Veronica With Four Eyes

Managing Chronic Migraines in College

I’ve had chronic migraines since I was in high school as a component of a then-undiagnosed neurological condition, which was later diagnosed as Arnold-Chiari Malformation Type 1 (also known as Chiari Malformation or Chiari 1 Malformation). Even though my migraines had a significant impact on my ability to attend school and led to me having a hybrid schedule senior year of high school, I still wanted to go away to college and have some parts of the “college experience”, even though it meant I would have to balance a chronic illness and choose what parts of the traditional college experience I would participate in- “having it all” was not an option. Here are my tips for managing chronic migraines in college, and how I lived on campus for four years at a state school with a chronic migraine diagnosis.

Choosing what college to apply to

My chronic migraines played a role in determining what colleges I would apply to, as I wanted to attend a school that had several services available for students with disabilities, as well as guaranteed housing options and a large selection of virtual classes. I also wanted to have flexibility if I wanted to change my major later on or had to take medical leave, which I did during senior year. I’ve created a list of questions to ask when choosing a college and preparing to attend college, which is linked below.

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Can you get a Disability Services file for chronic migraines?

Yes, you can get a Disability Services file and disability accommodations for chronic migraines at the college level. My primary disability is low vision/visual impairment, and I had an IEP in high school that focused on vision-related accommodations, though my migraines were a factor in me getting approved for online and hybrid classes in high school.

In college, the majority of my classroom accommodations focus on my vision, though I also have additional accommodations that are related to chronic migraine, including:

  • Accommodations for photosensitivity and photophobia- flashing lights are a migraine trigger for me
  • Options for attending class remotely or attending another section if I have to miss class time
  • Deadline extensions or options for moving exam days- usually requires some advance notice
  • Permission to have food or drink in class
  • Disability transportation services for getting to/from class

These academic accommodations are separate from housing accommodations, which I talk about in the next section.

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If possible, ask for a single room on-campus

When I talked to my doctor about living on campus, they suggested I file for disability housing accommodations and request a single room on campus, which is hard to request as a freshman. When I have a migraine, I have to spend time in a dark, quiet space, which would be difficult to accomplish with a roommate, and my doctor wrote out a list of the accommodations I should receive as part of my chronic migraine diagnosis- I didn’t have a Chiari diagnosis at the time.

Examples of college housing accommodations for chronic migraine include:

  • A single room with no roommate
  • Ability to make dorm completely dark
  • Climate controlled room with heating/AC
  • Lower-level room location
  • Close proximity to ResLife staff, such as resident advisor

My disability housing accommodations were initially denied as I did not have sufficient documentation of my undiagnosed neurological condition, which contributed to my migraines. However, my neurologist submitted a second letter to the university that stated that I was going through diagnostic testing, and I had my decision appealed about two weeks later.

It’s worth noting that students cannot be charged extra for disability housing accommodations- I was charged at the double room rate even though I lived in a single room, because the single was medically necessary.

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Scheduling classes with chronic migraines

Students who are registered with the Office of Disability Services typically qualify for priority registration, meaning they can sign up for classes a few days before other students. This makes it easier to schedule classes for times when I am less likely to have a migraine, or can find classes in nearby or preferred buildings. If I want to switch classes later on and find that the section I want to sign up for is full, I import the class number into Coursicle on my phone, which alerts me when there is an empty seat available- no repeatedly checking to see if a class has opened up.

Another strategy I use when signing up for classes is to take at least half of my classes as asynchronous online classes, which allows me to work on class material whenever I am feeling well and not have to worry about missing classes that meet at a set time. A lot of my professors who taught virtual classes were also on campus a few days a week, so if I had any questions I could meet with them or talk to other students on campus.

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Schedule time for rest

Every day, I would schedule a few hours of rest/downtime when I was likely to have a migraine or a lot of pain flare up. I wouldn’t schedule classes during this time or sign up for extracurriculars that met during these hours, and having the additional rest time made it easier for me to prioritize things I was interested in doing, as well as ensure I didn’t get burned out from having multiple classes in a row. I prefer this approach over scheduling a “rest day”, though since I never had Friday classes I could also use that as a rest day if I had a particularly challenging week, or I could travel to appointments.

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Check the ingredients of items in the dining hall for potential triggers

Many people with migraines have food triggers or avoid certain foods, and many college dining halls and food suppliers list ingredients for dishes on their website- either the college website or the supplier (i.e Sodexo). For example, I have a caffeine allergy that can trigger headaches and other adverse symptoms, so I look for items that have coffee, tea leaves, or chocolate listed as an ingredient, so I don’t eat them by mistake. I also would identify “safe” items I could eat at on-campus restaurants and food places with friends, such as a steamed apple juice drink at Starbucks or requesting an off-menu dessert without chocolate at a popular burger place.

Students who need additional assistance with navigating on-campus food items can request to meet with the campus dietitian, who can help with tracking down allergy safe food options at no cost to the student.

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Keep snacks/small meals in the dorm for flares

During my freshman year, I would have rest time in the late afternoon, which meant I was often up late at night after the dining hall near my dorm had closed- this was before my college had a 24-hour dining hall. To ensure I didn’t skip meals, I would keep small meals and snacks in my dorm, including items I would get from the grab-and-go section of the dining hall earlier in the day.  Another option is to pack an “extra meal” when going to the all-you-can-eat dining hall, such as packing an entree-sized salad in a reusable container with dressing on the side, ordering an extra wrap from the sandwich bar, or a serving of stir-fry.

During my final year of living on campus, my college started offering food delivery options with the Starship robots, which can deliver food from on-campus restaurants for students and accepted meal plans. To be honest, these robots are the reason I was able to eat breakfast when my migraines started to get more frequent and difficult to manage, as I was able to pick up food from right outside of my door.

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Refill medication regularly and dispose of old meds safely

For students who take medication for managing chronic migraines in college, I strongly recommend identifying nearby pharmacies that accept their insurance and are accessible by bus or other university transportation. Getting medication delivered directly to a dorm is not an option at most colleges for security reasons, but many of my friends reported using mail-order pharmacies like Express Scripts to get medication delivered in college, or getting 60 or 90-day prescriptions.

Another important consideration is how unnecessary or expired medication will be disposed of, since it’s unsafe to just throw it in the trash or flush it down the toilet. One of the pharmacies near campus offers a medication disposal service for free, and some colleges also have prescription drop-off boxes at the campus security office, or host drug disposal events as part of National Prescription Drug Take-Back Day. I’ve also linked a website from the National Association of Boards of Pharmacy that lists options for disposing of medication safely.

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Find activities that don’t trigger migraines

One of the realities of going to college with chronic migraines and college migraine management is that I do not have the “full” or “typical” college experience of going out to parties, concerts, or doing the same things as my peers. Instead of focusing on what I can’t do, I spent time finding activities and organizations that I could be a part of and still make fun college memories with. Some examples of college activities and extracurriculars I participated in include:

  • College pep band, which has flexible attendance requirements compared to concert band programs
  • Joining my college’s Roosevelt Institute chapter, a nonpartisan student-run think tank
  • Lunch hour lecture series and noncredit classes, many of which had food provided
  • Going to eat with friends at the dining hall
  • Attending other club events that my friends were part of, such as cultural celebrations
  • Going to shows at the campus performing arts center, which offered free tickets
  • Reading books that were part of virtual book clubs hosted online, by the college, or by the library
  • Attending events offered during the day at the local library
  • Getting nonalcoholic drinks with friends or testing out new recipes- a lot of my friends were sober or sober-curious, so I never had any pressure to try alcohol
  • Video chatting with friends when I wasn’t feeling well enough to go out, or keeping in touch with friends at other colleges
  • I love writing and would work on different writing projects, and I also started this blog to talk about topics in low vision and assistive technology that interest me

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Other tips for going to college with chronic migraines

  • I graduated with a degree in Computational and Data Sciences with a minor in assistive technology from George Mason University- this is the school I attended for my entire undergraduate career (Go Patriots!)
  • In general, I took a full course load every semester (15+ credits), though I did have to take medical leave for things like surgery
  • Since my college was located a few hours from home, I would travel home for doctors appointments or have telehealth appointments if something came up. Since I didn’t have Friday classes, I could travel home for weekends to meet with doctors- I didn’t have any specialists in the area near my college at the time.
  • My friends and I enjoyed watching movies, TV shows, and other videos together, and I had a few different strategies for avoiding flashing lights. I talk about these in How To Check Videos For Flashing Lights and How I Watch Concert Videos Without Strobe Lights
  • Eventually, my Chiari Malformation and chronic migraine symptoms became too difficult for me to control on my own with an additional POTS diagnosis, so I had to move home and finish the semester remotely. Learn more about this in Disability and Classroom Accommodations For POTS and Tips For Filling Out Medical Housing Release Forms
  • Want to read more posts about migraines and Chiari Malformation? Check out Migraine And Light Sensitivity Archives and Chiari Malformation Archives

tips for managing chronic migraines in college and my experience as a college student who had a migraine every day