Migraines are more than just strong headaches. While the underlying causes of migraines are somewhat nebulous, it is commonly thought to be a debilitating neurological condition that can be passed on genetically.

While this is a common phenomenon, migraines are a debilitating condition that also often occurs in people with mood disorders, including depression, anxiety, and bipolar disorder. Migraine is the third most common disorder worldwide, affecting 1 in 7 people. Chronic migraines affect about 1 in 50 people worldwide. Women tend to be affected by migraines more frequently than men.¹ These types of headaches can also greatly affect the quality of life experienced by a sufferer, leading to higher rates of work absenteeism and depression.

What exactly is a migraine?

Migraines differ greatly from other types of headaches. In fact, the American Migraine Foundation considers an episode a migraine if a person suffers from at least two of the following four criteria:

• A throbbing pain
• Occurs only on one side of the head
• Moderate or severe intensity that incapacitates sufferers (reducing planned activities)
• Worsening pain with any physical activity

Sensory sensitivity, such as sensitivity to light, strong smells, and sound, is one of the most common symptoms among migraine sufferers. It’s also important to note that a migraine can last anywhere from four hours to several days.² A migraine also tends to follow a specific sequence of four stages (however, a sufferer may only experience some of the stages, not all):

1. Prodrome:

   This usually starts anywhere from two hours to two days before the actual migraine begins. Symptoms commonly experienced during the prodrome phase often include irritability, depression or euphoria, altered mood, fatigue, food cravings, stiff muscles, often in the neck, sensory sensitivities, including sensitivity to smell or noise, and constipation.³

2. Aura:

   Following the prodrome, about 20% of people with migraine have an aura. This phenomenon usually occurs just before or during the migraine and isn’t experienced by all sufferers. It lasts about an hour, and starts gradually over a period of as little as five minutes, up to an hour. This aura can manifest as visual anomalies such as scintillating scotoma, in which the field of vision flickers or is partially obscured. It usually starts in the centre and then spreads out to the sides in zigzagging lines. Some sufferers experience pins and needles in one arm, spreading to the nose and mouth on the same side. Speech disturbances can also occur, and sometimes also motor problems. However, sometimes an aura can occur without the following headache, but with many of the other symptoms occurring.⁴

3. Pain:

   This presents as throbbing pain, most commonly in one side of the head. It’s usually moderately or severely painful, and its onset is usually gradual. Physical activity exacerbates the pain. While the pain phase is in full force, the aforementioned symptoms of nausea, vomiting, and sensory sensitivity cause many sufferers to withdraw to a dark, quiet room to recuperate.⁵

4. Postdrome:

   This phase can last up to a day after the headache, sometimes also called the “migraine hangover’’. During this phase, sufferers can feel tired and irritable. However, some people report feeling perky and unusually refreshed. Muscle pain and weakness also commonly occur, as well as a loss of appetite.⁶

What causes a migraine?

There are many possible triggers for migraines, for example hormonal changes commonly trigger migraines in sufferers. Emotional triggers can include stress, anxiety, tension, shock, depression, or excitement. Physical triggers are also very common, these can include tiredness, poor-quality or erratic sleep (particularly among shift workers), and strenuous exercise in people who are not used to it. There are also a number of dietary triggers, including irregular meals, dehydration, alcohol, caffeine, and excessive use of pain relief medications can also trigger or worsen migraines.⁷

How to treat a migraine?

Treating migraines is very difficult. Sadly there is currently no outright cure, but there are a number of treatments that can alleviate symptoms. Over-the-counter painkillers such as Cipladon effervescent paracetamols are often used to quickly and effectively reduce pain symptoms. They are most effective if taken when the first symptoms of an impending migraine are noticed. That allows the medicine to be absorbed into the bloodstream before the migraine attack hits. As with all medication, it’s important to read the packaging instructions for safety information regarding dosage and contraindications. You should also contact your doctor to discuss the best possible way forward for managing the causes of your specific migraines.
 
Sources:

1. Conditions, G. Migraine: MedlinePlus Genetics. Medlineplus.gov (2022). [online] Available at <https://medlineplus.gov/genetics/condition/migraine/#inheritance> (18/08/2020).
2. What Is Migraine? | American Migraine Foundation. American Migraine Foundation (2022). [online] Available at <https://americanmigrainefoundation.org/resource-library/what-is-migraine/> (21/01/2021).
3. What Is Migraine? | American Migraine Foundation. American Migraine Foundation (2022). [online] Available at <https://americanmigrainefoundation.org/resource-library/what-is-migraine/> (21/01/2021).
4. What Is Migraine? | American Migraine Foundation. American Migraine Foundation (2022). [online] Available at <https://americanmigrainefoundation.org/resource-library/what-is-migraine/> (21/01/2021).
5. Migraine – Symptoms and causes. Mayo Clinic (2022). [online] Available at <https://www.mayoclinic.org/diseases-conditions/migraine-headache/symptoms-causes/syc-20360201> (02/07/2021).
6. What Is Migraine? | American Migraine Foundation. American Migraine Foundation (2022). [online] Available at <https://americanmigrainefoundation.org/resource-library/what-is-migraine/> (21/01/2021).
7. Conditions, G. Migraine: MedlinePlus Causes. Medlineplus.gov (2022).. [online] Available at <https://medlineplus.gov/genetics/condition/migraine/#causes> (18/08/2020).