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It’s Not Just in Your Head

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Erasing the stigma of migraines

Nearly 30 million people, approximately 12 percent of the American population, experience migraines. Migraines are three times more common in women than men and most often affect people between the ages of 25 to 55. Also, according to figures from the U.S. Centers for Disease Control and Prevention, migraines are more prevalent than asthma and diabetes. Despite the prevalence and increasing public awareness of migraines, there are still significant misperceptions about the legitimacy of this neurobiologic condition and misunderstandings about the ways to manage them.

A migraine attack can occur at any time and varies in frequency and duration depending on the individual. Some people with migraines have less than one attack per month while others have multiple attacks each week. Regardless of frequency, attacks can be extremely debilitating. Even if a person has only one attack a month, that attack could last as long as three days if untreated–resulting in as many as 36 days a year of missed work. Additionally, the impact may be felt in a person’s social life, often causing him/her to miss special occasions and feel “out of sorts.”

While there are no definite answers to what causes migraines, new research is helping health-care professionals better understand what happens during an attack. Current thinking suggests that migraines are triggered within the brain. Once an attack begins, the symptoms arise from an inflammatory process that occurs because of the trigeminal nerve and blood vessels in the coverings of the brain. Pain signals are sent from these vessels into the brainstem. Here, pain processing centers become sensitized or overloaded and begin to spontaneously fire.

Migraines are often hereditary, and it is estimated that when both parents suffer from migraines, there is a 75 percent chance that their children will, too. Evidence also indicates that a variety of factors, such as food, odors and changes in the weather can trigger a migraine attack. Though the list of documented triggers is continuously growing, they are not the same for everyone and may not even be consistent within an individual. Identifying one’s triggers and staying clear of them may minimize one’s chances of future migraine attacks.
If a person experiences symptoms of any medical condition, it is important to seek medical care. However, many people who experience migraine symptoms do not go to the doctor due to denial, stigma or a perception that there is nothing a doctor could do. It is estimated that six percent of men and 18 percent of women in the United States have migraine attacks and about half of these individuals stop seeking care partly because they are dissatisfied with their therapy. In fact, public surveys indicate that headache suffers are among the most dissatisfied patients. This is just one of the reasons that approaching a relationship with your physician as a partnership–with clear lines of communication–is so important.

Make sure to make an appointment with your physician to specifically discuss your migraine. Talk about the frequency of your attacks, what medications you are already using, how often you are taking these medications and how they are working. Many people can manage their attacks through lifestyle modifications, while for others pharmacologic treatment is necessary; often a combination of both is most effective.

Migraine medicine typically falls into two categories: Acute medicine, which treats the symptoms after an attack begins, and migraine prevention medicine taken daily for those who experience frequent (at least two per month) and/or severe attacks. It is estimated that 40 percent of Americans who have migraines may be appropriate candidates to receive preventive therapy, but only one in five actually do.

Non-drug treatments can also be effective in managing symptoms, especially when used in conjunction with medication. Relaxation techniques, exercising, biofeedback, acupuncture, massage and simple hot and cold applications have all shown positive results.

No matter what works for you, if you suffer from this neurobiologic condition it is important to see your physician and find treatment now. Over time, migraine attacks can become more frequent and in some patients, chronic migraines may cause cell damage or an increased risk for stroke in certain areas of the brain. Don’t fall into the trap of brushing aside this pain as “just a headache.” See your physician, determine your triggers and decide on a treatment. There is no reason to live in fear of your next attack or in pain. Go today!

  • More than 25 percent of migraine suffers have missed at least one day of work over the past three months due to a migraine attack.
  • Nine out of 10 migraine suffers report they can’t “function normally” during days in which a migraine strikes and nearly three in 10 require bed rest.
  • Migraine attacks are associated with an estimated 112 million bedridden days per year.
  • An estimated 80 million workdays are compromised due to reduced productivity.
  • Migraine attacks cost $13 billion in missed workdays and reduced productivity and one billion dollars in direct medical costs.
  • Nearly 50 percent of suffers report that their migraines prevent them from doing household chores.