Migraine is a recognised disability. Due to the stigma of living with disability and the invisible nature of migraine, many people don’t refer to it as a disability and do not feel permitted to access support services that they are entitled to as being someone identifying with a disability. Comorbidities of people living with migraine can be that they are at a higher risk of stroke.
June is migraine awareness month. As someone that lives with chronic and diagnosed (neurologist) migraine, sharing information about how disabling migraine can be is very important.
The impact of migraine is as high as1 in 5 people. While both men and women are affected, women are more prone to migraine. It is a spectrum disorder and a highly complex neurological disorder that is often genetic. Some are caused by a single gene defect, and others are a combination of genes. It is not a condition that will not go away. Although there is no current cure, for many, it can be managed.
What is it? The physiology of migraine is not well understood and very complex. When a migraine brain is triggered by an overload of sensory input it becomes overwhelmed, triggering a chemical furore that causes the attack. The three events that happen during a typical attack are; irritation of the cranial nerves, in-particular cranial nerve V or the trigeminal nerve. Spasming of blood vessels in the head along with inflammation in the affected part of the brain. The consequence of this combination then results in an outcome of neurological symptoms and disabling headache.
Migraine Phases Migraine is very individual and no one attack is the same. Some people may have warning signs up to 3 days prior to an attack. There can be Peripheral neuropathy in 1 or both hands, there may be flashing lights that last a second, hyperactivity and even an increase in appetite.
The pain is often described as; pulsating, throbbing, perforating, pounding, debilitating. Migraine pain most commonly affects the forehead area. It’s usually on one side of the head, but it can occur on both sides or it can shift. Most attacks last from 4 hours up to 72 hours. In migraine with aura, pain may overlap with an aura or may never occur at all.
PRODROME SATGE Symptoms during this stage can include; food cravings, depression, fatigue or low energy, frequent yawning, hyperactivity, irritability, neck stiffness, frequent urination.
In a migraine with aura, the aura occurs after the prodrome stage. During an aura, you may have problems with your vision, sensation, movement, and speech. Examples of these problems include; difficulty speaking clearly, feeling a prickling or tingling sensation in your face, arms, or legs, seeing shapes, light flashes, or bright spots, temporarily losing your vision, peripheral numbness.
ATTACK PHASE (great name) when the actual migraine pain occurs. In some people, this can overlap or occur during an aura. Attack phase symptoms can last anywhere from hours to days.
Some symptoms may include; increased sensitivity to light and sound, nausea, dizziness or feeling faint, pain on one side of your head, either on the left side, right side, front, or back, or in your temples, pulsing and throbbing head pain, vomiting.
POSTDROME PHASE I like to call this the ‘Migraine Hangover’. During this phase, there are usually changes in mood and feelings. These can range from feeling euphoric and extremely happy to feeling very fatigued and apathetic. A mild, dull headache may persist and senses can be over whelmed.
Other migraine facts I have lived with migraine since puberty and recall the 1st meeting with a neurologist for a formal diagnosis (when I was 49), and her amazing support and explanation that my migraine is real and disabling. She also went on to tell me that in cave times, people like me would have been primitive alarm clocks, as our brains are so highly over reactive to sense, that we are the first to smell, taste, hear and see, things that don't belong. How amazing is that!
Another interesting fact is due to fluctuating and changing oestrogen (levels and type from oestradiol to oestrone) and progesterone levels, perimenopausal and menopausal women are more susceptible to migraine. You may even find your waking at 2-3am in severe pain due to a lowering in oestrogen and cortisol levels at this time.
WHAT YOU CAN DO if you live with, work with or are friends with someone that has migraine. Simply having an awareness of how to support them can be as easy as not wearing perfumes (wow they make me feel ill especially when its a symphony of competing scents).
Be ok with the fact they may prefer lower and duller lighting. Bright harsh lights can be intense for us, even when not having an attack. Don't be offended if we don't like what you may have cooked for us or if we really remove ourselves from deep conversations. Remember our brains have just undergone trauma. We will also be the ones to tell you something doesn't smell right.
Try not to judge us if our speech isn't quite connected to our brain or we have lot's of typo's in our work. Focusing is a little tricky for us after an attack and prior to an attack.
References Migraine Australia, (2020). https://www.migraine.org.au
Nall, R, (October 2021). Everything you want to know about migraine. Healthdirect. https://www.healthline.com/health/migraine
Cser-Pratzky, S. (2022). Migraine the other headache. https://www.pilates44.com/