Migraine is the second most disabling condition in adult women, causing physical and mental pain that can persist throughout their lives. Research shows that women are disproportionately affected by headaches and migraine, but there remains a wide gap in research, leaving many women in pain and with few resources for treatment. Oftentimes, these headaches start in adolescence and continue into adulthood. 

Ludeman Center researcher Michelle Clementi, PhD, is known for her work at Children’s Hospital Colorado in the Pediatric Headache Program. She says that historically, young girls’ symptoms have been written off as psychiatric conditions or as patients over-reporting their pain. Few clinicians specialize in headaches, meaning that patients can go years without receiving specialized care. This is especially debilitating when migraines affect every aspect of someone’s life, including their ability to focus, sleep, attend school or work, and connect in social settings.  

“You cannot talk about physical health without talking about mental health,” Dr. Clementi says. “Studying the intersection of both and how they impact each other will help us treat conditions like migraines more holistically.” 

One of Dr. Clementi’s mentors is Ludeman Center researcher and psychologist Stacey Simon, PhD, who encouraged her to apply for an Early-Career Faculty Research Development Award. Dr. Clementi applied and was awarded a grant in 2020 for her project, “Intraindividual Sleep Variability and Circadian Factors in Adolescent Girls with Chronic Migraine: Associations with Psychological Functioning.”  

"Getting my initial seed grant from the Ludeman Center and attending the researcher trainings gave me the confidence to see that I had great research potential,” said Dr. Clementi. “I had already known that there were high rates of insomnia, anxiety, and depression symptoms in adolescent girls generally, so I began inquiring about how we can develop behavioral interventions to help these girls.”  

This interest led her to open the Headache Coping Clinic, where she provides psychological support for children and teens with persistent headaches and migraines. The clinic sees patients as young as six years old with most patients ages 12 to 18. Dr. Clementi loves working with this age range of young adults who inspire her to develop creative and engaging ways to communicate and support them. It is a critical time in their lives and introducing them to coping habits now can help them into adulthood. Considering the systemic pressures of society, academics, competitive sports and the influence of social media, Dr. Clementi is in tune with the external issues that make being a young adult dealing with chronic headaches even more difficult.  

She has seen many patients step away from their favorite sports or hobbies as a result of their headaches, which causes a loss of identity that can feel very isolating. Dr. Clementi focuses on teaching adolescent females about seeking balance in their everyday lives. For example, attending classes for half the school day is better than staying in bed and missing the entire day. She also encourages them to manage their expectations of what they can do when they are in pain, which can help with their self-confidence, mood and identity development.  

“My goal is to find ways to manage their response to pain and encourage their self-efficacy,” says Dr. Clementi. “When the pain happens, I encourage them to engage in conversations with their friends to distract themselves. They are also encouraged to learn a new skill or practice mindfulness techniques.”  

Dr. Clementi’s multi-disciplinary approach includes developing, adapting and testing behavioral interventions to treat persistent headaches and migraine in adolescents — including medications where appropriate. While this work is crucial to advancing treatment options for patients, she also emphasizes the importance of connecting people with chronic headaches to services or behavioral health interventions as early as possible. The sooner they can address the physical and mental impacts, the sooner they can learn effective tools to positively cope with this difficult neurological condition.  

With grant support, Dr. Clementi balances her time between research and clinical work. Her passion for applying what she sees in the clinic to meaningful research is the reason that she is advancing patient care and improving their lives one day at a time.  

She is focused on continued work to adapt and test a mindfulness-based intervention to improve depression and anxiety for patients with migraine. They have seen positive responses in adults, but her focus is specific to teens who require a slightly different approach that considers the unique experience of adolescence. In addition, she is researching the impact of group telehealth sessions that connect people across the country who are dealing with headaches and migraines.  

“Following my diagnosis of mononucleosis, I became bedridden for seven months with debilitating migraines. My sensitivity to light was so severe that I couldn’t look at my phone or read. Before I got sick, I was a successful student and award-winning athlete, an identity that I completely lost. When I began seeing Dr. Clementi in 2020, she shared with me an empowering message: I could either be an oak tree or a willow. A willow dwells on how unfair this feels, while an oak fights to work through the struggles and come out stronger on the other side. This mentality helped me go from the bed and back to pursuing a career in psychology to help others who struggle with chronic pain, just like Dr. Clementi helped me.”  

--Alyse, Dr. Clementi’s patient