Are you singing the blues?

How do you know if you’re depressed?

When we greet each other, we typically ask:  “How are you doing?” and the automatic response is:  “Fine.  How are you?”  We say it almost without thinking, but are we really fine?

The pandemic has a lot for us to worry about:  financial insecurity, illness, death.  Being out of a job or forced to work fewer hours, and trying to get by on unemployment insurance while the cost of essential supplies goes up is stressful.  Worrying about the current state of COVID 19 when a vaccine is still probably at least 6 months away is stressful. 

On top of that, the pandemic has caused us to severely alter our regular routines and social interactions. We can’t gather in groups.  Shopping is limited to the number of people in the store or curbside pickup.  Doctor visits have changed to use telehealth.  We can’t go out to bars, restaurants, concerts, amusement parks, beaches, or pools.   Some of us haven’t seen friends and family members in person for months.  Having to handle all of this stress at the same time as you are unable to fall back on your regular routines or get the support you need from friends and family, sometimes leads to depression.

How DO you know if you’re depressed?

It is common for us to suffer from some anxiety during this pandemic.  But, some people are feeling overwhelmed.  The constant barrage of increased positive testing and death rates on the news –especially without a vaccine being available  in the near future—has caused some people to lose hope for any type of normalcy.  

COVID-19 has changed all of our routines – including how we have fun.   While some people have taken up new hobbies like walks on the rail trails, baking, home improvement projects, or gardening, others have a hard time finding new activities to have fun or relieve stress.  Others become fixated on what they can’t do.  If you feel overwhelmed or helpless, or take little or no joy in things that you can do, you may be depressed. 

Most people associate depression with people who are sad all the time.  It’s not always that obvious. 

Symptoms of depression can be sneaky.  They aren’t limited to feeling sad and hopeless.  They appear in other ways.  Depression can disrupt your sleep.  Often, people who suffer from depression have fatigue and are tired all the time.  Others, suffer from insomnia and either can’t sleep at night or wake up multiple times per night.  People suffering depression can be irritable with a “short fuse” easily frustrated or angered.  Someone who is depressed may appear “foggy”.  They may have trouble concentrating or remembering things.  Depression symptoms can also include someone who stops taking care of themselves.  They may stop changing their clothes, bathing regularly or brushing their teeth.  Others get teary-eyed over what may seem trivial or a minor incident to others.  People who are depressed also may “stress eat” and gain weight or lack interest in eating altogether and lose weight. 

So what if I feel sad, what does it matter?

It matters a lot!  One’s mental health, can exacerbate pre-existing conditions.  Being stressed or depressed has also been shown to intensify the severity of chronic pain and sometimes trigger migraine.  Additionally, depression left untreated, could lead to thoughts of suicide.

What can you do?

If you suspect that you or your loved one may be suicidal, please don’t wait to reach out.  The National Suicide Prevention Lifeline provides 24/7, free and confidential support for people in distress.  They will also provide prevention and crisis resources for you or your loved ones.

National Suicide Prevention Lifeline:  1-800-273-8255

If you suspect that you are or a loved one is feeling depressed, please contact your health care provider.   Whether in person or via telehealth, health care providers have many ways in which they can help you. 

If you suffer from depression and chronic pain or migraine, Boston PainCare and the Boston Headache Institute can help!  Boston PainCare offers patient-centered, integrated care for men and women in the Boston area.  They are accepting new patients (even now during the pandemic). 

Please call:  781-647-7246 to schedule an appointment.

If you are already diagnosed with depression and migraine, we are currently enrolling for a study.  Click here to learn more.

Mixing Migraine with Friends

It’s summer.  It’s warm.  The sun is shining, and we may all be social distancing, but it doesn’t mean we don’t go out with friends.  There you are, sitting on a hillside on a picnic blanket, basking in the sun, when you start to feel dizzy.  Then a pain begins forming behind your eyes.  You try to look away, but everywhere you look hurts because it’s so bright.  If you have migraine, you know what comes next:  You making a mad dash to throw up in the bushes as another killer migraine comes on.  Picnic over and day gone to hell (if not the next 2 or 3).

Does this sound familiar?  If you suffer from migraine, you have more than COVID 19 to give you pause before you go out.  If you have migraine, before you accept an invitation, you need to assess:

  • How do I feel right now?
  • Have I been drinking enough water today?
  • Did I already go drinking the night before?
  • Did I get enough sleep last night?
  • On a scale of 1-10, how is my stress level?
But just because you suffer from migraine doesn’t mean you have to give up your social life.

People who suffer from migraine benefit from accurately evaluating their current health status before they go out.  You have to know yourself (your typical migraine attack pattern) and your triggers to effectively manage your social life when you have migraine.   You have to know how do you really feel in the moment.  If you’re already sporting a headache, you may already know that going out that night is a migraine waiting to happen.  In that case, the best course of action is to hunker down, take your meds, and stay at home.  But if you are just feeling off, and there is the potential for migraine, but you still want to go out with your friends, what do you do?

Be honest with your friends and family.

Your family probably already knows you suffer from migraine and what that means, but do your friends?  The best course of action is to be transparent with them. 

  • How does your  migraine manifest itself and and what are your triggers?
  • How do you accommodate your social life when living with migraine?
  • What is the best thing they can do for you once a migraine hits?

Explain to your friends what a migraine is and what that means to you.  Do you get very sick to your stomach with  migraine?  Does it affect your vision so that it’s hard for you to see?   Is  your migraine triggered or worsened  by lights, smells, or sounds?  Are stress or allergies a factor for you?  Let them know what to look for in you when a migraine is coming on.  For example, maybe you get irritable or foggy.  Sometimes your friends may be able to see the migraine coming on before you do yourself.  And let them know if you say you’re “not ok” or you have a headache, what you need in response – even and especially if that means you need to get home as soon as possible. 

If you have migraine, keeping a social calendar can be challenging.  That’s why it’s important to be honest with friends and family about your condition: 

  • That having migraine sometimes means cancelling a long-term plan because you get a migraine the day of the event. 
  • That having migraine sometimes means you may need to decline a last minute invitation to go to the drive-in to see the re-release of “Die Hard”. 

But there are some days you will still want to go out.  Let your friends know what they can do for you if a migraine hits.  It can only help – and having a contingency plan up front, may also alleviate any stress that you may feel about going out with migraine in the first place.  If stress is a trigger, how many times have you ended up with a migraine just thinking about having to try to squeeze in whatever you wanted to do between what you needed to do?   Letting go of that pressure to join in may just get you out and about more often.

Help yourself!  Be prepared!

Whenever you go out, remember to take a “go bag” with you.  It doesn’t have to be large, just the essentials:

  • Sunglasses Mixing Migraine with Friends
  • Ear plugs
  • Water
  • Reactive meds
  • Crackers to take with your meds or settle your stomach
  • Hard candy
  • A tube of instant coffee (to mix in your water for the caffeine)
  • Whatever else can help you mitigate oncoming symptoms

Remember to drink lots of water the day of and during your outing.  If you’re not driving, close your eyes to avoid oncoming headlights at night or the sun glare during the day.  If you’re not feeling 100%, limit your drinking.  And make sure you have a personal exit strategy.  You don’t want to be caught with a full blown migraine and your only ride is unable or unwilling to get you home.  When you have migraine, going out can be challenging but not impossible with the right level of advocacy and self-care. 

If you think you have migraine but have never been diagnosed, or you already have migraine and need additional supports, the Boston Headache Institute can help!  The Boston Headache Institute is accepting new patients (even now during the COVID 19 pandemic).  Please call for an appointment at (781) 895-7940. 

If you are already diagnosed with migraine, please take note of our upcoming clinical trials

Or call us at (617) 875-0962 and ask for Dr. Counihan.

Stress, COVID-19, and Migraine… how do you cope?

Everyone feels stressed from time to time, but what do you do when it is worsened and prolonged by a pandemic?

We have faced a unique worldwide event that has surely increased stress for everyone in America.  Whether related to having to work from home, scramble for child care, or struggle through e-learning, most of us have had to make major adjustments to our lives in the past 2 months. These changes could have triggered physical, emotional, and/or financial stress. In turn, that stress may have increased physical pain symptoms such as headache or migraine.

When you are stressed, the body tenses up, which activates the “fight or flight” response in your body. You must learn how to produce a relaxation response to maximize the release of brain signals to the muscles and tell them to relax. You may have medications from your provider to enhance this response as well. Unfortunately, you may have missed regularly scheduled treatments due to closures and limited hours at the Boston Headache Institute. This can be addressed to help get your headaches or migraine under control once again.

First, talk to your family about the symptoms you are experiencing. They may be able to change behaviors that help to reduce your stress or share in the experience. Reach out to the Boston Headache Institute to discuss treatment options and anticipated dates for reopening to regular hours and treatments. Finally, practice stress relieving techniques such as exercise, deep breathing, meditation, or yoga.

If you think you suffer from migraine, the Boston Headache Institute at Boston PainCare can help you correctly diagnose and relieve your migraine pain.

If your stress level is triggering more migraine, the Boston Headache Institute can help! If you think you suffer from migraine, the Boston Headache Institute at Boston PainCare can help you correctly diagnose and relieve your migraine pain. The Boston Headache Institute is accepting new patients — even now during the COVID 19 pandemic. If you have a headache that does not get better with over the counter medications or you are experiencing additional symptoms such as sensitivity to light or sound or smells, please call for an appointment at (781) 895-7940.

If you are currently suffer from migraine, please take note of our upcoming clinical trials!  Or call us at (617) 875-0962 and ask for Dr. Counihan.

What are Common Triggers of Migraine? Spring Edition!

Do you look at Spring showers and May flowers with dread?

Rainy days, kids yelling, spring pollen, missed appointments for regularly scheduled migraine treatments…does the trigger matter when you are suffering with a migraine?

There is research that shows changes in barometric pressure can trigger headache or migraine. You can’t control the weather, but with the knowledge of your triggers, you can plan to avoid what you can and find treatments for the ones you cannot avoid.

You should always avoid or minimize your exposure to know migraine triggers when you can.  When bad weather is on the horizon, try the following:

  • Avoid food or drink triggers knowing the weather approaching may worsen symptoms
  • Avoid bright lights if the sun is shining prior to the spring storms
  • Keep the windows closed when the news reports high pollen counts
  • Drink more water to prevent dehydration that may trigger your headaches

Also, when the 10 day forecast is just a list of triggers for you, reduce your stress and talk to your friends and family about your symptoms associated with inevitable approaching migraine and what things help you alleviate those symptoms.   That way, when the migraine strikes, those around you are ready to help support you before and during an attack.  You can also make a list of what your triggers are and what can trigger an increase in severity (like light, sound, and smells).  These discussions combined with supplies on hand will help you navigate your next attack more smoothly.

Finally, create and keep a “Migraine Response Kit”.   That way, you will have items ready when migraine hits.  Your kit would be specific to you, but some items to include are:

  • Abortive rescue medications
    (so you won’t need to take unnecessary trips to the pharmacy while in the middle of a headache or migraine)
  • Sunglasses or sleep mask
  • Packets of your favorite tea
  • Saltines
  • Large bottle of water or refillable water bottle

Don’t suffer in silence.  The Boston Headache Institute at Boston PainCare can help you correctly diagnose and relieve your migraine. 

The Boston Headache Institute is accepting new patients — even now during the COVID 19 pandemic.  If you currently suffer from migraine, call and check availability for services during the pandemic to receive your current treatments.  If you have a headache that does not get better with over the counter medications or you are experiencing additional symptoms such as sensitivity to light or sound or smells, please call for an appointment at (781) 895-7940. 

If you are currently suffer from migraine, please take note of our upcoming clinical trials!  Or call us at (617) 875-0962 and ask for Dr. Counihan.

Are you Restricting Fluids During This Pandemic for Fear of Running Out of Toilet Paper?

Are you restricting fluids during the pandemic because you're afraid you'll run out of toilet paper?

Be careful!  Dehydration can trigger headache, including migraine.

Replacing lost fluid and electrolytes with an oral rehydration solution is the most important aspect of managing dehydration.  Unless severe, water is adequate. Under normal circumstances, a good hydration status can be adequately achieved with water and a healthy, balanced diet. However, if you are at risk of dehydration, an oral rehydration solution may have some advantages, including that rehydration is likely to be more rapid.

Even though we have been staying inside to socially isolate, avoiding dehydration may require additional effort to help keep you feeling good and headache free. Try setting a timer to remind you and anyone else “working” from your home to grab a glass of water to consume 32-64 ounces throughout the day. If dehydration has occurred, supplementing with Pedialyte or Gatorade can help replenish the necessary electrolytes. Monitor urine output and the color of that urine to determine how effective your efforts to rehydrate have been. You want to be producing urine in the same rate you consume fluids and a light yellow color is the goal.

Now, if you are having symptoms, is it a chronic migraine or dehydration headache causing your suffering? It could be both, so we encourage you to reduce any factors within your control and let the Boston Headache Institute help you manage the rest!

If you think you suffer from migraine, the Boston Headache Institute at Boston PainCare can help you correctly diagnose and relieve your migraine pain.

The Boston Headache Institute is accepting new patients — even now during the COVID 19 pandemic.  If you currently suffer from migraine, call and check availability for services during the pandemic to receive your current treatments.  If you have a headache that does not get better with over the counter medications or you are experiencing additional symptoms such as sensitivity to light or sound or smells, please call for an appointment at (781) 895-7940. 

If you are currently suffer from migraine, please take note of our upcoming clinical trials!  Or call us at (617) 875-0962 and ask for Dr. Counihan.

Is it just a headache?

When is your headache not “just” a headache but a migraine?

There are several ways to tell. First of all, most people take something when they have a headache to relieve it. Generally, this is an over-the-counter pain, headache, or migraine medication. If it does not fully relieve your headache within 1-2 hours, it’s a telltale sign that it’s not just a headache you’re trying to treat.

Secondly, if the headache is bad, it’s probably a migraine. Bad means, if it makes it difficult for you to function or if you have to lie down because of it. Also, if it makes you shy away from light or noise or causes you to feel sick to your stomach. Your ordinary headaches, whether tension, stress, or sinus, are not bad to that extent.

Thirdly, if migraine runs in your family, affecting parents, siblings, or children, your headache is probably also migraine. Migraine is a genetic condition that makes you vulnerable to bad headache as defined above, whether brought on by stress, tension, fatigue, menstruation, weather changes, allergies, etc.

The Boston Headache Institute at Boston PainCare can help you correctly diagnose and relieve your migraine.

The Boston Headache Institute is accepting new patients — even now during the COVID 19 pandemic.  If you have a headache that does not get better with over the counter medications or you are experiencing additional symptoms such as sensitivity to light or sound or smells,  please call for an appointment at (781) 895-7940. 

If you currently suffer from migraine, please take note of our upcoming clinical trials!  Or call us at (617) 875-0962 and ask for Dr. Counihan.