Understanding the impact of migraines
Updated: Apr 28, 2020
Here’s a story….
Jane has had headaches for as long as she can remember. As a kid, she remembers sitting in the school office quite a few times waiting for her mom to pick her up because her head hurt, and she felt sick to her stomach. Her parents discussed this with their family doctor at the time and she had some tests done - they were all normal and nothing else was said about it.
By the time she was in university, she was having headaches a few times each week and would often have to go to bed because of them. She noticed that they were worse around exam time and she always had neck and shoulder pain. She discussed these with her new doctor and was told they were probably tension headaches and to drink lots of water.
We’ll come back to Jane later, but her story is one that I hear all the time.
Is a migraine just a type of headache?
No. It’s not simply a “headache.” A migraine is a disabling neurologic disorder. It has a huge impact on the quality of life and function of individuals.
Migraines are ranked as the second most disabling condition worldwide by The Global Burden of Disease report in 2016. Aside from the physical pain – which is enough of a burden – there is the anxiety of anticipating an attack, strain on family relationships, decrease in quality of life, financial implications in missing work...and the list goes on. The worst part is that they are completely invisible and almost impossible to describe to someone who has never experienced a migraine.
Who is affected by migraine?
A huge number of people! Almost 15% of the global population suffers from migraines – which is roughly 1 in 7 people (WHO, 2014).
Women. Migraines are primarily a women’s health issue. Migraines affect 3 times more women than men. They have the biggest impact on people aged 35 to 45 years old. Think of the things that are going on in our lives at that age - completing higher education, reaching career peaks, having families, developing relationships. All these things are affected by migraines. Of note, anxiety and depression are also more common in migraineurs, and not surprisingly, in women.
If it’s not apparent – I have a strong interest in women’s health. I also know what it’s like to juggle a family, a career, and the self care needed to manage my migraines. This isn’t meant to be a tale of despair. In fact, I think there is SO much that can be done.
It starts with education directed at both migraineurs and healthcare providers. I had very little time in my clinical education dedicated to managing headaches. As healthcare providers we like to know that we rule out any serious causes for a headache and after that we tend to be less worried. Although there is a room for improvement in diagnosing and managing headaches, migraine sufferers need to be armed with knowledge to understand your own headache patterns.
Migraineurs are self-educating more about their conditions. I have patients who come to appointments with questions about specific treatments and are looking for evidence-based information on lifestyle strategies. Managing migraines is a long-term partnership between the healthcare provider and patient. We need things from each to reach the best plan and it can be an evolving process.
This is an exciting time in the world of migraines because of improved understanding of the biological processes and new breakthroughs in treatments – with more on the way. Circling back to Jane….
Jane wasn’t a patient of mine. This is my own migraine story. Like many migraineurs I have missed important events, days of work, and quality time with loved ones because of my migraines. It wasn’t until I became a nurse that I realized that my lifelong “headaches” were in fact migraines.
The more recent chapter of my migraine story is that I’ve been able to arm myself with a number of strategies that help to both reduce the frequency and severity of my attacks. I’ve learned to identify my own triggers and I have a good treatment strategy. Like many women with migraines, I had a compete reprieve from my headaches during my pregnancies and while breastfeeding. (I’ll talk more about pregnancy and migraines in a future post!). But these migraines are a part of my reality and are interwoven into my life’s narrative.
My 8 year old daughter also has migraines. Although I like to think she has inherited some of my better qualities, I’m likely the genetic culprit of these migraines. Unlike my very delayed diagnosis, we speak about what migraines mean. She can describe the severity, she knows some triggers, and she is learning techniques to help ease the pain. Being armed with the tools and knowledge to live with this condition makes it less likely that it will take centre stage in your life.
If you have headaches, know someone with headaches, or provide care to someone with headaches then I hope you will come back to see some of my upcoming posts.
World Health Organization, 2014 https://www.who.int/news-room/q-a-detail/how-common-are-headaches
GBD 2016 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390(10100):1211-1259. doi: 10.1016/S0140-6736(17)32154-2.