of individuals
5:15 reported reduced family participation or
5:18 enjoyment in the last month and in this
5:20 particular group 75% said this was the
5:22 case in chronic migraine uh 39% of
5:25 individuals with migraine canceled
5:26 entertainment with friends families or
5:28 colleagues 50% % felt they would be
5:30 better a better spouse if they didn’t
5:32 have migraine and sadly 12% of spouses
5:35 also felt that you know they would be um
5:39 have a better spouse if they didn’t have
5:40 migraine um 43% thought they would be
5:43 better parents if they didn’t have
5:45 migraine so these things are really I
5:47 think a testament to what it is like to
5:49 live with migraine and how it can impact
5:51 your life um we do have stats that talk
5:55 about how impactful it is and it’s
5:57 recognized as the second leading cause
5:59 of the yours lived with disability
6:01 across all ages and genders globally and
6:04 it’s actually the number one cause of
6:06 yours lived with disability amongst
6:08 females age 18 to 49 and this really
6:11 represents how many days accumulated
6:14 over you know somebody’s life or in this
6:17 span is somebody impacted by migraine
6:19 symptoms and because it’s often be
6:22 beginning in childhood this is a
6:25 profound impact um so we really you know
6:28 need to do a little bit better at
6:30 helping to support migraine care so I
6:32 talked a bit about the stigmatization uh
6:35 it’s very hard that migraine is
6:37 invisible so this pervasive bias that
6:40 it’s because of poor self-care I think
6:42 gets perpetuated by people around maybe
6:45 it’s co-workers um family members health
6:49 care providers that can suggest this um
6:52 and that really gets internalized in
6:54 somebody with migraine it’s not well
6:56 diagnosed so we really don’t do a great
6:57 job of calling migraine migraines
6:59 sometimes it’s tension type headache
7:01 sinus headache hormonal headache it it
7:03 doesn’t really get called that so you
7:05 really don’t get uh proper treatment and
7:08 as a result it’s not recognized as this
7:10 incurable neurological disease that does
7:12 have treatment options um if
7:14 investigations are normal it’s sort of
7:16 being dismissed as being insignificant
7:18 to health so you know your MRI is normal
7:21 you’re fine um and as a result and I
7:24 think Natan and I talk about this all
7:25 the time there are a lot of things that
7:29 can be done to help people manage
7:31 migraine live well with migraine but
7:34 really comprehensive treatment plans are
7:36 just not uh always developed so people
7:38 end up living for a very long time
7:41 without access to you know
7:43 evidence-based and and good quality
7:46 comprehensive care okay so another kind
7:49 of slide that I really like and then I
7:51 promise we will get to the mindfulness
7:52 stuff but I think that this is really um
7:56 impactful and it will be relevant when
7:58 we talk about uh mindfulness and how it
8:00 can kind of help you maybe be a little
8:03 bit more in tune to what’s going on with
8:04 your body but if you take a look at I
8:07 know this very very wordy chart here um
8:11 there is this is kind of a textbook
8:12 version of um migraine uh attack so it
8:17 it consists of several parts so there is
8:19 this prod Drome phase this comes on
8:21 before the migraine attack and sometimes
8:23 people will say I you know I have
8:25 cravings I feel a bit irritable I yawn
8:28 sometimes your neck starts to her you
8:30 feel a little bit more increased
8:31 sensitivity to you know the kid
8:33 screaming or the bright light um and if
8:37 you’re somebody like natania who has a
8:39 an aura you may experience this um you
8:42 know for a period of time before that
8:44 what we kind of refer to as that the
8:46 headache phase although I don’t love
8:48 that term the migraine attack so then
8:51 there’s the postdrome so a lot of
8:53 attention gets paid to this period of
8:55 time during which you know the symptoms
8:57 tend to be most severe for a migraine
8:59 attack but there can be days leading up
9:02 to this and also days afterwards um with
9:06 this whole constellation of symptoms and
9:08 when you see um it really isn’t just
9:11 this head pain piece now I kind of put
9:13 this together because um this is
9:16 actually a little bit more what my you
9:20 know my patients tend to live with um
9:23 and what certainly people with chronic
9:25 migraine live with so it’s this
9:26 fluctuating course where you know
9:29 sometimes people have no days where
9:30 they’re completely Crystal Clear symptom
9:32 free and then it escalates into much
9:35 more severe uh symptoms and then it
9:38 might kind of quiet down again so there
9:39 is a lot going on and sometimes kind of
9:43 constantly for people with migraine um
9:46 so this really um is not appreciated and
9:50 you know if if this part is invisible
9:53 then all of these other things are even
9:55 more invisible if that’s possible um and
9:59 it can be a really really difficult
10:01 journey to endure this in in isolation
10:04 with people really not
10:06 understanding where are the gaps in
10:08 migraine care how much time do we have
10:12 Wendy um so it is invisible it is
10:17 historically very stigmatized and I
10:19 think that gets really kind of ingrained
10:21 in people living with it there is no
10:23 clinical diagnosis there are lots of
10:25 things that don’t have a specific test
10:27 but somehow you know in the the kind of
10:30 clinical world if there is an objective
10:33 evaluation you can measure a blood
10:35 pressure you can measure a blood sugar
10:36 but it’s challenging with migraine
10:38 because there isn’t a test that says
10:40 migraine we know statistically it often
10:42 gets
10:43 misdiagnosed um there’s not great access
10:46 to you know the most current
10:48 pharmacological treatments there are a
10:50 lot of new treatments that have come out
10:51 in the last 10 years but it’s it’s
10:53 sometimes challenging to find a
10:54 specialized provider that’s well versed
10:56 in this um we know that there’s a lack
10:58 of Primary Care Providers um so aside
11:01 from even Specialists you you can’t get
11:03 to them if you don’t have a primary care
11:05 provider so on the medical management
11:07 side of things we know that there are a
11:08 lot of gaps so what happens um
11:11 individuals with migraine are really
11:12 left to navigate on their own um so
11:15 resources like migrant in Canada and and
11:17 these kinds of things are are helpful
11:19 but uh you really need somebody to kind
11:21 of spearhead that so we’re boiling this
11:24 down to the mindfulness stuff so what is
11:27 a proper treatment plan um it really
11:30 takes a multi- ProMed approach and I
11:32 think for many people that have been on
11:36 this journey they’ve probably been
11:38 dispensed advice at different times you
11:41 know maybe uh welcomed or unsolicited
11:45 about like have you tried drinking water
11:46 and have you tried doing this and you
11:48 should probably meditate and sometimes
11:50 these things can be very dismissive and
11:53 undermine the journey so um you need
11:56 lots of sort of tools in your toolkit
11:58 and a lot of different strategies to
12:00 tackle different things so this is
12:02 something that this sort of represents
12:05 um you know in my mind and also when I’m
12:08 uh wearing my healthcare provider hat to
12:10 patients we need something in each of
12:12 these areas um mindfulness and and uh
12:16 meditation uh are tools uh they’re not
12:19 tools that we suggest because somebody
12:21 can’t control their stress or they’re
12:22 not coping well um you still need other
12:26 strategies to prevent um um and as well
12:30 as treat an attack during it so um what
12:34 we’ll talk about tonight these
12:36 mindfulness and meditation strategies
12:37 will sort of fall under this category of
12:39 your lifestyle and behavioral
12:44 strategies all right I’m gonna turn it
12:46 over to natana and you should be able to
12:48 advance the slides
12:50 natania yes
12:53 yay all right so thanks chrisy um so I’m
12:57 going to start with uh just a little
13:00 definition cuz I think there’s a lot of
13:02 mystery around uh mindfulness and
13:05 meditation and what they are and how
13:06 they different so there are lots of
13:10 definitions of mindfulness but I think
13:12 this is a really nice one in terms of
13:14 managing pain and and chronic pain and
13:18 um people you know who are looking at at
13:21 mindfulness really from a health care
13:24 perspective so mindfulness is the
13:26 awareness that arises when we pay
13:28 attention Ion with intention and without
13:32 judgment to what is happening in the
13:34 present moment this includes events
13:37 happening externally in our world and
13:40 internally within us it encourages
13:43 non-judgmental awareness and acceptance
13:46 towards thoughts emotions and physical
13:50 Sensations so in a nutshell it’s really
13:53 about being in the present moment being
13:55 aware of what’s happening and not play
13:59 wasting a value on that not this is
14:02 great this is bad it just is um and and
14:05 really in a nutshell that’s what
14:07 mindfulness
14:11 is okay so I thought we could start by
14:14 just doing a really brief quick uh
14:18 mindfulness activity so I’m just going
14:20 to get my stopwatch so I want everyone
14:24 to if you want to breathe in and out
14:27 slowly just take a breath comfortable
14:31 breath and then for your first minute I
14:34 want you to explore how am I doing right
14:37 now whil focusing on your feelings your
14:40 thoughts any Sensations that you feel
14:43 throughout your body you can have your
14:44 eyes open or close there’s no
14:47 requirement and just keep your body
14:51 comfortable you can give each word or
14:55 phrase uh a description to each feeling
14:58 or
15:10 thought just how am I doing right
15:13 [Music]
15:14 now no judgment just
15:27 is
15:34 and then for the second
15:36 minute keep your awareness on your
15:39 breath just focus on your breath and if
15:42 that’s difficult for you feel free to
15:44 focus on something else maybe the tip of
15:47 your
15:49 finger or where where your thighs are
15:52 touching the
15:53 chair just keep your awareness on that
15:57 point of focus
15:59 no judgment just noticing how it feels
16:04 focusing on
16:10 it if your thoughts wand off that’s okay
16:14 just bring back to your point of
16:27 focus
16:37 and then for the last minute for your
16:39 third minute expand your attention
16:41 outward from your point of focus whether
16:44 it’s your breath
16:45 or uh a part of your body to feeling the
16:49 ways your breath affects the rest of
16:51 your
16:53 body what’s the impact of that again
16:57 it’s not right it’s not wrong
17:03 just
17:27 noticing
17:49 and then bringing your attention back to
17:52 the
17:54 webar opening your eyes if they were
17:57 closed and welcome back and that is a
18:00 very simple mindfulness activity no
18:03 judgment just being in the moment
18:05 noticing yourself noticing your feelings
18:08 and
18:09 thoughts noticing what’s happening
18:11 around you and how you’re what’s being
18:13 what’s affecting your body and then
18:16 noticing what’s happening on the outside
18:18 as
18:18 well and these tools you can use
18:22 throughout your busy day Nat yeah did
18:26 you want to give a little context to
18:28 your ction for a picture here when we
18:30 were talking about uh this yeah so so we
18:35 um recognize that most of us uh are very
18:39 busy we have a crazy life happening
18:41 around us that uh we still need to
18:44 participate in and we still you know we
18:46 might have a million things to do and um
18:50 you know you know this images of a a
18:53 young mom with with her kids you know
18:56 who are helping her helping her with her
18:58 laundry
18:59 and um really it’s about being able to
19:02 bring these mindfulness activities to
19:06 your present moment your day-to-day life
19:08 it’s not something that needs to be
19:11 practiced separately that you need to
19:12 set aside a whole heap of time for and
19:15 in fact for this woman she could um
19:19 really just concentrate on on that
19:22 laundry and on on how she’s how the
19:25 actions of the laundry and how it feels
19:27 in her hands and what the smells are and
19:30 that’s a mindful activity that’s
19:31 bringing her into the present moment
19:33 right here right now um so it’s
19:35 something you can just easily
19:37 incorporate into your day um there was
19:41 um when we were talking about this
19:43 natania too um you know one of the
19:46 things that we discussed in preparing
19:49 this was sometimes the the
19:50 misconceptions that go along in aen is
19:52 going to talk about them but one mindful
19:55 activity that um was sort of shared with
19:58 me and I found very helpful particularly
20:01 uh it was introduced to me at a time
20:03 when I had my kids were well they’re
20:05 still pretty small but very small and
20:08 and needing to be even in my arms most
20:10 of the time and even going through sort
20:12 of your five senses so while you’re
20:14 doing tasks like picking up toys folding
20:17 laundry you know chopping up snacks you
20:19 know um what are you hearing right now
20:22 and trying to kind of tune into you know
20:25 what a sound is in the room and you can
20:28 almost reduced down to like a a bird
20:30 outside and um you know maybe a car
20:34 going by and then what are you smelling
20:36 what are the you know of of something
20:38 that you’re cutting or the fresh laundry
20:40 um how does it feel what is a tactile
20:42 sensation uh and going through those and
20:45 I found it very very grounding it didn’t
20:48 have to stop me doing whatever I was
20:50 doing but it did help redirect maybe
20:53 some of those racing thoughts that can
20:56 kind of Bounce Around especially when
20:57 you’re maybe feeling overwhelmed that
20:58 you can’t get to some of the things you
20:59 need to and you’re preoccupied with
21:01 other things so um that can be applied
21:04 as well in in scenarios and situations
21:08 where you’re maybe being exposed to
21:10 things that are starting to escalate
21:12 some of those symptoms that go along
21:15 with migraine or even that anticipation
21:18 anxiety do do you think natanel where I
21:21 know that I’m I have to go to this event
21:23 I’m not feeling 100% what if that
21:25 migraine attack you know starts to
21:27 really escalate in what am I going to do
21:29 and we know that we can um Elevate our
21:34 stress levels and almost you know not
21:38 set us ourselves up um for the the the
21:42 best kind of um experience that we’re
21:45 going into just with that anxiety and
21:47 it’s very well known that there is lots
21:49 of anxiety around migraine and the
21:52 unpredictability of attacks and how
21:54 they’re going to impact us in our life
21:56 um so yeah thank you I I could listen to
21:59 natan’s
22:01 voice non-stop it’s
22:04 so I’ll let you I’ll let you go on the
22:07 so yeah and I think that thank you for
22:09 saying that because it’s true it’s it’s
22:11 um you know that I was I am going to
22:14 talk about it later but there is this
22:16 picture people seem to have in their
22:17 mind that it’s some somehow separate to
22:20 your life but if if we practice it when
22:24 we think of it as part of what we’re
22:26 doing uh it becomes more natural and
22:29 easier for our brain to utilize that
22:31 tool to calm those senses so it
22:35 increases our manage our th what we call
22:37 our threshold so so that you know um we
22:42 can you know we have a wider threshold
22:44 before the attack starts getting too bad
22:47 or too whatever so yeah
22:52 um so meditation is actually the formal
22:57 uh is a formal practice so where
22:59 mindfulness is not a formal practice you
23:02 can just do it you know as you’re going
23:05 about different tasks meditation you
23:08 actually do need to set aside time to
23:10 concentrate on your meditation um it’s
23:14 taking up a position for a period of
23:16 time it could be 5 minutes it could be
23:18 20 minutes some people do it for a lot
23:20 longer in which we practice focused
23:22 awareness of what we sense and
23:24 experience in the present moment without
23:27 judging anything passing through our
23:29 awareness as good or bad and not turning
23:32 the awareness into
23:34 thoughts we might start by focusing on
23:36 the breath without changing it but
23:38 simply noticing and focusing on this our
23:42 minds and then we can move on to other
23:44 things our minds inevitably wander off
23:47 to other thoughts but we notice and we
23:49 bring it back to whatever that Focus
23:51 point is if it’s our breaths it might be
23:53 a visual aid it could be um how you how
23:57 you feel against the seat it could be a
23:59 whole bunch of things so it’s a the
24:02 action of meditating is actually all
24:05 noticing that thought and escorting it
24:07 back to what your focus what you’ve
24:09 chosen to focus on for me often it’s the
24:12 breath or or a mantra a specific word um
24:17 but um you know it depends on what the
24:20 practice is so um and this is um a
24:26 formal practice so you know can’t do it
24:28 while you’re driving um or anything like
24:32 that because you really need to be very
24:34 much concentrating on on this process or
24:36 focusing on this
24:38 process so um yep so that’s
24:43 meditation go to the next slide so I
24:47 wanted to talk though about practical
24:49 strategies for meditation because I
24:52 think we do have this picture of what
24:55 meditation looks like and for us who um
24:59 who are facilitators of the
25:02 mindfulness-based chronic pain
25:04 management course and uh and who work
25:07 with people with migraine and other
25:08 types of
25:09 pain it’s important that we do whatever
25:12 is kindness to our body at that time in
25:15 that moment and it’s I think it’s also
25:18 something people don’t realize that
25:19 meditation can take lots of different
25:21 forms it’s not just the stereotypical
25:23 image of some woman at the top of a
25:26 mountain saying M you know with she’s
25:28 sitting on the ground with no back
25:30 support um I don’t know how she does
25:33 that so you can have walking meditations
25:36 you can have moving meditation you can
25:39 lie down you can sit up um your eyes
25:42 could be open but at a soft gaze or you
25:46 can close them and then of course you
25:48 can have different areas of focus it
25:50 could be part of your body it can be
25:52 breath a lot of people have trouble with
25:54 breath actually it could be a sound so
25:57 things you hear outside or it could be
25:59 some sort of visual object like a candle
26:01 or the trees outside or or something
26:04 like
26:05 that the idea is just to be focusing and
26:09 focusing your mind wanders off you bring
26:11 it back so it’s it’s pretty simple but
26:15 it takes it does take some practice um
26:18 so you know and I like to break down
26:21 this idea of what meditation is supposed
26:23 to look like because I think I think it
26:26 puts people off um I think if I learned
26:29 what meditation if I had that
26:30 stereotypical image when I was 19 and
26:33 first learned to meditate I probably
26:34 would never have done it but I I had no
26:36 idea what I was learning so um I think I
26:39 was lucky in that respect but um yeah
26:42 it’s it’s um it’s versatile and there’s
26:46 no scientific evidence uh that you have
26:49 to be sitting in a certain way that you
26:51 have to um concentrate on a certain
26:54 thing or anything like that the these
26:56 things are not backed up by by evidence
27:00 um so we can actually I think for me
27:02 it’s I find it much more important to be
27:05 kind to our bodies particularly you know
27:08 people with a neurological condition
27:10 often with other conditions have
27:13 physical conditions uh maybe you know a
27:15 lot of people with migraine have things
27:17 like fibromyalgia and and other pain
27:19 conditions so it’s really important to
27:21 respect our bodies uh and support our
27:24 bodies and what they’re asking for at
27:25 that time and for me as well that’s
27:28 actually mindfulness is to to be mindful
27:31 of what your body is requiring of you in
27:33 that
27:34 moment the other thing is if you’re
27:37 uncomfortable so you start a meditation
27:39 and you know you get five minutes in and
27:41 you think oh my back’s really hurting
27:43 move you don’t have to stay still the
27:46 entire
27:47 time is there anything you wanted to add
27:50 there Christie no I really um love the
27:54 way you explain it and I think in
27:56 contrast to natania I did have a lot of
27:59 those stereotypical kind of
28:01 misconceptions about meditation and you
28:04 know sort of tried it a few times and
28:06 thought you know I’m I think I’m bad at
28:08 this I just can’t clear my mind so that
28:10 blank canvas of a mind uh perception is
28:13 really not at all what it is um and I
28:17 think Nat is great as you know an
28:19 advocate and a migraine Co to
28:22 really getting that sense like to listen
28:24 to your body there’s not a right or a
28:26 wrong thing if focusing on on the breath
28:29 is not something that’s comfortable
28:31 which was something that well into
28:33 trying it several times was an aha
28:35 moment for me um that you can just
28:38 redirect your focus somewhere else um so
28:41 whether it’s kind of a physical
28:43 sensation usually for me it’s wherever
28:45 my my hands are kind of positioned or or
28:48 sitting um yeah I think that was great
28:50 thank you yeah excellent thank you
28:55 um so and Christy just t on this now but
28:59 people there are misconceptions around
29:02 mindfulness meditation I love this image
29:04 that you found which is like it’s you’re
29:07 Rising
29:08 above and the kitchen’s turning into a
29:11 complete like chaotic nightmare but you
29:13 can meditate and and practice your
29:15 mindfulness through of that yeah and
29:17 think about nothing about what’s
29:19 happening you know totally empty
29:20 thoughts it’s just not not realistic and
29:23 not what’s going to happen so there’s
29:26 misconceptions that meditation involves
29:28 clearing your mind that it’s supposed to
29:30 be empty of thoughts well that’s like
29:33 stopping the tide it’s your mind is
29:35 designed to have thoughts it it it’s
29:38 fine it’s supposed to have thoughts
29:41 meditation is actually noticing that
29:42 you’re having the thought and bringing
29:44 it back to
29:45 where where you wanted to focus that
29:48 that’s a muscle that you practice and um
29:51 and you get better and better at it as
29:53 you go along um I mean I’ve had
29:55 meditations even you know I’ve been
29:57 meditating for 30 years and sometimes I
29:59 come out and go oh my mind was full of
30:03 thoughts that entire whatever but I
30:05 wouldn’t say to myself oh I had a bad
30:07 meditation like that there’s just not
30:09 such a
30:10 thing um people view thoughts and
30:13 emotions as distractions to meditation
30:16 well as I just said they’re not they’re
30:18 just part of the process meditation is a
30:21 process not a
30:23 destination there’s an implication that
30:26 migraine is due to stress so as Christy
30:29 talked about before and then that
30:31 meditation is be you need to meditate to
30:33 manage your stress but that’s not really
30:36 how it works um meditation practicing
30:40 regular meditation and mindfulness um
30:44 does help you manage stress uh it can
30:47 help um uh reduce attacks uh migraine
30:53 attacks or your relationship to your
30:54 migraine attacks and um and that in
30:57 itself
30:58 um can reduce the impact and the um the
31:02 severity of of your
31:04 attacks there’s no as I said there’s no
31:07 such thing as bad
31:08 meditation um there are variable quality
31:11 and quantity of uh resources and
31:14 programs out there so it’s hard to know
31:16 what to pick for yourself um to do uh
31:21 we’ll talk more a bit more about some of
31:23 the things that are just online um the
31:26 other thing is that there’s no
31:28 expectation that once you do mindfulness
31:31 or you’re learning about mindfulness
31:32 that you have to be mindful all the time
31:34 it’s just not really realistic um you
31:39 know I think it’s about taking those
31:41 mindful moments it’s about bringing
31:43 yourself back when you notice when you
31:45 want to um and I actually think that
31:48 people who practice these tools slowly
31:52 as they practice more and more it just
31:54 becomes part of your life to notice what
31:57 to not what’s going on for yourself more
32:00 regularly but it’s you know I’m yet to
32:02 meet anyone that’s other than maybe like
32:05 the Del Lama or someone who where it’s
32:07 like 24 hours a day like it’s you know
32:10 we’re we’re humans I think we have to
32:11 recognize that we’re just human
32:13 beings um there’s another misconception
32:17 that mindfulness and meditation is the
32:19 same thing as
32:20 relaxation and it’s not so one
32:24 meditation seems to go through stages uh
32:28 of how you respond to meditation and how
32:30 it feels to meditate and at the
32:32 beginning often not always it can feel
32:34 like oh I’m getting into a really
32:36 relaxed State and then after doing it
32:39 for a while it starts to feel different
32:41 when you meditate and then you keep
32:42 doing it for a while and it feels
32:44 different again so it’s not the same
32:47 thing as relaxation it’s it’s um it may
32:50 lead to more relaxation but that’s
32:52 actually not the goal um it’s not a
32:56 quick fix and and it does take time and
32:59 consistency while important most
33:02 important of all being kind to yourself
33:04 and just noticing what’s happening
33:08 nothing’s right nothing’s wrong you miss
33:10 a day oh well okay that’s fine I’ve got
33:14 today so it’s it’s fine so um yeah I
33:18 think I think they key key challenges
33:22 and and
33:24 misconceptions um and I’d be interested
33:26 you know if anyone has any questions
33:28 please put it in the chat because we can
33:29 talk a bit more about that at the
33:32 end
33:35 too all right back to me um so we want
33:40 to kind of tie these things you know all
33:43 together and talk about mindfulness and
33:45 the brain and in the context of migraine
33:48 and um there has been uh not even
33:51 recently I think for a long time growing
33:54 interest in the role of of mindfulness
33:56 and meditation what is is it due to the
33:58 brain it’s been fairly well studied in
34:01 um areas of pain um and in other areas
34:05 of of mood and there’s some suggestion
34:08 that it can influence both the structure
34:11 and the function of the brain so um when
34:14 we have some of these changes we we
34:16 refer to this as neuroplasticity and I
34:18 think our understanding of you know what
34:20 we can do in the idea of strengthening
34:22 our brain and building new neural
34:24 Pathways um is something that has kind
34:26 of evolved in my lifetime time for sure
34:29 and um what really is kind of the
34:32 outcome of this so the regular sort of
34:38 practice of you know formal meditation
34:41 and then daily practices of kind of
34:43 mindfulness um can influence some of the
34:46 neurochemicals in your brain so some of
34:48 these things are responsible for mood um
34:52 and you know just how we’re kind of
34:54 feeling dayto day um it can influence
34:57 structures some that are related to
34:59 memory emotional
35:01 regulation uh so there’s these kind of
35:04 broad things that happen some of the
35:07 summary statements about what happens is
35:09 that it can improve some of your
35:10 psychological flexibility so this is you
35:12 know a bit of an abstract term but there
35:15 are lots of things one goes through when
35:18 they’re dealing and living with a
35:20 chronic disease um you know and it can
35:23 be really challenging to evolve or or
35:27 sort of move Mo towards a place where
35:28 maybe you have some acceptance of these
35:31 things or um to mitigate the very real
35:34 anxiety of it having sort of more
35:37 control over your life than you have so
35:40 you almost feel like you become sort of
35:42 a a passive participant in in the
35:45 disease leading you and I think that
35:47 truly the the lack of um resources that
35:51 can be out there including specialized
35:53 providers and you know access to
35:56 information about Migra
35:58 really exacerbates this as well so like
36:00 I said it can be a very lonely journey
36:02 and people are left to try and navigate
36:04 these things on their own um there there
36:08 is kind of another way to just that it’s
36:10 kind of described is that it reduces
36:12 some there’s no good way to says
36:14 detrimental habits or reactions I always
36:17 feel like this is kind of Laden with
36:18 judgment but there are things that we
36:21 all do that are maybe not the best
36:23 reaction to things and that can really
36:25 tip the balance sometimes in some
36:27 somebody who has migraine we always talk
36:29 about you know there’s sort of a
36:30 threshold maybe where somebody kind of
36:32 builds up to that and gets sort of
36:34 triggered into an attack so anything
36:36 that we can do in that multifaceted
36:39 approach that takes a few steps away
36:43 from that threshold of a migraine attack
36:45 can be helpful and mindfulness really
36:48 plays a great role in this so um as
36:52 natana had said you know we know that we
36:54 have to practice things fairly regularly
36:57 to incorporate them into our routine um
37:01 they become habitual you can really
37:05 strengthen this this skill set like
37:07 anything so I like these images as well
37:10 so you’re really going to kind of work
37:11 out your brain you’re going to nourish
37:14 these uh mindful habits and then you do
37:16 start to see some benefits and I think
37:19 the great thing is Natan and I have um
37:22 witness people go through these programs
37:25 and the stories and the impact that they
37:27 have have shared uh on their migraine
37:30 journey and their lived experience with
37:31 migraine is has been really nice so
37:33 she’ll share some of those as well um I
37:36 realized actually this was a very busy
37:37 picture to put on this slide but
37:40 um what is a research though so there
37:43 there’s one uh study I wanted to kind of
37:45 highlight it’s fairly recent um and it’s
37:49 a hard thing to capture what mindfulness
37:52 and meditation does for migraine um but
37:55 in this particular study they took 89
37:57 adults they randomized them to two
37:59 groups in one group they went through a
38:02 formal 8-week mbsr or mindfulness based
38:05 stress reduction program so really
38:08 giving them the foundation and the tools
38:10 and philosophy around mindfulness and
38:12 strategies and
38:13 practical um exercises to to work
38:17 through and the other group got eight
38:20 weeks just as much time of education
38:23 related to migraine um so both got the
38:26 same amount of kind of attention but
38:28 very different in information so what
38:31 happened both groups actually did have
38:33 some improvement in symptom days so that
38:36 was um that was nice so uh what the mbsr
38:40 group showed though was improvements and
38:42 they did standardized uh validated
38:46 questionnaires so migraine related
38:48 disability improved quality of life
38:50 scores improved depression scores
38:53 improved self-efficacy so people’s sense
38:56 and ability to manage their condition or
39:00 migraine on their own as opposed to
39:02 being reliant on external factors or
39:04 just not feeling like they could manage
39:06 it that improved pain catastrophizing
39:08 and then what sounds quite um medieval
39:11 but experimentally induced pain
39:13 intensity and unpleasantness
39:16 tolerability improved so um I think that
39:21 this is important because these are the
39:23 things that allow you to live better
39:25 right the quality of the of life being
39:28 able to not have maybe as much anxiety
39:31 or feeling like you have a plan if a
39:33 migraine attack develops even though you
39:35 have something important uh going on so
39:39 that’s what this study showed we know
39:41 that you know it’s hard to capture this
39:43 in in research but um we’ve also seen it
39:47 in in practice so I’m going to turn it
39:49 back to natania to talk a little bit
39:51 about some of the resources that are out
39:53 there and we’re happy to you know if
39:56 anybody has questions about some of the
39:58 the many things that they’ve encountered
39:59 related to mindfulness and and
40:01 meditation maybe we can help you
40:02 navigate them yeah so there are uh
40:06 practical strategies obviously um there
40:09 are apps out there like um the Cal app
40:13 which I use um the the bed of sleep
40:16 which I’ve used in the past and um you
40:18 know a number of others that I don’t
40:20 know of but I know that they’re there um
40:23 and there’s YouTube you can find U
40:25 meditations and exercises on YouTube and
40:28 of course lots of stuff listed on Google
40:32 um and then there’s mindfulness that’s
40:34 parts of other therapies like uh
40:37 cognitive behavioral therapy uh where
40:39 it’s a part of uh a more comprehensive
40:43 therapy that you might do um with a
40:45 psychologist or or practitioner um and
40:50 you may may not even realize that that’s
40:52 a mindfulness strategies uh strategy uh
40:55 and then there’s formal courses like the
40:57 ones christe and I offer um and you know
41:01 the mindfulness based stress reduction
41:04 and and other formal U mindfulness
41:07 courses I think for me um they’re all
41:11 useful and nothing uh you know it’s it’s
41:15 it’s you know Silly to go oh this is no
41:18 good and this is better it’s really that
41:20 um the formal courses teach you
41:23 foundational skills and tools that you
41:25 can use continually and um and really
41:29 allow you to explore what works for you
41:31 what doesn’t um how to implement things
41:34 how to have the you know you might have
41:36 those aha moments where you realize oh
41:38 this one thing like Christy did with her
41:41 breath all of a sudden she realized the
41:42 breath wasn’t working for her where uh
41:45 you know the formal courses allow you to
41:47 work through some of that stuff and to
41:49 have an experienced uh facilitator and a
41:53 trained facilitator to to help you work
41:55 through that and to really uh embed
41:58 these practices um and then I think the
42:00 apps for me the apps and YouTube are
42:03 really complimentary um you know they
42:05 help you to maintain practice and to
42:07 ongo you know to practice ongoing and um
42:12 you know they might help do a bit of
42:14 relaxation at different times as well so
42:16 I think they’re um they’re the key
42:21 practical
42:22 strategies um yeah and I think you know
42:26 Natan to your point before like about
42:28 kind of doing what is is right for you I
42:31 think for anyone that’s kind of deriving
42:32 some benefit from an app one thing that
42:35 we did talk about and and you mentioned
42:37 is like that typically are those are
42:38 usually focused on a formal meditation
42:41 as opposed to integrating the
42:42 mindfulness piece um and if you are
42:45 enjoying that then you know maybe um
42:49 being open to explore kind of other
42:52 strategies and and other types of um
42:57 resources so kind of growing maybe your
42:58 skill and repertoire and for anyone
43:00 who’s maybe tried these things and
43:01 thought this is not for me then I think
43:04 this is where you and I Natan were
43:06 hoping that maybe we could dispel some
43:08 of the the misconception uh around it
43:12 and have people revisit and maybe kind
43:15 of keeping an open mind to how this
43:19 could fit into their their life um I I
43:23 and and it’s true like you can kind of
43:25 come to things and kind of move away
43:26 from them at at different times but I I
43:28 think probably all of us can agree that
43:31 we have many many things that are vying
43:34 for our attention at all times um there
43:38 are screens all around us we’re getting
43:40 inundated with different forms of you
43:42 know messaging and emails and whatnot
43:43 and if we have people in our lives that
43:45 also meet us it is not possible to do
43:48 all things at the same time and you know
43:53 when you know one feels like they’re
43:55 maybe getting pushed to their limit
43:56 close to migraine attack or otherwise
43:59 bringing back some of these um
44:01 strategies and and gaining some of that
44:03 mindfulness can really help to
44:04 deescalate that stress response and you
44:08 know take a breath and kind of move on
44:10 and and rep prioritize maybe what needs
44:13 to be done and be kind to well yeah and
44:16 you’re exactly right so I I mean this is
44:19 actually a later slide but I’m going to
44:21 um say it now because Christie brought
44:23 it up um you know I recently finished
44:28 facilitating uh a mindfulness based
44:31 course um for people with migraine and
44:35 um in fact that that type of feedback is
44:39 exactly what people were saying at the
44:41 end um you know it really uh it it’s
44:45 really uh helpful for them to to be able
44:49 to practice it ongoing There’s No Limit
44:53 there’s no limit uh to how often you can
44:56 practice your mind fulness you know when
44:58 with medication obviously you can only
45:00 have so much you have to wait so long
45:02 you have to wait for so long you know
45:04 between doses you have to wait so long
45:06 for it to be effective and then it may
45:08 or may not be that effective depending
45:10 on where you’re at in your attack um
45:13 whereas with
45:14 mindfulness you can use it as much as
45:16 you like and there’s really no negative
45:20 side effects so um yeah so I think
45:23 that’s one of the one of the benefits
45:26 that the formal of course teaches you
45:28 how to utilize
45:30 that so and so and this is actually the
45:34 slide um so yeah I I just um co-
45:38 facilitated with Dr Jackie Gardner Nick
45:41 um a um chronic pain management a
45:45 migraine a man my words are slipping um
45:49 a mindness based chronic pain management
45:52 group specifically for people with
45:54 migraine and headache disorder there
45:56 were 16 participants with chronic
45:58 migraine or other forms of headache and
46:01 um it was an 8-week course
46:04 um and these we I just wanted to give
46:08 you a couple of testimonials that um
46:11 people have given us that that um we
46:13 have permission to share um so one
46:16 participant said it’s really been
46:19 life-changing and I’m so grateful for
46:21 that it gave me the sense of
46:23 accountability I’m on day 49 of daily
46:26 meditation and I’ve noticed such a big
46:28 difference in my Outlook even when I do
46:30 get bad headache
46:32 episodes I’ve had a significant decrease
46:34 in headaches and nerve pain which makes
46:36 my life so much
46:38 better so for for this particular
46:41 participant they found that it really
46:44 you know the the daily practice really
46:47 uh has had a a significant impact on um
46:52 on reducing their disability in
46:55 increasing their ability to participate
46:58 in their day-to-day life um and then and
47:00 we have had other feedback um from
47:03 patient uh from participants who um you
47:07 know they were basically housebound and
47:11 after going through uh one of these
47:14 formal courses they they were able to um
47:17 to get out and about and start
47:19 participating more uh with their family
47:22 and in Social
47:23 circumstances so um
47:27 uh you know it’s it’s a really helpful
47:29 tool if you know it is a really helpful
47:32 tool um and this is the the participant
47:36 who basically um chrisy was you know led
47:40 me into mindfulness is side effect free
47:43 um you know this person um said you
47:47 don’t need to buy things to practice
47:50 that for for them it was uh lifechanging
47:52 and it’s been the best choice that
47:54 they’ve made in their Wellness care and
47:57 and that’s the important part too it’s
47:59 just as that SL earlier Slide the three
48:03 parts this is just one part and it
48:06 doesn’t it doesn’t replace anything else
48:08 it’s it’s a thing you can do yourself
48:11 ongoing um and and you know help
48:15 yourself to to continually manage your
48:22 condition all right so quick summary so
48:26 so some of the things we sort of hoped
48:28 that participants um would take away
48:31 that mindfulness and meditation are
48:33 tools in a in a multifaceted toolkit um
48:37 you know we know that there can be a lot
48:40 of powerlessness involved in uh
48:43 something like migraine especially if
48:45 you are trying to navigate a
48:48 system get a diagnosis get to a a
48:51 provider that can manage you there’s
48:53 just a lot there are enough things that
48:54 are out of your control um that can
48:57 really complicate things so tools like
49:01 like these can really build that
49:03 selfefficacy and individual capacity to
49:07 help manage migraine you don’t need to
49:09 as natania said wait for another dose
49:11 you don’t need to wait for another
49:12 appointment um you can utilize these
49:15 things uh clearing your mind so I I for
49:18 sure have was all the stereotype uh
49:21 misconception so this idea of clearing
49:23 your mind is not the goal or even
49:25 possible um um there isn’t sort of a you
49:28 know a a good a bad meditation you will
49:30 have days where you are just you maybe
49:33 don’t even notice that you’re not
49:35 thinking about uh anything because
49:36 you’re so unfocused and then over time
49:40 it may really surprise you how long and
49:44 how able you are to kind of um tune into
49:48 the things around you and it’s a really
49:50 good sense like I I don’t know how to
49:52 describe it but it is a really really
49:54 good feeling um
49:57 you can as we kind of said there’s a
49:59 sense of sort of increased control back
50:01 in the individual that’s living with
50:02 migraine and this was certainly what a
50:04 lot of the participants to natan’s
50:06 program had said um aside from just some
50:09 of these anecdotal things it’s great
50:11 that there is kind of growing evidence
50:13 that show reported improvements in
50:15 quality of life uh reducing depression
50:18 increasing tolerance to discomfort uh
50:21 and and then there’s a blank there so
50:23 and fill in the blank all the good
50:25 things um but a lot of really important
50:28 things that I think ultimately I always
50:30 talk about you know it’s not about
50:32 curing it’s about living well and not
50:34 letting kind of migraine um live your
50:37 life for you so it really does I think
50:40 uh lend itself well it’s one more kind
50:42 of tool in your toolkit um and it can
50:45 help improve some response to Medical
50:47 intervention so there’s talk about two
50:49 um when I I listed that slide with all
50:52 of those different symptoms at different
50:53 times I’ve had patients talk about how
50:56 oh
50:57 they’re able to kind of tune in maybe to
50:59 some early signs of a migraine attack
51:03 maybe they’re um able to treat a little
51:05 bit sooner because they have a
51:07 little improved awareness around some of
51:11 those symptoms um and if you can reduce
51:15 yourself away from that uh threshold
51:17 then maybe you can spare yourself some
51:20 some days of acute medication use as
51:22 well so there’s lots of different
51:24 potential
51:25 outcomes