It’s just a headache. How many times have you or someone you know said this? Some of us misunderstand and downplay the severity of migraines, thinking of them as a minor affliction preventing people from taking part in daily life.
Dr. Dolores Dominguez Santamaria, the director of the Headache Center at Allegheny Health Network, sheds professional light on the stigma surrounding migraines: “When patients come to me, they say no one believes them. I diagnose their migraines, and they say ‘What? That’s it?’ They don’t understand … it’s truly a neurological disorder.”
The presence of migraines is heavily linked with genetics—90 percent of patients with headaches have people in their family with migraines. Other triggers for chronic headaches include changes in weather, storms, and the (mis)management of stress.
What the stigma does get right, however, is its recognition of incapacitation. According to Dr. Santamaria, one of the distinguishing factors of chronic migraines is that they incapacitate patients: “The patient is not able to participate in daily life activities—[they] can’t light the candles at their son’s birthday party or are forced to call off work because they can’t concentrate or pay attention. It’s really debilitating.”
Incapacitation often leads to a misdiagnosis of the affliction, and many people who suffer from migraines are labeled as depressed. Because migraines affect the limbic system and cause anxiousness, depression, and light sensitivity, patients often retreat to dark, quiet places for rest.
These symptoms also can have deeper implications for patients. “They are looked down on at work, or they have marital problems because it affects their state,” Dr. Santamaria said.
Two main types: cluster headaches and migraines
She identified two of the main types of chronic headaches: cluster headaches and migraines.
Cluster headaches are known as “suicidal headaches” and can last from 15 to 90 minutes, whereas migraines can last four hours or longer.
Patients who experience cluster headaches are usually unable to keep still during an attack. “Cluster headaches make patients want to jump out of the window. The pain is disabling—they want to bang their head off the wall because of the severe pain,” Santamaria said.
The symptoms of a cluster headache are characterized by unilateral (one-sided) pain, although for some people the side can vary from time to time. The pain is usually centered over one eye, one temple, or the forehead.
Men tend to have cluster headaches, while women are more prone to migraines. According to the Migraine Research Foundation, of the more than 38 million American migraine sufferers, 28 million are women. Research has connected hormones to migraines. However, not all migraines are hormonal.
How do you treat cluster headaches and migraines?
Cluster headaches are more challenging to diagnose because they are often mistaken for migraines or allergies. Therefore, it is important to pay attention to the concentration of the pain. Common treatments include oxygen, injectables, and noninvasive therapy.
There isn’t a one-size-fits-all approach to treating migraines. Pain-relieving medications and triptans are often recommended, in moderation, for treating migraines as they occur. Preventive treatments for migraines include cardiovascular drugs or beta blockers, antidepressants, and anti-seizure medication.
Can these headaches be prevented?
When deciding on preventive therapies, it is important to talk to your physician and weigh the pros and cons of different medications. Beyond pharmaceutical prevention, your day-to-day habits can go a long way to help you have fewer, less-severe migraines.
Dr. Santamaria recommends a multidisciplinary approach through lifestyle modifications such as removing foods containing nitrates and MSG from your diet, drinking more water, exercising, and getting uninterrupted sleep.
“Listen to your body. If it’s telling you to sleep more or to manage your stress … it’s all about how you train yourself,” Dr. Santamaria said.
It’s not just a headache. It’s more than that.
If you are experiencing chronic headaches, be proactive and see a doctor to learn more about the treatment options.