What is a Migraine really?

Introduction

Migraines are horrific, I get them myself. Whilst being an isolated event, migraines can be a symptom of chronic pain disorders, sleep disorders, anxiety and even IBD conditions. They are very different from the more common headaches but often get mixed up or put in the same group. The key difference between the two is that migraines literally affect your brain, rather than just the head structure like headaches, and this is why they’re so terrible.

Migraines aren’t even that common, with a loose 10-20% of the worldwide populations having had one. Chronic migraines, however, lie in the 1-2% range, and are diagnosed by having them, or symptoms of them, for at least 15 days – for three months. This sort of frequency and intensity is utterly life-changing due to the nature of migraines stopping a person in their tracks for days and so multiple episodes in a month will completely change that month. It is certainly an understated issue, especially when alongside other conditions.

A migraine is typically split into several stages, between 4-6 depending on what resources you’re looking at. Migraines may not have all the stages occur in the same order either, or they may miss out stages entirely. I tend to use the six-stage model, and if you get less phases than this with yours, that’s fine. See graphic below for an illustration of these.

What causes them?

There are a bunch of factors that can lead to you getting a migraine, or chronic migraines for that matter. First are your genetics. If you have a close relative who gets them, it’s likely you will too. This doesn’t necessarily mean from birth, but the migraines can come out at any age, puberty being most common. In my case, my dad would get migraines and so it’s not too surprising that I do too.

The second cause is change within the brain itself. This change can come in the form of blood flow alterations, levels of neurotransmitters fluctuating, signals from clusters of nerves being overloaded, general malfunctions within the brain that cause instability and many others. You could write essays and essays on each one of these changes, and how they happen as well as their effects on migraine stimulation short-term and long-term. How do all of these happen? That list is exhaustive but check out some common triggers on the graphic below.  

What are the solutions?

You have two different pathways when it comes to treatment of a migraine, and I will add a third. They’re known as preventative methods, and rescue methods. One prevents, or supresses, the onset of a migraine episode, and the other attempts to lessen the experience or shorten the duration of which you have one. Both don’t conclusively work but can certainly improve your chances of an easier life with migraines.

Preventative methods often come in the form of different medications, either prescribed or over the counter. These include anti-depressants, ARDs, some beta-blockers, and some injection treatments with anti-bodies like Fremanezumab, CCBs, and Botox injections would you believe it. Be warned though, some of these medications treat a variety of other things, and their migraine prevention abilities often come at a price e.g. some anti-depressants create constant drowsiness, as well as not being certain to prevent them.

Rescue methods or things you can do during an episode include common NSAIDS, triptan medications, as well as various procedures such as TMS, acupuncture, and various types of nerve stimulation! You might not have known just how much can help the migraine situation, but they certainly have room for some trial-and-error.

To conclude, I’ll add a third method which is directly before the preventative pathway – I’d argue it should be called pre-preventative. This is basically living in a way that means your body and brain can function at their best, as much as possible. If you have a chronic illness or two, this will be extremely difficult, but it’s something I teach to every client I’ve ever had. You must get the basics under control first and these are sleep, food, hydration, movement, and a certain selfishness when it comes to your own wellbeing. Get these things in order, and you may find you get migraines less anyway but also find that known measures against them will work better. If you have any chronic illnesses, these basics will absolutely help you on your way to suppressing those too.

Mark