When you first start coping with migraines, the one of the biggest challenges is identifying your triggers. A migraine comes from out of the blue, and you spend a lot of time pondering the question, “what did I do to deserve this?” Using a migraine journal to document your migraines is the first step to answering this question.
A migraine journal is a place to keep notes about your migraines: when they happen, what the symptoms are, how severe they get, how you treat them, whether the treatments are effective. You also record your activities and your diet for the days preceding each migraine to look for clues about your migraine triggers. Collecting all this information will help you learn the best ways to prevent and treat your migraines.
Getting Started on Your Migraine Journal
The first step in using a migraine journal is deciding what kind of journal to use. If you want to use your smartphone, there are some great apps for keeping a migraine journal, such as the Migraine Buddy app. There is an online migraine journal available free-of-charge on the Migraine Trust website. The advantage of using an app to track your migraines is that a lot of analysis is done automatically for you. The disadvantage is that you may find them difficult to use while you are having a migraine, and valuable information could be lost.
Using a pen and paper to keep your migraine journal is a tried-and-true method. I like to use a loose-leaf binder rather than a standard notebook, so I can start a new journal entry on any available piece of paper and add it to the journal later. This is really useful when analyzing your migraines too, because you can remove the pages and sort them in various ways to look for patterns in your migraines.
If you are going to use this “old-fashioned” medium for creating your migraine journal, here is the method I recommend:
- When you first notice you are having a migraine, get a piece of paper and write the date and time along with all the symptoms you are experiencing.
- When you do something to treat your migraine, write down what you did, and when.
- When your symptoms change, write down the time and what changed.
- When your migraine is over, write down the time it ended and overall how long it lasted.
- Assign a rating to the migraine on a scale of 1 to 10.
- Finally, document everything you did and everything you ate in the days preceding the migraine. Put some thought into it. Especially make note of things that you don’t normally do, and things you don’t normally eat. Write down as much as you can remember for 1-3 days before the migraine started.
Structure each page in a way that makes it easy to find specific information later. I like to divide the page into quarters, putting symptoms in the upper-left and treatments in the upper-right. The lower section is for the days preceding the migraine, with things I did on the left and things I ate on the right. I put the overall rating in the top-right corner and add it to my binder.
Develop a shorthand for your symptoms and treatments so you can jot them down as quickly as possible. Focusing on writing while you are having a migraine is one of the last things you want to do. Creating your own shorthand notation will make this easier.
Identify Your Triggers
Using a migraine journal to identify your triggers can be complicated, especially if you tend to only get migraines from combinations of triggers. This is where the automated journals take the prize; they can create graphs and color charts to help you easily identify your most common triggers.
It helps if you have a list of known triggers to start with, like this comprehensive list of migraine triggers I compiled for the Migraine Cure community. Review the pages of your migraine journal and highlight any of the known triggers you recorded. Especially take note of any combinations that occur on the same page, as trigger combinations are the hardest to understand. You can even add notes to your pages if you suspect one of the triggers was involved but you didn’t record it at the time.
You may want to print out the list of known triggers and use it to keep score as you review your migraine journal. Place a tick mark next to each trigger you find in your journal. When finished you will have a clear picture of your most common migraine triggers.
Analyze Your Treatments
The migraine journal is also helpful in understanding what treatments are most effective for you. To start this process, review the list of changes in your migraine and identify the times when the migraine became less severe. Now look for the treatments that preceded those times and highlight them. Again, you will start to see patterns in your highlights that identify the most effective treatment for relieving your migraines.
A similar analysis will help you identify things you shouldn’t do when you have a migraine. Look for the times when the migraine became more severe and what you did before that happened.
Once you have started using a migraine journal and learning about your triggers and the most effective treatments, be sure to bring this information to your doctor at your next appointment. Your doctor may be able to provide additional insights into your condition based on the information you collected.