by a disabling migraine.
I started comparing my heavy migraine months with those that were migraine-free and found that when I ate and slept better, drank more water, and was less stressed during the previous month, I would not get the migraine. The opposite was true when my previous month’s activities were not as healthy. Perhaps you have noticed a similar pattern in how several things seem to add up to create your pain.
This led me to concoct the Chinese Menu Theory. The name goes back to my childhood in Los Angeles. On some Sunday nights, my family would go out to dinner at our favorite Chinese restaurant. We would order our food “family style,” meaning each person would choose a dish from column A, a dish from column B, one from column C, and so on. All the delicious dishes of food would be brought out and placed on a lazy Susan in the middle of the table, and we would all partake of each dish to make up our meal.
In that same way, combinations of factors often add up to headaches, whereas one alone might not. Imagine that instead of ordering a family-style dinner, you are ordering your migraine from a menu of triggers. You could choose a potential trigger from column A — skipping meals, for example — which by itself may or may not produce your migraine. You could choose one from column B — for instance, lack of sleep — and again, you might get a migraine, maybe not. Choose another from column C — perhaps shoulder tension — and you may or may not get a migraine. From column D, we’ll choose stress; perhaps you will get that migraine, perhaps you won’t. But . . . if you combine items from columns A and B; B and C; A and D; A, B, C, and D, and so on . . . together they would add up to create your personal migraine stew.
Sample Migraine Triggers Menu
My most reliable trigger combo used to be hours of chewing gum while clothes shopping, plus no water or lunch. (Who needs food?) My energy was powered by dopamine, the feel-good hormone that shopping produced in my brain. It was fun while it lasted, but my jaw was working overtime, combined with everything else, and the next day’s migraine would make me regret it.
Everything Counts
This program works because we consider everything that might trigger a headache — and in all domains.
If you have tried a number of individual self-care strategies with limited success, including a variety of natural methods, it could be that you’re not looking at everything. For example, you might have quit caffeine or eliminated entire categories of foods, such as wheat or dairy products. Then your headaches continued, so you ruled those items out as triggers and put them back into your diet. After all, eliminating them seemingly had no effect. Or perhaps you tried massage or meditation to reduce your stress but concluded they weren’t helpful because your headaches persisted.
That’s where the Chinese Menu Theory comes in: it addresses your whole self. You are not just what you eat or drink or your exercise routine or your stress. You are all of it combined. By taking everything in your life together as a whole — diet, lifestyle, posture, thinking, mood, stressors, and so on — you can gain new insights into how your triggers add up to your headaches.
Common Headache Triggers
The following list of headache triggers is adapted and expanded from one first published in Migraine: The Complete Guide by the American Council on Headache Education (Dell, 1994).1 It’s usefully arranged by category — dietary, environmental, lifestyle, physical, medication, and hormonal — so you can mine each area for clues and look at your life as a whole. You might notice this list is similar to but more extensive than the one you completed in the personal profile in chapter 3.
Lists of headache triggers are subjective. You are a unique individual, a delicate balance of chemistry with a history and an emotional life. What affects you might not affect me and vice versa. With some triggers, quantity also counts: a small amount of chocolate, wine, or exercise might not trigger your migraine, but a larger serving or a longer workout just might.
Perhaps you will recognize some of your triggers and rule out others from the list. Perhaps you aren’t certain, or have no idea. For now, simply read it and see if anything rings a bell.
Headache Triggers
Dietary
additives, preservatives
aged cheese
alcoholic beverages
artificial sweetener
avocado
banana
beans
beer
caffeine
chocolate
citrus fruit
corn
dairy products
fermented food
food allergy
food sensitivity
garlic
high-fructose corn syrup
honey
hot dogs
lack of caffeine
lack of water
liquor
low blood sugar
luncheon meat
MSG
nuts
onion
pickled food
skipping meals
sour cream
sourdough bread
soy sauce
spicy food
sugar
wheat gluten
wine
yogurt
Environmental
air pollution
bright light
chemical sensitivity
dim light
dry air
excessive cold
excessive heat
flashing light
fluorescent light
fumes
high
