What is Migraine?

Migraine is a complex, disabling neurological disease that is commonly misunderstood, or often shrugged off as “just a headache”.

Are you overwhelmed trying to determine what migraine really is?

Keep reading to learn why migraine strikes, what symptoms to look out for, how to discover relief, and much more!

Migraine is a Chronic Illness

Whether you have daily pain or only have one symptomatic day a year, your migraine is a chronic illness.

A common mistake people make when thinking about migraine is comparing it to other acute conditions, like a cold or flu. By this line of thinking, migraine is something that just “happens” to you.

• “I had a flu this week.”/”I had a migraine this week.”
• “I caught a cold today.”/“I got a migraine today.”

Migraine should instead be compared to other chronic conditions, such as asthma or epilepsy. In all these conditions, the disease may be managed daily, but there are flare-ups of symptoms that are associated with the disease.

• “I had an asthma attack this week.”/”I had a migraine attack this week.”
• “I had a seizure because of my epilepsy today.”/”I had severe head pain because of my migraine today.”

Causes vs. Triggers

As described above, migraine is a chronic condition with flare-ups of symptoms known as migraine attacks. To explain why migraine happens, we must consider both the cause of migraine disease and the triggers associated with attacks.

The cause of someone developing migraine may be due to genetics. Migraine disease runs in families, meaning some people are predisposed (or inclined) to start experiencing migraine attacks.

Migraine attacks begin after being exposed to a trigger, which is an internal or external event that causes abnormal activity in the brain. Some common migraine triggers include:

• Environmental 
  • Weather changes
  • Bright lights
  • Strong smells
• Lifestyle
  • Stress
  • Exercise
• Diet
  • Dehydration
  • Skipped meals
  • Food sensitivities
• Hormones
  • Menstrual cycle
  • Menopause
  • Pregnancy

Migraine Symptoms

Migraine is commonly believed to be “just a headache”. Would you be surprised to hear that some people with migraine don’t ever get head pain? (Learn more in the “migraine subtypes” below.)

Migraine attacks come in several phases (learn more in my migraine attack phases article), all accompanied by different sets of symptoms. The phases are listed below:

1. Prodrome – early warning signs
2. Aura – sensory disturbances
3. Attack – peak of disabling symptoms
4. Postdrome – lingering impacts
5. Interictal – symptoms on “migraine-free” days

Everyone may experience different symptoms with their migraine, but common symptoms to look out for include:

• Head pain (usually one-sided and with a throbbing quality)
• Sensitivity to light, sound, and/or smell
• Dizzy, lightheaded, vertigo
• Irritability, anxiousness, or depressed mood
• Nausea, vomiting
• Confusion, brain fog
• Fatigue, weakness

Migraine Treatments

There are two strategies to focus on in migraine treatment: relief and prevention. A good migraine treatment plan will address both. 

Relief:

When a migraine attack occurs, we need a strategy in place to alleviate symptoms. This may include a combination of holistic tools and medication.

Popular holistic relief options include:

• Ice packs
• Heating pads
• Electrolyte drinks
• Essential oils
• Neuromodulation devices (Cefaly, Nerivio, etc.)
• Gentle exercise
• Meditation

Medications commonly used to relieve migraine attacks include:

• Over-the-counter painkillers
• Triptans (Maxalt, Imitrex, etc.)
• Gepants (Ubrelvy, Nurtec, etc.)
• Anti-nausea medications

Prevention:

To reduce the frequency of migraine attacks, we need a prevention strategy. Both holistic tools and medication may accomplish this.

It’s important to know that migraine has a threshold, which determines how sensitive you are to triggers that may initiate attacks.

To prevent migraine, we either want to avoid activities that bring us closer to our threshold or develop strategies that strengthen our threshold.

Popular holistic prevention strategies include:

• Avoiding potential triggers (if possible)

• Daily gentle exercise (walking, yoga)
• Mindfulness or meditation
• Consistent sleep
• Supplements
• Eating regularly, at least 3 meals a day

Medication classes commonly used to prevent migraine include:

• Beta blockers
• Calcium channel blockers
• Antidepressants
• Anticonvulsants
• Botox injections
• Nerve blocks
• CGRP 

Migraine Subtypes

Below is a list of several (but not all) migraine subtypes. It is possible to have more than one of these subtypes (for example: chronic migraine with aura).

• Episodic Migraine
  • Symptoms occur less than 15 days per month (30 days)
• Chronic Migraine
  • Symptoms occur 15 or more days per month (30 days)
• Intractable Migraine
  • Attacks last longer than 72 hours (3 days)
• Migraine With Aura
  • Presence of “aura” phase (sensory disturbances)
• Migraine Without Aura
  • Absence of “aura” phase (sensory disturbances)
• Silent Migraine
  • Attacks occur with no head pain
• Vestibular Migraine
  • Vestibular symptoms present during attacks, such as vertigo
• Hemiplegic Migraine
  • Stroke-like symptoms during attacks
• Menstrual Migraine
  • Attacks related to hormonal cycle
• Medication Adaptation Headache
  • Development of chronic migraine patterns due to excess use of relief medications (read more in my medication adaptation headache article)

Summary

Migraine is a chronic condition, typically caused by genetics, with flare-ups of symptoms known as migraine attacks.

These attacks begin from exposure to triggers, which are internal or external events that cause abnormal activity in the brain. During a migraine attack, there are a wide array of symptoms that may be experienced including head pain, nausea, fatigue, and more. 

To treat migraine, it is important to focus both on relieving symptoms and on preventing attacks from occurring. There are a variety of both holistic tools and medications to consider.

Not sure where to start in your migraine treatment plan? Click the link below to discover how the Migraine Nutritionist can be your partner in managing migraine.