If you have migraine headaches or any frequent headaches, you may benefit from keeping a headache diary. The headache diary is a record of each headache you get, and it also includes information about the events that preceded the headache. The diary can help you identify potential headache triggers and monitor the effectiveness of treatments. It can also help your doctor correctly diagnose migraine or other disorders.


Steps

1. Make or get a diary. Unlike other diaries, there are very specific things you need to include in your headache diary. In order to make sure you remember to include these items (and also to make your headache diary more easily readable) it's best to structure each diary entry as a form with pre-written fields. You can write or type these out on a sheet of paper, or you can search for "headache diary" online and print out a diary form from one of a number of sites. Your doctor may also provide you with a diary template. Make copies of your template and put them in a three-ring binder to keep them together.
2. Include fields for information about your headache. This can help you identify patterns in the frequency and severity of headaches. It can also help your doctor make an accurate diagnosis.
   
   
   • Date/time the headache started and date/time it ended: Some migraines can last a few days
   • Any warning signs: Migraine headaches in particular are frequently preceded by so-called prodrome symptoms which may include visual disturbances (migraine with aura), neck stiffness, and irritability. For a more complete list of these symptoms, see the article on preventing migraines. Keep in mind, though, that you may experience none of these symptoms, or you may notice other warning signs.
   • Location, type, and severity of pain: Describe the location of the pain as specifically as possible. Use adjectives such as throbbing, pounding, splitting, blinding, killing or any other word that accurately describes the type of pain. Rate severity on a scale of 1-10.
   • Accompanying symptoms: Did you feel nauseated or vomit? Did you also have a fever or diarrhea? List any symptoms that occurred in conjunction with, or right after, the headache.
   • How the headache impacted you: Were you able to function normally, or was the headache completely debilitating?
3. Include information about potential triggers. Migraines and other headaches seem to be linked to, or triggered by, certain factors, including sleep, diet, and certain activities. These triggers vary widely from person to person, so it's important to identify the specific things that may trigger your headaches.
   
   
   • What you ate and drank: Record everything you ate and drank on the day of the headache and, if possible, the day before.
   • What you did on the day of the headache: Record your activities on the day of the headache and/or on the night before. Be sure, of course, to include any unusual activities, but don't leave out the more mundane ones, either.
   • How much sleep you got: Record what time you went to bed on the night before your headache, and what time you got up. Think also about the quality of the sleep (e.g., whether you woke up several times during the night).
   • Any medications you took before the headache: Record prescription and non-prescription drugs as well as herbal or nutritional supplements. While you especially want to focus on any unusual intakes, it's also a good idea to write down drugs that you take regularly.
   • Any stressful or unusual events that occurred in the day or two before the headache: Was there anything causing you excitement, anxiety, or other types of stress? Record these events, and also record how you were feeling, (happy, depressed, angry, etc.), before the headache occurred.
4. Document your headache treatments. While your headache diary will hopefully help you to reduce the number of headaches you experience, you may never be able to eliminate headaches altogether. As a result, it's important to assess the effectiveness of any treatments you use.
   
   
   • List any preventative medications you're taking: If you suffer frequent or severe migraine headaches, your doctor may prescribe preventative (also called prophylactic) medications. It can take a lot of trial and error to determine which medicine will work for you, so it's important to keep track of what you're taking, and when.
   • List any painkillers or abortive medications you took: When you get a headache, you might take either abortive medications (medications that stop the migraine mechanism), painkillers, or both. As with preventative drugs, you need to find out which medications work best for you, so document what you took, when you took it, and how well it seemed to work.
   • Document any other steps you took to alleviate the pain: There are many steps people can use to try to get rid of headache pain, from lying down in a dark room to drinking a cup of coffee. Record what you did, when you did it, and how well it worked.
5. Include any other information that you think might be useful or that your doctor asked you to record.
6. Fill out a diary entry each time you get a headache. Even if the headache isn't severe, it deserves an entry. Record all the information as faithfully and thoroughly as possible.
7. Look for patterns. The more diary entries you have, the more likely you'll be able to find patterns either in the triggers or in the effectiveness of your treatments. That said, you can often accurately identify potential triggers after just two or three headaches.
8. Avoid likely triggers. If you identify a possible cause of your headache, try to avoid that food, activity, or situation. You'll be able to reference your diary to determine how long you go without a headache and how severe your headaches are, and this information can help you figure out if the trigger you suspect is indeed a culprit.
9. Consult with your doctor. Bring the diary to your doctor. Inform the doctor of any patterns you noticed, and then let him or her take a look at the diary, as your doctor may notice things you didn't. Based on your history, including your diary, your doctor may also make changes to your medications or other treatments as needed.

Tips

• Think like a scientist and simply record the facts. You may think you know that a certain food triggered your headache, for example, but be sure to thoroughly document everything else you ate, as well. Over time a culprit may emerge that you never even considered.
  
  
  • If you're not sure if a particular food or beverage is triggering your headaches, abstain from consuming it for a couple months. Take note of whether your headaches are fewer or if they're less severe. Then start consuming that item again to see if your headaches become more frequent or more severe.
  • Many foods are known triggers for migraines. You may want to pay special attention to see if any of these occur in the 30 or so hours prior to your headache: chocolate, artificial sweeteners, certain seasonings, alcohol, aged cheese, or processed foods (including pickled, canned and fermented).
• Try to make your entries while the events are fresh in your mind. If you wait a few days to record a headache, you'll likely forget a lot of important information. If possible, make your entry as soon as you feel capable of doing it. Some people can write in their diary, or dictate their entry to someone else, while they are experiencing a headache, but if this worsens your headache or nausea, wait until the symptoms have passed.
• Excessive exposure to bright lights, sun glare or loud noises can be cause for migraines in some people.

Warnings

• Don't start medications, quit using medications, or change doses without consulting with your doctor. While you may think you need to increase a dose or stop using a medication, you may not know all the possible side effects of doing so. In addition, it can take weeks or months for some drugs to effectively reduce the frequency or severity of headaches, so you don't want to give up on them too soon.