Migraines: What Causes Them and How Can You Get Relief?


It is difficult to explain to someone who has never experienced a migraine exactly how one feels. In fact, misunderstandings about migraines have led many people to believe they are having one when they may just be experiencing a stress or sinus headache. Unfortunately, these misconceptions can leave potentially serious health issues unaddressed. Understanding migraines is important both for those who mislabel their own intense head pain as well as those who truly suffer from these attacks.

For caregivers, migraines can be especially debilitating. Normal routines for sleep, meals and other activities often fall by the wayside, which can contribute to one of these painful bouts. It is crucial for family caregivers to be knowledgeable of their condition and know when it is time to seek medical help, especially since they are responsible for providing care for a loved one.

What Is a Migraine?

Many people assume that the term “migraine” refers to a very bad headache, but that is not what it really means. According to Christina Peterson, MD, medical director of The Oregon Headache Clinic and author of The Women’s Migraine Survival Guide, “A migraine is a particular type of headache that is actually a reflection of a complex neurological process in the brain. In fact, you can have a migraine (meaning the process itself) without even having a headache, although most are associated with some level of headache pain which is often moderate or severe.”

Symptoms of Migraines

Migraines occur in stages. First, a type of warning called a prodrome can arise in the day or two before an attack. Prodromes consist of things like emotional changes, cravings, goose flesh, thirst, excessive urination and fatigue. According to Dr. Peterson, prodromes can last a short time or for a day or more.

Many people experience another warning before the onset of more painful symptoms called an aura. “About 20 percent of sufferers will have an aura, which consists of neurological symptoms lasting for five minutes to an hour before the headache phase begins,” says Dr. Peterson. Often, auras are the visual symptoms people experience, like vision loss or seeing spots, lights, or more complex visual things like lightning bolts or crescent shapes in rainbow colors. Other nonvisual neurologic phenomena may occur during an aura, including numbness or tingling in the face or extremities, difficulty speaking or confusion.

Pain during the headache phase is the primary symptom that most people associate with migraines, but it isn’t the type you experience with a typical headache. Migraine sufferers usually have moderate or severe pain that is one-sided, although it doesn’t have to be. “The pain is often pulsating or throbbing in nature, though researchers have found that it does not pulsate with a person’s heartbeat,” notes Dr. Peterson. Physical activity, like going up a flight of stairs or bending over, and exposure to light or sound often exacerbates the painful symptoms.

Furthermore, migraines are frequently accompanied by nausea and/or vomiting and are sometimes made worse by exposure to certain odors. Many sufferers have difficulty thinking clearly during an attack. These symptoms are inconvenient and uncomfortable enough on their own, but for caregivers, migraines can seriously interfere with their ability to look after a loved one. “About half of all attacks will begin in the back of the head and neck, and most last between four and 72 hours,” Dr. Peterson says.

Who Is at Risk for Migraines?

Dr. Peterson shares that migraines run in families, and most researchers now believe it to be due to a genetic disorder. “Several genes have been discovered, but this is thought to be a very complex condition. Therefore, many more genes need to be discovered before the genetic underpinnings are fully understood,” she says. “We do know that if a careful three-generation family history is taken, there is a family history of migraines in over 90 percent of cases.”

Common Migraine Triggers

It is thought that exposure to certain things in everyday life can trigger migraines in those who are genetically susceptible. “Common triggers include changes in your schedule, sleep deprivation, dehydration, stress, skipping meals, hormonal changes, weather changes, and certain foods, drinks and additives,” Dr. Peterson explains. Some medications can also contribute to an attack.

Every person is different, so recognizing triggers is especially helpful for predicting when a migraine may hit and avoiding them altogether. Dr. Peterson also points out that triggers can be additive. Exposure to more than one lowers a person’s threshold and increases the likelihood that an attack will occur. For caregivers who are no strangers to stress, odd schedules and limited sleep, minimizing any exposure to known triggers is paramount.

Treatments for Migraines

Dr. Peterson advises people who experience infrequent attacks to simply treat each one as it happens. There are many effective over-the-counter and prescription antimigraine medications that act to abort the attack quickly. However, acting fast is important. Migraines typically respond best to treatment within the first couple hours of onset when the pain is still mild.

If migraines occur several times a month, it is best to work with your doctor or a migraine specialist to develop a prevention strategy. “Good results have been shown in studies of magnesium, CoQ10, and riboflavin supplementation,” suggests Dr. Peterson, “and there is also a single study supporting the use of boswellia.” There are also stronger medications available for the prevention of frequent attacks. In some severe cases, Botox, anti-depressants and anti-seizure medications may be prescribed. “All preventive strategies are usually used in conjunction with an abortive medication at the onset for acute attacks, as it is unrealistic to expect complete suppression,” Dr. Peterson notes.

When Is It Wise to See a Doctor About Migraines?

“As a physician, I am continually astonished by the patients I see who have suffered for years before deciding to see someone about their headaches,” laments Dr. Peterson. “We now know that allowing migraines to occur without suppression encourages the brain to create more and more of them until, without intervention, a chronic problem can occur.” If you realize that you are having an increasing number of headaches and that over-the-counter medications are losing their effectiveness, Dr. Peterson strongly encourages you to do yourself a favor and see a doctor.

Can Migraine-Like Symptoms Actually Indicate Something More Serious?

Dr. Peterson offers the following examples of when something that seems like a migraine at first glance could be caused by another serious health condition:

  • If fever or weight loss is part of your symptoms, it is important to see a doctor. These are not normally associated with migraines and mean something else is going on.
  • If you have neurological symptoms, like those experienced during auras, but they last longer than an hour or so, that is a problem that requires medical evaluation as it could be a stroke.
  • If you have migraine-like headaches, but they have come on later in life (50 or older), you should be evaluated by a physician. Migraines usually start during adolescence.
  • If you have the sudden onset of a severe headache, or if you have a headache that comes on with exercise or sexual activity, these are things that indicate the need for evaluation as they could indicate other health issues.

The Importance of Caring for Yourself

It is crucial for family caregivers to look after their own health, whether migraines are a concern or not. Do your best to avoid triggers, count the frequency and severity of your headache days, and maintain an open dialogue with your doctor about the effectiveness of your treatment methods. Be sure to have some sort of back-up care plan in place for your loved one, too, in case you experience an attack.

Carol Bradley Bursack

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Over the span of two decades, author, columnist, consultant and speaker Carol Bradley Bursack cared for a neighbor and six elderly family members. Her experiences inspired her to pen, "Minding Our Elders: Caregivers Share Their Personal Stories," a portable support group book for caregivers.

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This is a great article. Although constant migraines can hinder you from leading a good life, I found that soothing music can frequently help it subside.
That's part of the reason our company uses a music program for people with mental illnesses as well as dementia. Music a very powerful tool to combat many ailments.
Please be careful about migraines I had migraines that started in my mid 20s and became so severe as I aged they would put me down for a week after shots for migraines and not helping me at age 45 I couldn't maintain anymore. I started having TIAS and mild heart attacks when a cardiologist told me they may be associated with a hole in heart. Sure enough after testing me i had a hole in top atrium wall which nearly killed
Me. For the women, when they say we are missed diagnosed for heart trouble it is true
Food can definitely be a trigger. Anything with aspartame gives me a migraine. There are quite a few "foods"known to trigger migraines.
I sometimes still get a migraine but I haven't had to take my migraine meds in weeks.