“If you can’t get yourself together in a week, I expect your resignation,” Megha’s boss told her as she had been asking for sick leaves almost every week for the past three months. On this particular day, she could sense an impending migraine attack and asked for the day off. Her colleagues, although sympathetic, could not understand why she needed to leave for just a headache. They asked her to visit the medical room and get some pain pills while insisting that she stays hydrated. However, as the day progressed, Megha started experiencing visual disturbances such as blind spots along with shooting pain on one side of her head.
Like Megha, many people with migraine are often misunderstood. Unlike regular headaches, migraines are not a ‘run-of-the-mill’ pain that can be ignored. Migraine is a highly disabling disease with an adverse impact on productivity and personal and social relationships. Moreover, doctors don’t know what causes this crippling headache. However, living with migraine can be challenging and needs a lot of attention and care. Therefore, it is essential to be aware of the signs and symptoms to know what to do when a loved one is suffering from this chronic condition.
Know the symptoms
A condition identified by episodic attacks of impairing headaches, a migraine often presents with a combination of nausea, light and sound sensitivity, and/or vomiting. When episodic migraine gradually increases in frequency, it evolves into a chronic migraine. People with chronic migraine will have at least 15 days of headaches every month for more than three months. Generally different for every patient, chronic migraine presents in four stages:
1. The prodrome stage involves warning signs, usually a day or two before the attack. The signs include constipation, frequent alterations in mood, and excessive food cravings. For some people, this phase can last for several hours. Moreover, sometimes abortive medication can be used in some cases during this stage to prevent a migraine attack.
2. About one-third of people with migraine experience an aura which may last from 5 to 60 mins. In this stage, patients may experience visual disturbances along with temporary loss of sight or numbness/tingling in certain parts of the body.
3. The headache phase of the attack can last for several hours up to 3 days. The pain may vary from mild to debilitating and may be accompanied by nausea, anxiety, sensitivity to sound, light and smell and inability to sleep.
4. Post-migraine, patients feel exhausted for the entire day and require rest to recuperate.
Not just a headache
When a person experiences migraines for a significant part of their lives, it can lead to several co- morbidities. Migraines and mental health go hand in hand. In a global study, about 50% of people suffering from migraine said that the condition had a negative impact on their lives as they missed important events and avoided commitments, while 44% reported feeling guilty about the impact of their migraine on family life. These negative impacts on education, career, and finances can lead to depression, anxiety, and panic disorders.
Chronic migraine can be extremely draining but can be successfully managed. It requires a holistic approach that involves not only medication but also self-care. Maintaining a healthy lifestyle, such as getting enough sleep, eating a balanced diet, staying hydrated, and exercising regularly, can help reduce the frequency of the attacks. Avoiding triggers such as stress, caffeine and certain foods can also help. Consulting a doctor or a neurologist can help identify triggers and develop a personalized treatment plan. However, about 2/3 rds of people with chronic migraine may also experience medication overuse headaches. Hence, it is also important to manage this so that preventive medication can work.
Therefore, if you’re experiencing any symptoms of chronic migraine, it’s important to consult your doctor. Moreover, there needs to be increased awareness about the condition among the masses, so that they don’t discount a migraine as just a headache.
Dr Anil Venkitachalam, Consultant, Neurologist, and Movement Disorders Specialist, L H Hiranandani Hospital.
