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HeadWay, Issue #091 -- Explaining Migraine to Family and Friends
December 21, 2011

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In this month's issue:

Just what is Migraine again?

Just what is Migraine again?

After the last edition of HeadWay (see Did You Tell Your Doctor This?), I received a very kind email from Maggie in the United States.  She expressed some concern about the article.  Here's what she said:
I became slightly concerned after reading the most recent article where it was revealed that some headaches are also migraines. I have had migraines since a head trauma from a near fatal auto accident in 1984 and it angers me that people who do not understand the severity of migraines refer to a mild headache as a migraine! That is trivializing a very serious condition for those of us who truly suffer from these awful headaches and I become resentful because of their ignorance! Now this article appears to give them carte blanche on the very thing that I have fought so many years to help those people understand - migraines are serious and painful and are not to be take lightly! Would you please address that issue in the future? Thank you so much! I enjoy the education I continually receive on migraines!
Now Maggie may or may not be a new subscriber - and even if she isn't, I don't expect everyone to read everything I've written on migraine.  I hope I've been clear through the years that migraine is not to be taken lightly.

However, I decided to actually address Maggie's (very valid) concerns in this edition of HeadWay for two reasons:
  1. To clear up any confusion that may have resulted from my last email
  2. To give us all a refresher on just what migraine is and why it's something serious
At this time of the year, many of us are getting together with family and friends more than usual - we need to be prepared once again to explain just what migraine is.

Question 1: Are Migraine Headaches and "Common Headaches" the same thing?

No.  The term migraine headache refers to the possible symptom of headache that someone may have during a migraine attack (yes, you can have a migraine attack with no headache at all).  For more, read my article on migraine headache here.

The headache that usually comes during a migraine attack tends to be moderate to severe.

Yes, it is possible to have a migraine headache that is mild or moderate on the pain scale.  But in order to be diagnosed as migraine, it will be a specific type of headache usually accompanied by other symptoms, such as nausea or photophobia.  Read more about migraine symptoms here.

And so a migraine attack is not just a bad headache.  It's a specific set of symptoms, with do vary from person to person.

I was not saying that migraine headache and tension-type headache are the same thing.  But they do seem to be linked.

I should speak briefly from personal experience so that you know I'm not minimizing migraine because I've never experienced it.  I have had migraine attacks so bad I've been writhing on the ground groaning and crying in agony.  The pain of a severe migraine can completely disable you - and I mean I've been unable to eat, drink, talk, or even sit up.

Question 2: How are Tension-type Headache and Migraine related?

We don't know.  The mysteries of both TTH and migraine relate to the complexity of the body and the mysteries of the brain that we still don't understand.  But we think that they may come from a common mechanism.

However, they are diagnosed based on the symptoms.  In that sense, TTH is a completely different animal, with different symptoms.  It tends to be less severe and disabling than migraine.  But both are something to be concerned about.

Question #3: What is Migraine?

Migraine is a disease with a complex set of symptoms.  It has been called by many fancy names - for example, a genetically based neurological disease, or a channelopathy, or a common complex polygenetic disorder.  It has also been called a neurovascular disease, because of the complex interaction between neurological biology and mechanisms of blood vessels (migraine is no longer thought of as a vascular disease, or something solely related to badly behaved blood vessels).

Anyone can get an isolated migraine attack when something goes wrong in the body (though most people don't ever have a migraine attack), but some people have migraine disease - they are predisposed to migraine attacks because their bodies are different than the general population.

In other words, migraine is not "caused" by something you eat, or your personality, or bad coping habits.  It's a measurable biological problem.

I won't go into a full description in this newsletter of what migraine is, but here are some articles to get you started:

Question #4: Is Migraine Serious?

Yes, migraine is serious.  It's serious because of the impact it has on all of life (not just during an attack).  It's serious because of the disabling symptoms (and it's one of the world's major disabling diseases).  It's serious because of the long-term impact it has on your body.  It's serious because of the other diseases that tend to accompany it.  It's serious because of its link to heart disease and stroke.

This is not to say tension type headaches should be ignored - they can be serious too.  But migraine is serious in different ways, and usually has more of an impact on the patient's life.

In other words, if you are having migraine attacks, see a specialist as soon as you can.  If you have any headache that's different or more severe than normal, go to a doctor right away.

For more, read Are Migraines Dangerous?

Question #5: How can I explain Migraine to friends and family?

It's not always easy!  And everyone's situation is different.  But here are some quick tips:
  • Speak from your own experience:  This can be hard, because we often aren't aware of how much migraine impacts us.  But it helps to talk about how disabled you are, what special things you've missed because of migraine attacks, other symptoms you experience besides headache (many people aren't aware that migraine is not just a bad headache), and the impact migraine has on all of life (ie being afraid to schedule events).
  • Show them some information:  Start here, particularly with the What is Migraine? series.
  • It's very useful to have some visual third-party examples on hand.  The book Migraine Expressions: A Creative Journey Through Life With Migraine is a stunning visual journey through people's lives with migraine from many, many sufferers.  Just showing it to friends and family will go a long way.  Or, some may want to go more in-depth.
  • Create a 20 second symptom speech:  Be prepared to answer when someone asks about migraine.  Here's how.

In Conclusion

I agree with Maggie - it can drive you crazy when you say you had a migraine last night, and someone says that they just keep working when they have a migraine.  Or if someone gives you a "look" that says it's all in your mind, or you just need to get on with life and ignore it.

Not only should migraine not be ignored, in most cases it can't be ignored.  I would like to see you keep working with an attack like the one I described above!

Everyone's attacks are not the same - we do need to leave room for that.  And it's hard to judge how much pain someone else is in.

But let's not make the mistake of concluding the migraine attacks are just bad headaches, and you should just take two pills and keep going.  It's not that simple.

I'm going to leave it at that in this edition of HeadWay - I'm sure we have lots to think about!

Thanks for reading!  Remember, if you have feedback or ideas for future issues, visit the HeadWay MailRoom.  Your password is nomoache.
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