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The Two Minute Guide to Migraines

Migraine is a disease that lasts a lifetime, but if you’ve got just two minutes I can tell you why it’s NOT a headache… Go ahead, look at the clock. I know you want to…

Migraine is a genetic neurologic disease. The cause is in our genetic code — our DNA. The cause is not stress, something I ate or did yesterday or this morning, although these things can make an attack more likely to happen. Just because I have Migraine doesn’t mean that either of my parents had to suffer Migraine, or that my children will suffer Migraine attacks, although it’s true this is more likely the case. Although we don’t entirely understand all we need to about Migraine genetics, scientists think that for some people, the gene that gives them Migraine may need to be *turned on* at some point in their life or they may not ever suffer a Migraine attack.

Migraine is about my brain and how it functions neurologically. It isn’t necessarily about the blood vessels in my brain, although they can play a part too. So can my immune and other body systems. How my brain functions as a Migraineur isn’t any more in my direct control than how the brain of an autistic child, or a person with ADD, Parkinson’s disease or epileptic seizures can be controlled by the patients who have those neurological disorders.

Migraine can’t be tested for. There are no positive Migraine labs or imaging. We recognize the symptoms and make sure it’s nothing that will be more easily treated by testing for everything else. Scientists have located several Migraine genes, and the day may come that we can test for those genes in our DNA, but until then don’t expect me or my doctor to understand why I have debilitating Migraine attacks.

Migraine can be excruciating, but it isn’t a pain condition, and pain medicines can actually be the worst thing to give a patient during an attack. The best treatment is to abort the Migraine attack, and the pain will disappear with it. Migraine doesn’t even have to have pain associated with it, although pain is one possible component to an attack.

The symptoms and pain of Migraine are much like a spectrum disorder. While one person may treat themselves by taking an over the counter pain medicine and be fine until the attack has resolved itself, others are disabled. Rarely Migraine can even be fatal when it either results in a stroke, or so much untreated pain that the patient gives up and chooses death over life with their disease. Accidents also take the lives of Migraineurs — overdoses, car accidents, even side effects of the medicines we are forced to take, often in amazing quantities. The World Health Organization stated that a severe Migraine attack is more disabling than quadriplegia.

*Looking at my watch* How did I do?

Migraine is much more than a headache. Those without Migraine may never understand what living with Migraine is like, but they can understand that it is hard, and they can support us in our daily lives.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

  • Tony Burkinshaw
    6 years ago

    This is a really good article. Migraine can be dificult to explain and this has done it very clearly.
    I have several clients who have suffered with Migraines and thankfully they have found some relief.
    As a result, I designed a migraine relief mp3 which has had some greatt feedback. It isn’t pain relief and it isn’t yet more drugs.
    I wrote an interesting article on chronic pain and hypnotherapy which (although not addressing migraine directly) does address some of the reasons why hypnotherapy can be helpful.
    In case you’re interested its at [url removed by moderator] I’d be really interested in your thoughts.
    All the best
    Tony

  • Julie
    7 years ago

    This is a great article. Is it in PDF so it can be printed? Or downloaded to print? I’d love to print it or attach it to email and forward it. That would be the cats pajama’s. Thank you for posting it.

  • Cindi
    7 years ago

    Well done! I, like MJ, have often told non-migraineurs that I am treated with drugs that epileptics take in order to get them to grasp that it is NOT a regular headache and that I have NO control over the disease. Sometimes the imagery helps them, even though I know it’s really not all that similar. Your Two Minute essay is great… I’m going to copy it and hang on to it, giving proper referance to you, of course! 🙂 Thanks, Ellen.

  • Paulaff
    7 years ago

    This was a very good article. Even though I’ve had chronic migraine for more than 20 yrs, I can get caught up in trying to find out why it comes or what was the trigger or why is this one so bad. I’ve only had two preventatives that lasted more than six months, but even they had a ‘shelf life’ as my body became accustomed to the med, & it no longer worked. Now my current neurologist wants to give me Botox injections because she feels that the three meds she tried in the past six months means nothing else will work for me! Botox doesn’t seem like a preventative I want to put in my body–it’s not only a toxin, but the results of this treatment don’t seem very promising. On the Botox site it states that it can prevent up to 9 headache days per month, vs the placebo which prevents up to 7 days per month, & it’s only approved for people who have 15 or more per month! I think I’d rather take the placebo or find yet another doc. I’m tired… of docs that have their own (often narrow-minded) beliefs of the ‘one size fits all’ approach. None seem to really listen, & none want to prescribe pain relief even though it often works for me.
    Sorry I spouted off; guess I’ve really frustrated on day three of a mega migraine.

  • Ellen Schnakenberg author
    7 years ago

    Cindi – Good luck and hang in there <3 Like you, my insurance wouldn't cover Botox for a very long time. Now that it does, I am getting super busy! I've found a new headache specialist and our prayer is that we can get it approved during my first visit. Barring that, we are looking at other less known treatments that might be helpful and not cause problems with my other comorbid conditions. I'll be writing about it as I go, so stay tuned! 🙂

  • Ellen Schnakenberg author
    7 years ago

    Paulaff – I hear you and I really do get it. This is just a super-quickie helper to explain what Migraine IS and ISN’T.

    There are some docs who feel that ANY pain meds are bad for patients. I suppose I fall somewhere in the center of things, because A. I want my Migraine attack aborted so I don’t have to worry about pain meds and their lousy side effects or MOH and further progression of my already nearly unbearable disease… and B. because I also know that there is a real place for pain meds for anyone suffering severe pain. Yes, Virginia, there are pain meds for a reason, and denying a patient who is intractable and unable to find any other preventive, abortive or rescue treatment that helps is to render that person helpless to the torture of the kind of pain most people only *think* they can understand.

    Bottom line is what I told AC – we need to know more about how Migraine occurs in our brains so that new treatments can be devised. Patients need to step up to the plate for this because Congress is ignoring us right now. Until we have enough patients getting involved in standing up for our needs, we will continue to be ignored. So I would encourage you to get involved however you can. Call or write your legislators. Come to Headache on the Hill. Fundraise for Migraine research. Shanghai our family and friends into helping us. We can all do something…

  • Cindi
    7 years ago

    I am at the same place, doing nerve block shots every other month until my insurance approves the Botox. I’ve put it off (Botox) but I’ve heard many that have had good results that experience the same short shelf-life that you and I seem to have. Anyway, what I really mean to say is that I totally understand and you are not alone! I wish you the best.

  • Janet
    7 years ago

    Ellen,
    Again another article stating the facts. I always forward your articles to my family, special caring doctors and my pastors at church.
    Thank you and have a wondrous holiday season.
    Janet Jones

  • Ellen Schnakenberg author
    7 years ago

    Janet – feel better hon, and have a joyous month! 😀

  • AC
    7 years ago

    I really liked this article and plan on sending it to a few people in my life but I agree with Indymama. It’s not so helpful when you have chronic migraines. If there isn’t a time when you don’t have pain, then there isn’t much you can do other than take medication. I have yet to find a medication that works properly for me and, as a result, I generally suffer through the pain. It’s not ideal but what can you do?

  • Ellen Schnakenberg author
    7 years ago

    AC – Thanks for your comment. To answer your question: Hopefully find a preventive. It will take over 20 years of constant trying to actually make it through all the treatments – however imperfect they are – that might be helpful to us. Then there are combinations, and things still coming down the pike. When a few of us become intractable, then it’s time for us to be standing up for ourselves and telling Congress how important it is that Migraine and headache disorders are taken at least as seriously as they impact society and the general economy. Without federally funded research into the pathophysiology and epidemiology of Migraine, there won’t be any new medicines or treatments for us. We just don’t know enough yet about how Migraine happens for researchers to create these for us, and drug companies don’t research these issues – they use what we already know about Migraine to come up with new ideas. This is truly in our hands. I’m sure you’re aware that, when you talk government, the squeaky wheel gets the oil. http://migraine.com/blog/migraine-congressional-hearing-petition/ We can sign petitions like this: http://migraine.com/blog/hearings-on-migraine/ and we can make our voices heard by joining our dedicated specialists and advocates at Headache on the Hill http://migraine.com/blog/live-from-headache-on-the-hill-2012/

    This is intended as a quickie basics post though – it definitely can’t possibly cover even the basics! The hope was that it might help others understand that Migraine is not just a headache.

    For more information on chronic Migraine – see this link: http://migraine.com/migraine-basics/chronic-migraine-overview/

  • Donas773
    7 years ago

    Ellen,
    I think you did a great job summing up Migraine in 2 mins. Currently I have been diagnosed with chronic migraine, which is becuz I am on rebound with Imitrex and Tylenol. My doctor is going to try and get me off of this ridiculous cycle with Prednisone and Cambia to help with pain…. I know it will be tough, but I need to get off this train. I’m hoping for a miracle.

  • Ellen Schnakenberg author
    7 years ago

    Donas773 – I am right with you there! Thanks for the comment, and good luck with getting off the MOH bandwagon http://migraine.com/blog/help-how-can-i-not-overuse-migraine-medications/ It is a hard road, I won’t lie to you. However, following the doctor’s instructions will mean that at the end you will either feel better because you’re off MOH, or you’ve eliminated MOH as a contribution to your chronic Migraine situation. Either way, it’s a win-win. Just try hard to hang in there and stick it through <3

  • mjsymonds
    7 years ago

    Ellen,
    Thanks for this article. I think it is difficult for many people to grasp the difference between what causes the disease and what can trigger an attack. I’ve gotten to the point where I start by telling people that having migraine is something like having epilepsy. You can take medications and follow behaviors that, if you are lucky, will reduce the number and severity of the attacks you get, but you will always have the disease and never be able to control all the variables that might lead to an attack.

  • Ellen Schnakenberg author
    7 years ago

    MJ – I’m right with you there. I think a lot of Migraineurs use this explanation to help others understand that their disease isn’t just a headache. My goal is just to be sure that patients understand the true meaning of the use of these meds so that they understand their doctors DO believe them and ARE trying diligently to help them. Too often I see patients who are angry and fed up with trying anything because they believe their doctors think they are having mental problems instead of Migraine problems 🙂

  • mjsymonds
    7 years ago

    I guess what I was trying to say was I have had better luck getting non-migraineurs to understand that migraine is a neurological disease by comparing it to another neurological disease that they are generally more familiar with. Then they seem to grasp that migraine attacks are symptoms of a single disease, rather than “really bad headaches” with multiple causes.

    The confusion surrounding the medications used for migraine is very unfortunate as well and seems to demonstrate how the development of migraine specific treatment has really been neglected for far too long. Until we have preventive medications solely targeted for migraine, doctors could alleviate a lot of confusion in their patients, and probably get better compliance, too, if they’d simply take the time to explain that there are NO preventives specifically developed for migraine YET and that what s/he is prescribing, though it belongs to another class of medicine (anti-depressant, blood pressure med or anti-convulsant, usually,) is among the most effective preventive measures available to us at this time. Sad, isn’t it?

  • Ellen Schnakenberg author
    7 years ago

    MJ – The important thing to remember though, is that these conditions are not Migraine. Due to the fact that so many of the preventives we take are for other conditions including epilepsy, patients and others often misunderstand and think that their Migraines are being triggered by something related to an epileptic condition, ergo the anti-seizure medicine. Same thing with depression and even blood pressure issues. Or they assume that their doctors don’t believe their symptoms and are prescribing for something else.

    It can be so hard explaining and understanding these finer points can’t it!

    Thank you so much for your comment MJ 😀

  • indysmama
    7 years ago

    I loved this article. It validates everything that people with Migraine know and should help people without it to understand. The comment about pain medications actually worsening things is so true. I no longer take any over the counter pain meds for anything. I have had migraine attacks as long as I can remember, but the past 8 years have been horrendous. I now have been “diagnosed” as chronic migraine and just recently told someone that I no longer think of it as when a migraine attack will start but as how long the abortive drugs and preventative drugs will keep the symptoms at bay… If I go 48 hours without having to take an abortive drug, it is a victory!!

  • marlenerossman
    7 years ago

    I MUST take abortives way more than 3X a week. Otherwise, I would lose my job, my home and my life. We already know that the abortives can bring on rebound. Try a new broken record. This one is getting old.

  • Ellen Schnakenberg author
    7 years ago

    indysmama – Thank you so much for your feedback! I love that this post seems to be ringing a bell with so many…

    Please remember that abortives can also cause medication overuse headache. As awful as it may sound, taking them more than 3 times a week can backfire on us too. Have you discussed the possibility of MOH with your doctor?

  • elizabethglenn
    7 years ago

    Thank you Ellen! I am going to make my husband read this. You really explained it very well. I may even keep a copy and let my doctors read this. I think that many don’t even understand Migraines.

  • Ellen Schnakenberg author
    7 years ago

    elizabethglenn – I hope this is helpful 🙂 It is just the tip of the iceberg of course, but maybe it will help to open up some of the lines of communication… Thank you so very much for the comment!

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