Living with migraine is like a roller coaster 

«I feel like I’m never on top of things. I’m either in the middle of an attack or catching up after one. I feel bad that my co-workers/spouse must cover for me when I am sick so when I feel better I try to rush and make it up to them. That leads to another attack.» Does that sound familiar? 

Everyone would benefit from a bit of pacing, but people with migraine may need it more.

roller coaster with pacing

What is pacing?

Pacing is an effective strategy that allows people with migraine the ability to maintain functional independence without causing an increase in headache intensity.  Many people with migraines report that stress and overexertion can be consistent triggers.   With pacing, people can keep reasonable schedules and workloads and, as a result, keep stress and exertion to manageable levels. 

Pacing is based on biomechanical principles and is closely tied in with personal values.  

Tip 1: Prioritize

Prioritize the items on the list using a system of your choice, then focus on your priorities. This is easier said than done, as we have a tendency to do the easy things that are not urgent instead on what really is important. 

  • Number system: based on importance, 0 can wait, 1 is not urgent, 2 should be done and 3 is very urgent. 
  • Colour system: Highlight in green things that are most important, yellow things that are next-most important, and red things that can be postponed or not done. 

Tip 2: Say no or delegate

  • Delegate tasks to others when necessary. Do not feel obligated to «do it all». That may be relevant at work (co-workers) or at home (partner and children). 
  • Don’t forget that saying  “no” is an option.  When asked to do something, never accept right away. Instead, say «let me get back to you», check your schedule, THEN decide if you want to accept the task. 

Tip 3: Schedule and plan ahead

  • Fill in a weekly schedule with your items.  
  • Ensure multi-step and/or heavy tasks are broken down into manageable chunks that can be scheduled throughout the day or over the course of a week (e.g., do one load of laundry each day instead of a mountain of laundry every Saturday).  
  • Alternate work with mini-rest breaks and heavy tasks with light ones. 

Tip 4: Plan for buffer time to rest or manage the unexpected

  • Schedule in rest breaks and meals. 
  • Don’t make your schedule jam-packed.  
  • Leave a little extra room in case of anticipated delays or problems. 
  • Earmark activities that can be modified or removed, so that if you have a headache that day, you can easily eliminate or reschedule items.  
  • Some people like a mid-week break and don’t schedule much on Wednesdays. 

Tip 5: Manage meals

  • Plan to purchase healthy pre-made, frozen dinners, or take-out some nights so that meals don’t always have to be made from scratch.  
  • A slow cooker is a wonderful idea.  While supper is cooking, you can catch up with your family or do some relaxation exercises.

Tip 6:  Relax Your Standards

  • Learn to let go of the «it has to be perfect» mentality. «Good enough»….is probably more than enough! 
  • You have to manage with a neurological disease. Cut yourself some slack. 

Tip 7: Discuss with your employer 

  • Migraine can be disabling. Many employers don’t know about the causes of migraine, the treatments that exist, and the impact it has one someone. 
  • Raise awareness in the workplace. Read here for more information

Tip 8: Work with an occupational therapist or professional coach

Sometimes, you know what you have to do but you just can’t do it. Maybe you feel overwhelmed, or don’t know where to start, or just don’t have the motivation. Working with a professional can help you and give the kickstart you need to really change your habits effectively. Pacing requires a lot of flexibility. Occupational Therapists are used to find concrete strategies. Yes, money is required, but it might be a very wise investment. 

In summary, pacing is a skill that you can learn to manage your time better and get away from the crazy migraine roller-coaster. Give it a try!


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