What’s a Real Migraine?Last Updated:
I’m tired and cranky today thanks to an early morning wake-up call from a cluster headache attack. So today’s post is a bit of a rant about one of my migraine pet peeves. It gets old having to explain this over and over. In the future when people say that so-and-so doesn’t really have migraine, I can just give them this URL.
As we have discussed before, migraine (like all headache disorders) is best diagnosed using the International Classification of Headache Disorders. This classification divides headache disorders into two groups: primary and secondary. Secondary headache disorders are those with a scientifically-known cause. For example, if you hit your head in an accident you’re likely to have a concussion that causes a nasty headache. Likewise, an infection, like menningitis, can also cause terrible headache pain. Once the brain heals, the headache goes away. Primary headache disorders are those without a known cause. People may think they know the cause (bad food, strong smells, etc.) but those are merely triggers that set off the attacks. The cause for WHY these triggers set off headache pain for some people and not others remains a mystery.
Primary headache disorders are categorized as
2. Tension-type headaches
3. Trigeminal Autonomic Cephalagias
Migraine types are further categorized as
1. Migraine without Aura
2. Migraine with Aura
3. Migraine with Brainstem Aura
4. Hemiplegic Migraine
5. Retinal Migraine
6. Chronic Migraine
As you can see, it’s not so simple to just say “I have migraine.”
All of these diagnoses share similar symptom profiles, yet each has unique characteristics that separate them from each other. Even if two people share the exact same diagnosis, their treatment may be vastly different. Frequency, duration, severity, comorbid conditions, and responsiveness to treatment all play a role in how migraine is treated. Even in patients with chronic migraine, symptoms vary greatly.
Patients with mild symptoms frequently cannot understand why everyone does not respond to OTC medicines, caffeine, or simple avoidance measures. They are skeptical of patients with more severe forms of migraine. In return, those with more debilitating symptoms have a tendency to dismiss those with milder symptoms by accusing them of “not really having migraine”.
Stop it. Just, STOP IT.
Migraine occurs on a spectrum and none of us land on exactly the same spot. We’re all just trying to do the best we can to muddle through our lives, not letting migraine get the best of us too often. We can learn so much from each other if only we will stop trying to beat each other at this imaginary game. We would do well to listen to each other’s experiences without putting up that defensive wall. How are we ever going to convince healthy people to take us seriously when we waste our time tearing each other down.
I have migraine.
You have migraine.
We all have migraine.
Whether you use Coke and aspirin, Excedrin, Aleve, Advil, Imitrex, Zomig, Relpax, Axert, Maxalt, Amerge, Frova, Treximet, Toradol, Ketamine, DHE, Fioricet, Cefaly, SpringTMS, or WHATEVER…I don’t care. If you and your doctor have decided on a course of treatment that is working for you, that’s great. If not, well maybe I can help you find a doctor who can help. Either way, none of us has any business accusing the other of not really having migraine.
This is getting ridiculous people. Please stop playing the “Migraine Olympics.” There is no prize for who has the worst pain or who can “suck it up” better.
This article is part of the July 2016 Ultimate Blog Challenge