Column | It isn’t ‘just a headache’

Globally, there are only 15 percent of people who are affected by migraines. The earliest description of migraines came in 1500 BCE in ancient Egypt. In 200 BCE, writings from the Hippocratic school of medicine described the visual aura that can precede the headache and a partial relief occurring through vomiting.

Migraines often begin in childhood, adolescence or early adulthood. The Mayo Clinic says migraines may progress through four stages: prodrome, aura, headache and post-drome, though not everyone experiences all stages.

The prodrome stage happens one or two days before a migraine. There are subtle symptoms such as increased thirst, frequent yawning and neck stiffness that will warn you a migraine is coming.

Aura may occur before or during migraines. Most people experience migraines without aura. Auras are symptoms of the nervous system. They are usually visual disturbances, such as flashes of light or wavy, zigzag vision. Sometimes auras can also be touching sensations, movement or speech disturbances. Your muscles may get weak, or you may feel as though someone is touching you. Each of these symptoms usually begins gradually, builds up over several minutes and lasts for 20 to 60 minutes. Visual phenomena, such as seeing various shapes, bright spots or flashes of light, difficulty speaking and vision loss are all examples of the aura stage.

The actual migraine attack usually lasts from four to 72 hours if untreated. The frequency with which headaches occur varies from person to person. Migraines may be rare, or strike several times a month. During a migraine, you may experience pain on one side or both sides of your head, pain that feels throbbing or pulsing, sensitivity to light, sounds, and sometimes smells and touch, nausea and vomiting, blurred vision and lightheadedness, sometimes followed by fainting.

Lastly, the post-drome stage is after a migraine attack. Some people feel elated because the pain is gone, others feel completely drained.

I have suffered from migraines for at least six years, though I’d wager more than that because I used to think they were stress headaches. If I had to explain what happens during a migraine, I can only say imagine two railroad spikes driven into your eyes before they are repeatedly pounded on.

I have thrown up because of migraines. Passed out because of them. I largely can’t even drive home if I get one at work. Light hurts. My teeth hurt. My bones hurt. I can hear someone breathing from across the room and it sounds like they are screaming in my ear.

To sit in a blacked out room at night with sunglasses on, a hood up and still cringe in pain because there is too much light, that’s not “just a headache.”

Though migraine causes aren’t understood, genetics and environmental factors appear to play a role, according to the Mayo Clinic. Migraines may be caused by changes in the brainstem and its interactions with the trigeminal nerve, a major pain pathway. Imbalances in brain chemicals – including serotonin, which helps regulate pain in the nervous system – also may be involved.

Several factors make people more prone to having migraines. If you have a family member with migraines, then you have a good chance of developing them too. Age can sometimes play a factor as well. Migraines can begin at any age, though the first often occurs during adolescence. Migraines tend to peak during your 30s, and gradually become less severe and less frequent in the following decades.

Women are three times more likely to have migraines. Headaches tend to affect boys more than girls during childhood, but by the time of puberty and beyond, more girls are affected.

Hormonal changes are another risk factor with migraines. Women who have migraines may find that their headaches begin just before, or shortly after, the onset of menstruation. They may also change during pregnancy or menopause, though they tend to improve after menopause. Some women report that migraine attacks begin during pregnancy, or their attacks worsen. For many, the attacks improved or didn’t occur during later stages in the pregnancy, though migraines often return during the postpartum period.

The impact of headache disorders is a problem of enormous proportions, both for individuals and society. Migraines are a significant source of both medical costs and lost productivity. In the United States, direct costs have been estimated at $17 billion. Nearly a tenth of this cost is due to the cost of triptans – tryptamine-based drugs used to treat migraines – including $15 billion in indirect costs, of which missed work is the greatest component. In those who do attend work with a migraine, effectiveness is decreased by around a third.

For those of us who suffer migraines, the worst thing a person can say is “It’s just a headache.” The pain we are going through can only be described in the most colorful language and with the most outlandish metaphors to make those lucky enough to never experience them understand what we are going through.

These are not “just headaches.”