137. Triggered with Dr. Leslie: Why Hypervigilance May Be Fueling Your Migraines

In this episode of Triggered with Dr. Leslie, I break down a popular migraine graphic that I think perfectly captures one of the biggest problems in the migraine world right now.

So much of the messaging women are receiving teaches them to see themselves as having a defective “migraine brain,” to track every symptom, ration medication, and live in a constant state of hypervigilance. I talk about why I believe that mindset is not helping women heal, how it can actually reinforce fear and disconnection from the body, and why we need a very different framework if we want real recovery.

If you’ve ever felt like living with migraines has turned you into a full-time monitor of your own body, this episode will probably hit home.

If you’re ready to address the root drivers of your migraines, you can book a free consultation at the link below:

https://www.drlesliecisar.com/apply

Free Training: 5 Proven Steps to Being Migraine Free (Even if you think you've already tried everything.)

https://www.drlesliecisar.com/5SHMN

Connect with us:

Website: https://www.drlesliecisar.com/

Free Facebook Group: Healing Migraines Naturally, with Leslie Cisar, ND

Ready to try something radically different that actually works? Read more about my approach here: https://www.drlesliecisar.com/map

In health,
Dr. Leslie Cisar

Episode Transcript

hi there welcome to another episode of triggered
with Doctor Leslie this is a series that I do where I
uh go through some of the hmm
sometimes it's false sometimes it's misleading
but in general counterproductive
information about migraines on social media
so today and again
you know
this isn't no way to criticize people okay
I I totally understand where people are coming from
they're coming from the mindset
that migraine is a chronic
incurable health condition
that progressively gets worse and worse
now the
the language is that you have a migraine brain right
so it's even something
inherent to your brain right
so how are you gonna fix that right
so this is the mindset that people are coming from
and what I'm trying to do with this series
is kind of
help people see how this is false okay
so this is not a personal attack on anyone
these are very well meaning people
I have no doubt
but like I've talked about on my podcast
and in this series
what we think about something dictates our actions
right so if we think that something is caused by x
then we're going to act according to that
and how we act is going to dictate the outcome okay
and unfortunately
migraine suffers are getting worse and worse okay
we have stronger and stronger medications
more and more technology and yet
I talked about this on a podcast a few months ago
the severity of migraines
is getting worse
again
the paradigm that we're operating in is not correct
okay if it were correct
wouldn't we be making progress
wouldn't people be feeling better
but they're not right
they're like they've done studies on this
migraine suffers are getting worse
so we've got to switch course here
people's lives are on the line
the leading cause of disability
around the world is migraines okay
like this is no joke
okay we're losing our life to this
we're laying in bed as our life is passing us by
you know people are being given bad advice
the problem is being framed the wrong way
people are acting accordingly how they've been told
and then their life they're missing out on their life
so this is why I'm so passionate about it
because I used to suffer from chronic migraines
and if I had followed all of this advice
I wouldn't be recording this right now
I'd be laying in a dark room with a ice pack on my head
and you know
a eye mask on I have no doubt OK
so I'm very passionate about this
so this is again
not to criticize the person who created this post
I have no doubt that her heart's in the right place
but we have to take a more critical eye
and really understand the underlying assumptions
when we are looking at this information
on social media okay
so let's let's dive in here
hi there
I wanna jump in real quick and tell you about my client
Beth she was getting 15 to 20 migraines and headaches
per month and as you can imagine
this was impacting her work performance
and her confidence she also has two small children
and she was
starting to feel like she was a horrible mom
because she had nothing left for them
at the end of the day but she reached out
and she booked a free consult call with me
and after I asked her about her migraines
and her health history
I felt confident that I could help her
I help women uncover
the root drivers of their migraines
and follow a step by step plan to dramatically reduce
the frequency by up to 90%
without adding more medication
or taking a bunch of supplements
so we built her personal migraine map
followed the plan
and now she will get one to two migraines per year
which she uses ibuprofen to treat if she needs to
verses up to 15 to 20 per month
when we first started working together
that weren't responding well to any medication
she just reached out to tell me that
she got a promotion at work
she's on top of her career again
and has been able to come off all of her migraine
medication but most importantly
she's a confident mom again
and she's attending birthday parties at Jump Zone
with her kids and saying yes
instead of saying maybe later
I've worked
with women like Beth from all over the United States
who were told this is the best we can do
but they were still willing to dig deeper
so
if you are serious about changing your migraine story
go to Doctor Leslie Caesar dot com slash apply
or tap the link in the show notes
and on our free consult
we'll map out why your migraines keep coming back
and the first three steps you can take
over the next 30 days
I do cap new client spots each month
so if the calendar is full
the doors are closed for now
but if you're done
feeling helpless and ready to do the work to heal
pause this episode for 30 seconds
and book that console call now
so this is from the Migraine Network
and it's a graphic life with migraine
okay so everybody with migraines is going to
is going to know these talking
points about life with migraine okay
so first one here waking up every day
guessing what version of your brain you'll get okay
now I call this the head check right
wake up and you do the head check right
people have been
I have clients that have been doing the head check
every morning for years
and years and years
what version of your brain you'll get okay
so again
what underlying Assumption is driving that language
right
you don't have a migraine brain okay
there's nothing inherently wrong with your brain
I'm sure you've gotten the scans right
have you have you gotten the MRI
have you gotten the CT scan
and they told you there's nothing here right
maybe you got a little white matter lesions
those don't cause a lot of problems right
so what version of your brain you'll get so
do you have two brain right
like already we this
this language
is sort of disconnecting ourselves from our own body
and it reinforces this
common thought that chronic migraine sufferers have
my body hates me right
I have heard this from so many women over the years
my body hates me so this language right
what version of your brain you're going to get
it's within
it's sort of under that umbrella that our body
it is not trying to help us
our brain isn't on our side right
it's sort of like our body
our brain has been taken over by this alien that's just
you know bent on sabotaging us
I know it feels that way but that's not the case
your body is doing the best it can
in the conditions that it finds itself in
and right if
if I have a belief that my body hates me
and my brain is overtaken by like
this alien force that's trying to sabotage me
my actions my emotions
how I think about myself
how I think about life on planet earth
is gonna be very different than if I think
or know that my body
is actually doing the best that it can
and it's trying to keep me upright
but it's struggling in the conditions
that my body finds itself in
it's a very very different mindset
and our actions are going to change accordingly
according to the belief that we have
so feeling guilty for canceling plans again right
oh yeah
this is such a big one right
I mean it's not only
like this sentence right
first the person actually committed to the plans right
that's a miracle in itself
right because we become so hesitant to even
commit to anything right
now finally
I got up the guts to commit to something
and now I gotta cancel right
it's ugh
it's agonizing it's absolutely agonizing
so this is definitely a reality
if we're suffering from chronic migraines
you know when I work with clients
one of the things that we usually have to work on
is building confidence back right
so we're not struggling to even make the plans
we're not kind of going back and forth in our mind
should I agree to meet with meet them for dinner or not
should I should I book the cruise or not
we're not second guessing that for no reason
right
second guessing it
because we've had plenty of experiences
where we haven't been able to
meet our friends for dinner
and we've paid for an expensive vacation
and spent half the time in the room right
so it's not like we're doing this for no reason
and even when people are feeling better
many times
we have to consciously rebuild trust in our body
so that we do feel confident to make those commitments
to book the vacation
I had to go through that personally myself
to regain that trust because to undo all of that
it just doesn't happen automatically
when somebody starts feeling better
I understand this I've had to go through this
I know where my clients are coming from on this
this is something that we work on
but you can't work on it
when you're still in the throes of chronic migraines
you have to be feeling better
you have to start having new experiences
of feeling well enough
when it comes time to meet your friends for dinner
and you can actually go
you have to actually experience that
and then you have to build on those experiences
and then many times
you have to sort of consciously build a new thought
habit around how you're actually feeling
now
let's go on to the next one
so um
doing mental math
to decide if meds are worth taking now
or saving for later right
and this ties in to the one in the top middle here
wondering if that tiny twinge means an attack is coming
right I call that the uh oh moment right
uh oh so I think something's brewing here right
and then
we've always been told to take our abortive medication
right at that instant but like I've talked about before
if you follow doctor's advice
you're very quickly unfortunately
as the months go on doing that
you're going your migraines are going to get worse
you're going to burn through your abortive medication
and so then the mental math
as she calls it has
starts to develop right
okay uh
let me read the tea leaves
is this going to be a bad enough one for my imitrex
could I take a naproxen right
we start
we start doing that sort of reading the tea leaves
is what I call it and do we want to burn a medication
do we want to waste a medication
I want to address the uh oh moment okay
um the uh oh moment
uh oh I think something's brewing here right
I think a migraine's coming on
uh oh here we go right
many chronic migraine sufferers
have actually disassociated from their physical body
a little bit because of the pain right
and so um
when I have a client that's had chronic migraines
for decades many times
they can't pick up on that uh oh moment very clearly
it gets a little fuzzy because they're not really
fully in their body anymore
they're a little disconnected
and this is a coping mechanism
this is a well documented coping mechanism
when people have all sorts of chronic pain
they will sort of disassociate from their physical body
and that allows them to not feel the pain as much
as far as recovery
this again is something that many times
we have to work on as part of the healing process
because we want to be connected to our body okay
because our body is sending us subtle signals
and if we're sort of disassociated
slightly disassociated from our body
we're not gonna pick up on the subtle signals right
we're just picking up on the sledgehammer signals
we're not gonna be picking up on the
subtle signals
and
when we can pick up on subtle signals
it can help us take better care of ourselves
and sometimes for chronic migraine sufferers
when they hear me say something like this
they think I'm talking about the migraine paranoia
that comes up okay
so this migraine paranoia
does she have this on the chart
um
no if I could if I could add to this chart
I would add the migraine paranoia uh
to the chart
so the migraine paranoia is should I do this or not
you know ugh
my friend asked me to go for a walk with her um
should I do that or not if I do that
you know I've got this other you know
I wanna go to that concert tomorrow night
but if I go for a walk in the sun today
am I gonna be down tomorrow for a migraine
and then I'm not gonna be able to go to the concert
right so this is like a whole another level
right of calculations that we're doing in our head
right I call that the migraine paranoia
that is in contrast to
doing things that are going to be caring and supporting
for ourselves self care right
everything now in this
we're having a self care moment culturally right
I get all these YouTube ads
oh do this for self care
it's buy a product from the advertiser
right for your self care
what I mean is actual taking good care of yourself okay
making decisions
that are compassionate and caring towards yourself
what you might advise your best friend to do okay right
if only we treated ourselves as well as we uh
told our friends to treat themselves right
so if we are picking up on that uh oh moment
uh oh I think something might be brewing here right
things are getting a little out of balance
this is where
we may be able to change course a little bit
to conserve additional stressors on us so
you know if we're
if we wake up and you know
by 10:00am we're kind of getting that light sensitivity
uh oh uh
I keep having light sensitivity this morning
this is you know what
what's gonna happen next right
and then our friend asks us to go for a walk with her
out in the summer sun
now I have a choice right
and if I'm making a choice
not so much out of paranoia
but what would be the most compassionate thing
for for us to do for ourselves right
so like if
if our friend said you know
I'm not feeling 100%
but you and I made plans to go walk out in the hot
August sun um
do you think I should still do that with you
you know I'm not feeling 100%
what would we say we would say
oh no
don't let's not
if you're not feeling 100%
let's not do it right
I mean maybe there's some place inside we could walk
where we're not gonna be in the heat
in the sun or um
why don't we I'd
you know I still would love to see you today
maybe we go walking at dusk
when it's not so hot in the sun right
I mean there's a
there's a whole host of choices we could make or
or we would encourage our friend if she said
you know I'm not 100%
do you think I should still do this
oh no
my goodness take good care of yourself right
but do we treat ourselves like that
usually not right
usually right
we're so concerned about the guilt right
oh I don't wanna
I don't wanna put her off
is she gonna you know what
if she really needs to talk to me right now
I hate to cancel plans um
you know we're
we're kind of raking ourselves over the coals
and that's preventing us from just making some
maybe relatively simple changes
that really aren't gonna upset anybody
so that we're taking better care of ourselves
we're doing something that's going to be
more supporting
and more compassionate towards ourselves
but that's going to be very difficult
if the guilt comes in
uh
these two points here on her infographic
I think really I mean
you could really go deep on these two points
like I say
I think for most women with chronic migraines
working on some of these themes is critical
it's critical as part of their recovery and then
being exhausted from both the pain and the planning
oh yeah
so I just did another triggered with Doctor Leslie
episode around
oh managing abortive medications and some of the
you know
well meaning but really
I'll just say ridiculous advice around right
planning your abortive medication
and rotating meds and everything else
and planning you know
do I have my migraine kit with me and everything else
um and so luckily
right as people start to feel better
and they don't need as many abortives
they find themselves oh my goodness
I left the house without my migraine kit
how did that happen right
these things start to lift as well
um next up
trying to smile through the pain
so people think you're okay right
and this is another really insidious one
for chronic migraine suffers
you know usually when people first start getting
you know headaches and migraines
they'll tell people oh boy
I don't feel good right
I gotta go home from work
my head hurts right
um but you know
if you gotta say that three times a week
you don't wanna say that at work
you don't wanna keep telling your boss
that you're not 100% that's not gonna
uh do you any good at work right
you don't wanna keep coming back to your husband
and telling them you're not feeling good
and that he's gonna have to pick up the slack
and like nobody wants this right
and so women start to not share how they're feeling
and migraines
like the physical symptoms of the migraine
a real bad one are so isolating anyway
because we literally can't function right
once the severity gets to a certain point
you're down you're
your day is done you're lying down
you're on the you're on the couch
you're in bed you're not functioning
you're not gonna be driving your car
you're not gonna be sitting at a ball game
you're done right
um and so that is just literally isolating
and then we've got the isolation of feeling like
you know I just can't keep saying this right
um
what I hear my clients say a lot is
you know nobody wants to hear it
I just stopped telling people
because nobody wants to hear it
and unfortunately
that is sort of part of the human condition right
because we become uncomfortable
unless we're like a psychopath with no empathy
but we become uncomfortable
when someone else is uncomfortable right
we have an empathetic response
to other people's suffering most of us
hi there
I wanna jump in real quick and tell you about my client
Beth she was getting 15 to 20 migraines and headaches
per month and as you can imagine
this was impacting her work performance
and her confidence she also has two small children
and she was
starting to feel like she was a horrible mom
because she had nothing left for them
at the end of the day but she reached out
and she booked a free consult call with me
and after I asked her about her migraines
and her health history
I felt confident that I could help her
I help women uncover
the root drivers of their migraines
and follow a step by step plan to dramatically reduce
the frequency by up to 90%
without adding more medication
or taking a bunch of supplements
so we built her personal migraine map
followed the plan
and now she will get one to two migraines per year
which she uses ibuprofen to treat if she needs to
verses up to 15 to 20 per month
when we first started working together
that weren't responding well to any medication
she just reached out to tell me that
she got a promotion at work
she's on top of her career again
and has been able to come off all of her migraine
medication but most importantly
she's a confident mom again
and she's attending birthday parties at Jump Zone
with her kids and saying yes
instead of saying maybe later
I've worked with women like Beth
from all over the United States
who were told this is the best we can do
but they were still willing to dig deeper
so if you're serious about changing your migraine story
go to Doctor Leslie Caesar dot com slash apply
or tap the link in the show notes
and on our free consult
we'll map out why your migraines keep coming back
and the first three steps you can take
over the next 30 days
I do cap new client spots each month
so if the calendar is full
the doors are closed for now
but if you're done feeling helpless
and ready to do the work to heal
pause this episode for 30 seconds
and book that console call now
and so if somebody says you know
I'm hurting I'm struggling
I'm yeah you know
we we feel it too right
so it it is a very literal phenomenon
I mean this isn't just people being cold and callous or
you know they just don't care
when we're not feeling well
and another person's empathic response is triggered
it's uncomfortable for them
and people don't like being uncomfortable
when people are uncomfortable
they will do things to
try to mitigate or end that discomfort
and so
people will pull away from someone who is generating
this uncomfortable empathic response
that's just part of the human condition right
so you
you trigger that uncomfortable empathy in people enough
and yeah they're gonna pull they're gonna pull away
so that's why that's why we're doing that right
because we can feel you know
if I keep doing this people are gonna pull away
they're not gonna wanna talk to me
they're not gonna wanna call me right
so it's a very very difficult place
because of both the literal isolation
and then the psychological isolation that occurs
just because of human psychology frankly
and then we've got what about the weather right
checking the weather like it's a medical forecast
oh boy yeah
this is something um you know
obviously this is notorious amongst migraine suffers
I personally you know
I've talked about on the podcast I'm
um I'm very sun sensitive
that's that's something that I'm very sensitive to
but I'm not weather sensitive
um but yeah
certainly I've had so many clients over the years
where they call themselves like the
the Human Weather Station
you know um
they you know
I I know when um a storm's coming two days in advance
in fact um
one of my clients just last week
she lives in Arizona
where you would think there isn't a lot of weather
but particularly in the summer
there's some pretty big storms um
and when I talked to her last week
she was
she was floored because they had a big monsoon storm
come through and normally
she would know literally
one to two days before a monsoon storm would come she
she would start to feel it and she said
I had no idea
and I just stood there and enjoyed the storm
and I didn't have any um
I didn't get a migraine so it's just wonderful
it's just wonderful when that happens
I love hearing those stories
um pretending bright lights don't hurt
when you just want to crawl into darkness
uh huh
uh huh definitely
so I can relate to that one because I am sun sensitive
I am light sensitive I have had auras
I I
I had an aura one time in the winter
in January in Chicago
where we've got snow all over the place
it's very it can be very
very bright
on one of the rare days that it's not cloudy
and the light bounced off of the hood of a car
and it was already super bright
and that light hit my retina
and I mean within 20 minutes I started getting an aura
so yeah so yeah
uh more pretending right
and then I want to talk about these last three
constantly tracking everything like a human experiment
yeah right
this is the trigger tracking the migraine logs
the journaling right
tracking every food the barometric pressure right
whatever it is that you're sensitive to
tracking all of that and trying to read the tea leaves
try to decipher um the
the secret messages in the
it's like the Da Vinci Code right
like how do I decipher this
fighting a battle no one else can see
but we're fighting a battle
I want you to think about that we're fighting a battle
when every day is a balancing act between hope
and hypervigilance
hypervigilance
it's a fascinating word
comes up all the time amongst migraine sufferers
so I've talked about on the podcast
the the connection
the common thread
many women now
if this doesn't apply to you
you know if the hat doesn't fit
put it back on the rack that's fine
but we need to talk about this
because amongst women who are prone to migraines
hypervigilance is very prominent
now I'm not just talking about the hypervigilance
related to the migraines right
related to the migraine triggers
related to the food the sleep patterns right
I'm not talking only about that hypervigilance
I'm talking about a deeper running hypervigilance
that a lot of women with migraines
they may be unaware of
that this is running in the background all the time
or they might think that this is just how they're wired
this is like their personality
they're just sort of you know
a kind of a keyed up high strung
nobody likes to say the word perfectionist
nobody likes to say type a personality right
but it's this kind of hyper vigilant
a high expectation
what many people think is their personality
and this comes up
so frequently for women with migraines
and I can relate to it for sure
and what I found in my work is that
this underlying hypervigilance that's running
all the time
was running before the migraine started
and it's part of the migraine picture
I think that
hypervigilance as a coping mechanism
because it's so common amongst women with migraines
I don't think that's a coincidence
I think that that is a mental and emotional component
of the migraines
so
right and
and it can be very difficult to discern this
when we're in the throes of chronic migraines
because we do become hyper
hyper vigilant in that state because
again any little thing can tip us into a migraine
and so
it would be very natural for the mind to start to
become hyper vigilant you know
can I read the tea leaves
can I decipher the hidden code
what's going to happen next
so a lot of women think that
you know they
they might recognize
that there's hypervigilance in the picture
but they may think that it's
only due to their migraines
and they'll say things like well
I wouldn't be so hyper vigilant
if I didn't have the migraines
and I would say are we sure about that
are we sure about that
sometimes it's not a coincidence
when we have sort of this underlying coping mechanism
running for a long time
that we develop physical symptoms that also reinforce
or feed into that deeper coping mechanism
that's been running
before the physical symptoms started
so what I think is so interesting here
is that language comes out on this infographic
and every migraine sufferer resonates with it
we all get it right yeah
constantly tracking everything like a human experiment
hyper vigilant over what I'm eating my sleep schedule
my water intake oh my goodness
my water intake right
fighting a battle no one else can see
if no one else can see it and it's only you
you better be you're you are definitely hyper vigilant
you have to be if nobody else can see it
you've got to see it right
and then we literally have the word
hypervigilance on the infographic
and we we all get it we all get it
but what if right what if the hypervigilance was there
even before the migraine started
what if the hypervigilance is draining
our resiliency and vitality
and making us more susceptible to the stressors
what some people call triggers
that tip us into a migraine in the first place
again this is not the case for
every single client that I work with
but I probably have a few clients
listening to this right now
who go oh yeah
we worked on this when I was working with Doctor Leslie
we worked on hypervigilance
not only related to the migraine
but related to a deeper coping mechanism that got
laid down prior to when the migraine started
so this I think you know
not only do I think that this was
a very interesting infographic
and that yes
absolutely
a chronic migraine sufferer is gonna read this haha
I get it right
even though it's been a while since I've had a migraine
I've had enough migraines
I've had enough Skull Buster uh
afternoons laying in bed that I totally get it
and then of course right um
I know exactly what my clients who are thick
in the throes of this I know what they go through too
of course so um
I think one the infographic really hit
hit the highlights um
but 2 I think that there are some pieces here that are
pointing people
to a false understanding
of what's driving their migraines
and then what we have sort of hiding in plain sight
hypervigilance
hypervigilance it's fascinating so
if this is resonating with you
then I would you know
I would invite you to notice
hyper vigilance as it relates to your migraines right
but also
was that there even before the migraine started right
and for some people you know
the migraine started when they were kid
when they were 10 it's hard to remember before then
but then
when we go into what the family dynamic was like or
you know sometimes
children have a
a school environment or something like that
that would generate hypervigilance
or family environment
that would generate hypervigilance as a
as a coping mechanism to the environment
when we go through that when we kind of explore that
a lot of women have in sort of a
a ha moment
but uh
even when the migraine started later
cause for most women
the migraines start sometime in their 20s is
is very typical
and then when we look at you know
if we really look back
we see that there was a hypervigilance
coping mechanism at play before the migraine started
and then the migraines feed in to that hyper vigilance
I don't think that that's a coincidence
so thanks so much for joining me today
I hope you enjoy this series
I really enjoy doing it
and I hope it gives you some good food for thought
so I will talk to you guys soon