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Mind Over Migraines

Kids' migraines are more common than you think—but one type of therapy is offering hope.

A young girl is having a painful kids' migraine. Her mom wants to try CBT for chronic migraine—chronic behavioral therapy.

Medically reviewed in March 2020

Updated on March 1, 2021

There’s good news for children who suffer frequent, debilitating migraines—and for parents who suffer seeing their kids in pain. Research shows that using cognitive behavioral therapy (CBT) for chronic migraine in children can greatly reduce the number of headaches kids have, as well as the disability they cause. 

A lot of pain for little ones 
You might be surprised to learn that up to 10 percent of kids have migraines, and nearly 2 percent have them at least 15 days each month. Kids’ migraines tend to be shorter than adults’, lasting only 1 to 2 hours, but they’re no less painful, and they’re often accompanied by abdominal pain, dizziness and vomiting. 

These headaches can make it hard simply to be a kid. Aside from keeping a child out of school and from participating in after-school or weekend activities, migraines can also lead to anxiety, because the child is constantly aware that a migraine attack could happen at any time. 

Migraine headaches are particularly hard to diagnose in children because the symptoms are common to other conditions. And when they are diagnosed, doctors usually prescribe medication designed for other purposes. Currently, there is no FDA-approved treatment specifically for migraines in children. 

Mind over migraines 
A study, published in the JAMA: The Journal of the American Medical Association, looked at 135 kids, ages 10 to 17, who had migraines 15 or more days a month. The children were randomly assigned to groups receiving either 10 CBT sessions (which taught children ways to cope with their pain) or 10 headache education sessions. Patients in both groups were given the medication amitriptyline, an antidepressant drug shown to be effective at combating migraine symptoms. 

At the beginning of the study, the kids averaged migraines on 21 out of 28 days, with a severe level of migraine-related disability. However, immediately after the first session, children in the behavioral therapy group had 11.5 fewer days with migraines, compared to just 6.8 migraine-free days for those in the headache education group. Twelve months later, 86 percent of the kids who received cognitive therapy cut their days with migraines in half compared to only 69 percent in the headache education group. 

The researchers say CBT for chronic migraine should be offered as a first-line treatment along with medication, not just as a last resort if prescription medicines aren’t working. Treating the symptoms of chronic migraines chemically is only part of managing the condition. CBT also helps children feel in better control of the pain they’re experiencing. 

Other ways to help your child ease migraine pain 
Aside from behavioral therapy, several other treatment approaches are available to relieve kids’ migraines. 

  • Avoiding triggers. The more aware your child is of their migraine triggers, the easier it will be for them to anticipate when they’ll get a headache. This can help them halt the pain before it becomes debilitating. Try to help them avoid certain foods that have been known to cause migraine headaches, as well. 
  • Medications. Certain prescription medications can help stop a migraine in progress, and other drugs may be taken daily to prevent the headaches. The medications do come with the risk of side effects, so check with your doctor to see which one is best for your child. 
  • Alternative remedies. Supplements like butterbur have been shown to be an effective treatment option for migraines in children. 
  • Rest. For many children, sleep alone can greatly reduce pain from migraines. 

While watching your child suffer through a migraine can make you feel powerless, know that there are steps you can take to get relief and put you both back in control of the condition.

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