Migraine is extremely common (it affects one in four households) and disabling (it is the leading cause of disability in adults under 50 years old both the USA and worldwide). Migraine attacks can start at any time of life, but most commonly start in young women in their early 20s - it affects nearly one in three women in their early 20s.

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In addition to the biology of migraine that leads to a migraine peak in young women who are in college, attending college comes with a lot of changes that may worsen the issue such as reduction in parents’ close support and supervision, possibly being far from home and one’s doctor, the stressors of a new environment, the increased workload, changes in sleep patterns, access to alcohol and drugs, diet changes, and a change in the level of regular physical activity.  

Lifestyle changes might trigger your migraine

College is already a challenging time with so much to learn, and having migraine or developing migraine on top of everything makes it much harder. Migraine may affect our ability to study and retain information. It can also impact our ability to socialize. Going out during a migraine attack is impossible. Late nights partying with alcohol will lead to more migraine attacks.

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Partying aside, migraine can be very isolating due to the stigma. Because migraine does not come with readily visualizable body signs people can notice, most people without migraine don’t understand the severity of migraine, the pain, the migraine symptoms, the feeling off, the fatigue, the dizziness, the vision changes, the inability to think “right.”

Tips for managing triggers

As difficult as it can be in college, it is important to keep a regular schedule. The migraine brain does not like change. Try to plan classes and activities so you can have a regular sleep time and regular mealtime. Take frequent breaks for hydration and stretching and to give your eyes some rest from neon lights and computer screens. It may be helpful to focus on your most challenging assignments on the days you feel best without pushing yourself too much and leave the more mindless tasks for the days you do not feel as well.

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Explore your school library and talk to upperclassmen to identify the quietest spots with the most comfortable seats (that you may recline) with dimmed light. Consider changing your screens to night mode, dimming the intensity of light, and/or placing a blue-light screen filter or follow recommendations by Dr. Berk discusses in school-related triggers.

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College is a very busy and social time, but try to schedule some “me” self-care time at least weekly when you can do something that you enjoy and that relaxes you.

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The food you eat also has an impact on your migraine. A diet high in omega-3 fats and limited in omega-6 fats can help. Try to regularly eat breakfast, and choose slow carbohydrates over fast carbohydrates, combine carbs with protein and healthy fats, and eat healthy snacks.

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As a Doctor, I have to mention that even a few sips of alcohol can trigger a migraine attack in people who are prone to migraine. Be mindful of caffeine intake. As Dr. Berk discussed in a prior blog, caffeine in moderation can help with migraine, but an excess of caffeine can worsen migraine. Try to limit your caffeine intake to up to 2 cups of coffee daily. Do not drink coffee in the afternoon and evening. If you do drink caffeine, drink it at the same time every day including on weekends.

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Reach out for help in school and as you transition to work

Despite medical management and all your efforts for a healthy way of life, you may need migraine accommodations to set up yourself for success. You can discuss your accommodation options with your doctor and with your college Office of Student Accommodations or Office of Educational Accessibility. Examples of migraine accommodations include extended time for assignments and tests as migraine and pain can affect your ability to think; taking tests on paper instead of the computer due to the migraine-related light sensitivity; time for breaks during tests to rest your eyes, stretch, and use the restroom so you can hydrate yourself without restraint.

With time, you get to know your body better, you build a support network around you, you and your health care provider will optimize your migraine management plan, and you know what life habits work in keeping migraine attacks at bay. It is helpful to consider the factors that help your migraine when planning your transition to the full-time workforce. Starting a new job comes with changes and sometimes stress, both of which the migraine brain does not like, so it is helpful to plan for it as much as possible. Try to explore your options in terms of your future job environment and conditions to find identify the job that will work best for you. Some companies value employee wellness more than others.

You are not alone

There are private Facebook groups and patient blogs and stories that may help you feel less alone. You should also discuss your situation with friends or family. Your university student health services, wellness services, and mental health services can also help.

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It is important to see a health provider as soon as possible to evaluate and help treat your migraine attacks. The earlier you start addressing the problem, the better.  You can discuss options with your student health service and the video visits with neurologists that Neura Health offers make it very convenient to get a treatment plan. Plus Neura offers weekly care coaching to help keep you on track and support you emotionally along your journey.

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