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  • Writer's pictureJo Soria

When It’s Not Just a Headache: Living With Migraines and Misconceptions

Migraines are among the most common neurological disorders, affecting over 1 billion people annually. And while they're most often associated with severe and recurring headaches, those are just one symptom.

Migraine sufferer in pain

If there's one thing migraine sufferers wish the rest of the world could understand, it's that a migraine is not "just a headache." But the misconceptions surrounding this potentially debilitating condition may be just as painful and isolating as the disorder itself. This week the #TRN team takes it back to the basics with a look at the situation, the stigma, and how to support best the loved ones who deal with it all.

Migraines vs. Headaches: What's the Difference

First, a quick refresher: migraines and headaches share the common feature of causing head pain, but a migraine is a neurological condition. In contrast, a headache is a painful symptom often mistaken for it.

Headaches typically involve mild to moderate, dull pain affecting both sides of the head, while migraines often entail severe, throbbing pain concentrated on one side. And aside from the differences in severity, migraines may also come with additional symptoms and stages.

Stages and Accompanying Symptoms of a Migraine

While not all migraine sufferers go through every stage, noticeable stages leading up to a migraine attack are often a giveaway that there's more to the pain than a single stress headache.

Migraine Stage 1: Prodrome

What many don't realize is that migraines, and their warning signs, may be developing days before the actual attack. In some cases, the prodrome phase may appear a day or two ahead of the most severe symptoms and may include bodily changes like:

  • Unusual stiffness or tension in the neck or shoulders

  • Mood swings, such as unusual levels of hyperactivity, depression, and/or irritability

  • Constipation

  • Increased food cravings or other noticeable changes in appetite

  • Increased urination

  • Fluid retention

  • Diarrhea

  • Yawning more than usual (yes, really)

Migraine Management Tip #1: The Mayo Clinic estimates that 40-60% of people with migraines experience the prodrome phase. So, if you or someone in your life suffers from recurring migraines, it could be helpful to begin keeping a daily wellness log or journal for tracking. What may seem like an isolated episode of neck stiffness or mood swings could be part of a larger pattern you can learn to predict.

Migraine Stage 2: Aura

When this stage exists, the aura may act as the more noticeable and time-sensitive warning sign that a migraine is on the way. Auras may occur right before a migraine attack (or even during it) and often involve some visual disturbance or hallucination, from seeing shimmers or bright flashes of light to developing blind spots or other partial vision loss.

But while auras are often visual, they can involve other sensory experiences like numbness, tingling, physical weakness, or trouble with speech.

Migraine Management Tip #2: It's estimated that about 20% of migraine sufferers experience an aura before a migraine attack. If a loved one, coworker, or employee mentions an aura (or a symptom that sounds like an aura, even if they don't call it that), this could be your signal to help them wrap up what they're doing and prepare for a migraine attack.

Whether sending them home for the day, arranging transportation, or helping them get to a safe, comfortable environment to deal with the attack, offering support during this stage can be critical and time-sensitive.

Migraine Stage 3: Attack

The migraine attack is the stage we most commonly observe or hear about. If untreated, this could involve anywhere from 4 to 72 hours of throbbing head pain, light or other sensory sensitivities, nausea, and/or vomiting.

The frequency of migraine attacks can vary significantly from person to person, with some experiencing them very rarely, some dealing with up to several episodes in a month and every possible predictable or unpredictable pattern in between.

Migraine Management Tip #3: Because the actual migraine attack is the stage we collectively know (or can at least observe) the most about, we may overestimate our understanding of it. The American Migraine Foundation notes some of the most common misconceptions that leave migraine sufferers feeling misunderstood or unsupported at home or in the workplace:

  • Migraines are just headaches.

  • Migraines aren't as bad as the sufferer says they are and are just used as a way to get attention or an excuse to get out of responsibilities.

  • Migraines can easily be treated with over-the-counter medication.

The reality is that while migraine is the 6th most debilitating medical condition in the world, countless sufferers don't even want to admit they have the condition due to the judgments that may come with it. We need to recognize that the people who suffer from it will benefit more from our understanding than our biases.

Woman holding head in pain, migraine sufferer

Migraine Stage 4: Post-drome

The post-drome or "migraine hangover" stage marks the transition out of the painful attack and has characteristics that can vary significantly among migraine patients. While some may go through a lengthy recovery phase of feeling exceptionally drained or fatigued, others have reported feeling elated that the attack has passed and are ready to return to regular activities.

Migraine Management Tip #4: Just because the most painful stage of the cycle may be over doesn't mean your support is no longer needed. Offering patience and understanding during the recovery phase is critical, as well as encouraging good "headache hygiene." Migraine sufferers may need extra sleep, hydration, and reduced stressors during this time to aid their return to typical workloads or activity levels.

The Bottom Line on Migraine Support

While we remain hopeful about the new medications and treatments that are constantly in development, we can't lose focus on how those around us need our support now. A little help can go a long way, whether it involves changing household responsibilities, a workplace accommodation, or even simply understanding that sometimes your friend has to cancel movie plans due to migraines.

Migraines--unfortunately--come with pain, but the accompanying pain of isolation is something we can help with. When we offer our loved ones and colleagues the safety to share their condition and needs, we can ease that pain a little.

Not everyone experiences the same stages, symptoms, or severity of episodes; the time between migraine attacks can also be a significant variable for migraine patients. But if you are experiencing any of these symptoms or stages or think that you or a loved one might be suffering from the condition, the American Migraine Foundation has a guide to point you in the right direction. Also, be sure to consult your primary care physician about any symptom patterns or concerns that may be related to migraines.


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