6 things people misunderstand about migraine attacks

Someone sitting on couch, seen from behind, clutching their hair with left hand.
Migraine attacks aren't the same thing as simple headaches, say experts. (Photo: Getty Images)

Although migraine is quite common — affecting about 12 percent of the U.S. population — the neurological disease is often misdiagnosed and misunderstood, with people sometimes lumping headaches and migraine attacks together or underestimating how debilitating migraine can actually be.

According to the American Migraine Foundation, historically, migraine has been “overlooked as one of the most disabling diseases on the planet.”

While they are three times more common in women than men and tend to run in families, migraines can affect anyone, including children. Understanding what triggers them and the best ways to treat them can make all of the difference.

Here, experts talk about what people often misunderstand about migraines.

1. Migraine attacks aren't the same thing as a headache

Migraine attacks are not just a simple headache, experts say. “Migraines are far more complex,” Lauren Green, neurologist with Keck Medicine of USC, tells Yahoo Life.

Dr. Kiran Rajneesh, a neurologist who specializes in headaches, migraine and pain medicine in the department of neurology at Ohio State University's Wexner Medical Center, tells Yahoo Life that migraine can be “debilitating” and is caused by “electrochemical imbalances” in the brain.

“They are associated with nausea, light and sound sensitivity, and a multitude of other associated symptoms,” says Green. She adds: “Oftentimes non-migraine sufferers do not realize just how debilitating a migraine left untreated can be. The pain can be significant and the associated symptoms horrendous, leaving someone incapable of performing their normal daily functions.”

2. Not all migraine attacks are the same

Migraine symptoms aren’t universal and can vary from person to person. “One person might have a migraine with an aura that includes flashing lights or zigzagging lines, while another person may not experience this,” notes Green. “Some people have significant nausea, while others are bothered more by light sensitivity or dizziness. The way a migraine presents is very different between people, the same way the treatment plan is very individualized.”

Rajneesh explains that the electrochemical imbalance that leads to a migraine attack can start in different parts of the brain. “Depending on where it starts, your symptoms might be different,” he says. However, Rajneesh notes that most of the time the imbalance happens in the occipital lobe, located at the back of the brain and containing the visual cortex, which helps people interpret what they see. This also helps explain why some migraine sufferers see auras, which occur in the occipital lobe and can appear as “spots, zig zags [and] flashes.”

Dr. Niushen Zhang, clinical assistant professor in the department of neurology and neurological sciences at Stanford Medicine, also points out that there are many classifications of migraine. "For example, the frequency of migraine attacks determines if a person has episodic or chronic migraine," Zhang tells Yahoo Life. "People with episodic migraine have less than 15 headache days/month. Chronic migraine is when someone has greater than 15 headache days/month, with [more than] 8 of those days being moderate to severe with associated migraine symptoms, for greater than 3 months."

3. Food isn’t the No. 1 cause of migraine attacks

Although certain foods and alcohol, such as red wine, chocolate and cheese, are well known for bringing on migraine attacks in some people, the No. 1 cause of migraines is actually stress. “That’s such a big, big trigger,” says Rajneesh. According to the American Migraine Foundation, stress is a trigger for nearly 70 percent of people who suffer from the neurological disease.

Keeping stress in check by practicing stress management techniques — particularly mindfulness meditation, which involves calm-inducing breathing methods or guided imagery to relax the body and mind, according to the Mayo Clinic — can help. Prioritizing sleep and regular exercise, including yoga, also helps with stress management, notes Rajneesh.

4. Over-the-counter pain relievers don’t always help with the pain

If you’ve ever had a painful migraine attack and over-the-counter pain medication didn’t help, you’re not alone. While some migraine sufferers respond to over-the-counter medications such as acetaminophen with caffeine, “many others do require prescription medications to either prevent the migraines from occurring or treat the migraine acutely,” says Green.

When patients don’t respond to over-the-counter pain relievers, Green points out, there are “many” different prescription options available — including triptans — to treat the pain, which you can ask your doctor or a neurologist about. "Every patient is unique in terms of what type of medication is effective for them," says Zhang. "It is helpful for patients to talk with their doctors about what is right for them."

5. Timing your pain medication matters more than you might think

When it comes to treating migraine attacks, getting the timing right matters. When you feel the first hints of a migraine attack coming on, experts say, it’s important to take medication right away. “Migraine medication should be taken immediately at the onset of the migraine,” says Green. “If it is not taken in that way, the migraine will continue to build and the medication is less effective.”

6. Pain medications aren’t the only way to treat migraine attacks

Migraine medications are only one part of a treatment plan. As Rajneesh puts it: “Addressing lifestyle modifications are as important as being put on prescription medication” for migraine attacks.

These lifestyle modifications include figuring out what your personal migraine triggers are — which can include stress, certain foods, odors such as perfume and even weather changes — and avoiding them or minimizing exposure to them whenever possible. But Rajneesh says it’s just as important to eat a healthy, balanced diet — “not just avoiding triggers” — and to prioritize sleep. That’s because research shows sleep deprivation can increase the severity and frequency of migraine attacks.

So while medication can certainly be a lifesaver for migraine sufferers, Rajneesh says: “I can’t overstress the importance of lifestyle modifications.”

Zhang agrees, saying that "the foundation" of migraine management is lifestyle modifications. "Creating a regular, predictable daily schedule for eating, sleeping and aerobic exercise can be very helpful for decreasing migraine frequency and severity," she says.

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