Migraine as early childhood trauma
Some of the best article ideas come from reader responses to earlier posts. Your participation helps keep the ideas flowing. This post is one of those ideas born from reader feedback. Among the comments about the possible link between migraine and childhood trauma, someone shared the opinion that migraine itself can be traumatic for a young child. My gut reaction was, “Isn’t that the truth!”
There is growing evidence that infant colic may be an early form of migraine. If you’ve ever spent a sleepless night with an inconsolable baby, you probably understand. The excruciating pain of a migraine could easily make me scream all night if I didn’t know what was happening. When she was 1 week old, my granddaughter started screaming for hours almost every day. She didn’t have any infections or reflux. The doctor’s explanation was colic. My daughter and I were both very concerned. She is now almost 10 months old. The days of four-hour screaming sessions are over, but she is still considered a “high needs” baby. Her little nervous system is very sensitive and we all worry that she might be experiencing migraine attacks. The thought of an infant facing a migraine attack is unbearable, especially when it’s your own child.
Every kid gets them. A child with migraine will get them a lot. The pain will be severe and vomiting often follows. Many times, children will first be diagnosed with Cyclic Vomiting Syndrome or Abdominal Migraine before the head pain appears. This was the case with my daughter. She started having Abdominal Migraines when she was two years old. No one believed me. Other family members refused to keep her away from food dyes and nitrates (her triggers at the time) and would not treat her symptoms when they appeared. When not at home, she was left to suffer and told to “think happy thoughts”. Now almost 22, she has a much more colorful vocabulary for that kind of treatment. I consider those responses to be abusive and medically neglectful.
Lack of understanding
Sometimes people who work with small children really don’t understand Pediatric Migraine because they don’t understand Migraine in general. They view Migraine as something adults get when they are stressed out. So they can’t imagine what would stress a young child to the point of migraine. Typical responses can include suspicions of child abuse, suspicions of mental illness, or worse. Many times they assume the child is faking or exaggerating in order to avoid an activity or gain attention. So their response is to ignore the child or delay treatment.
This happened to me several times a week in elementary school. The bright lights, loud noises, and weather changes were intolerable to my young nervous system. I couldn’t explain it well at the time. All I could do was cry and tell an adult my head hurt. If I was lucky, eventually I was allowed to visit the nurse’s office to lay down in the quiet dark. But the nurse wasn’t always on duty. Many times the school secretary (a loud woman with strong perfume) simply offered me some Tylenol and sent me back to class.
At least once I week I would get ignored and all hell would break loose. After repeated attempts to get help, the migraine attack would take over. All the color drained from my face. I became cold and my skin felt clammy to the touch. Then my stomach would issue a retreat and everything would come up faster than I could ask for help. Nobody likes to clean up vomit so I faced the teacher’s scorn, my classmates teasing, and a grouchy custodian.
Rarely was I ever sent home. I would spend days in agony under harsh lights with loud noises beating in my head. Everyone swore I was just trying to get attention.
I was “the headache girl”. Other kids kept a wide berth to avoid getting hit by the vomit as I was famous for random puking. I hated recess and Physical Education class. Outside was full of intolerable tortures: bright sunlight, strong winds, blistering heat, freezing cold, rain, snow, the screams of other children, the smell of fresh blacktop, the banging of balls and jump ropes, and that infernal whistle the teacher blew to signal rule breaking and time to line up. Forced to join everyone outside, I tried my best to find a quiet spot where I could hide.
“You’ve got a headache AGAIN?” was the frustrated sigh I heard most often.
In order to get help, I was required to raise my hand, wait to be called on, and then announce my problem loud enough for the entire class to hear. My impulse was to quietly approach the teacher in order to prevent the entire class from knowing that my head hurt for the umpteenth time that week. The pain was embarrassing. Asking for help was unpredictable and humiliating.
My pain was a nuisance, an interruption to tightly-planned schedules, and an inconvenience. As a young child, I internalized the judgments. I was a nuisance, an interruption, an inconvenience. The verdict was clear. I needed to straighten up and act like everyone else. But I couldn’t. I had no understanding of what was happening and was powerless to stop it.
Shame is a powerful weapon that can destroy the fragile self-esteem of a young child. Shaming a child for migraine attacks is abusive.
I was forty years old before I heard the term “prodrome.” Imagine what that’s like for a child. You can’t think straight or put words together coherently. You might be dizzy, irritable, euphoric, or start hearing, seeing, or smelling things that aren’t there.
In my world, I was told that I could control these “behaviors” and needed to stop because my choices were causing migraine attacks. I can see how the mistake could be made. If every time I got upset, a migraine attack followed, then making the assumption that getting upset caused the attack seems rational. But that wasn’t the truth. Bright lights, skipping meals, certain foods, strong smells, allergies, and sleep problems triggered my attacks. The attacks started by compromising my ability to think and speak. I stopped being able to control my emotions, becoming first manic, then irritable, then crying inconsolably. Within minutes the headache would start.
So I was the “emotional child”, too. But I really wasn’t. That’s what confused so many adults. Without migraine, I was an intelligent child with really good social skills. Unfortunately migraine attacks hit so frequently that not everyone got to see the best of me.
How do you explain postdrome to an eight year old when you don’t even understand it. The pain would subside, so I was expected to return to “business as usual”. That usually meant sending me outside for more fresh air that would ultimately trigger another attack. I was labeled “moody” when I was actually exhausted. My physical body and my emotions were still very raw.
All of these experiences took a toll on my self-image. I was one of the lucky few, I guess. I saw migraine as a challenge – something to beat. So I denied its reality as much as possible, tried to hide the symptoms when they appeared, and forced myself to bounce back into life as quickly as possible. Starting in my teens, I carried out a personal crusade to rid myself of migraine forever. Reality didn’t really hit me until I was almost 40. Migraine isn’t going away. Forced to learn how to live with migraine, I embraced my identity for the first time.
Please, share this story with anyone who works with children. They need to know that how they respond to a migraine child’s pleas for help can make a huge impact. Children with migraine need extra nurturing, understanding, compassion, and validation. They deserve the same quality treatment that we all deserve.