Anyone who’s ever had a migraine – and you can include me in that – can understand the misery it brings. Yet migraine sufferers are often branded as ‘neurotic’ and made to feel guilty about their ‘weakness’. This is completely unfair, as studies have shown that there is no typical ‘migraine personality’. Migraine affects as many as one in ten people (mainly women) of any race, occupation, class or age, including children. More than half will have a relative -often their mother – with the same problem.
Frequency of attacks varies greatly, from only once or twice a year to several times a week. Severity and type of symptoms differ widely, too. A sufferer may find that he or she has a mild attack at one time and then a severe one next time. The severity is usually related to extra tension and strain and it is really very important to remain as calm as possible.
So what makes a migraine more than ‘just a headache? The pain is usually one sided, and in the ‘common’ type, there are other symptoms such as loss of appetite, nausea or vomiting. A few sufferers will have the ‘classic’ type of migraine, preceded, 20-30 minutes before the headache itself, by warning symptoms – called an aura – which may include flashing lights before the eyes, shimmering or double vision, slurred speech, numbness and giddiness. These symptoms are probably due to a sudden constriction in some of the blood vessels in the brain.
The headache comes on as these vessels then expand and the blood surges through, leading to the characteristic throbbing headache. Many experts believe that this constriction and dilation of the blood vessels is brought about by changing levels of certain chemicals circulating in the body, such as adrenaline – also released during stress – and prostaglandins. Adrenaline tenses the muscles, the heart and its blood vessels to prepare us for ‘fight or flight’. Prostaglandins sensitise the nerve endings to make us more alert. In susceptible people, they will ‘overdo’ it and cause the above symptoms. Studies also suggest that there may be a slight difference – perhaps inherited – in the biochemical make-up of migraine sufferers which makes them more susceptible.
The trigger for an attack can be emotional or physical and common ones include anxiety, excitement, depression, changes in weather or routine, bending for long periods (such as when gardening), hot baths, loud noises, flashing or bright light, including that from a VDU screen. Glare filters are now available which many people find helpful. Alcohol, especially red wine, is one of the worst culprits, and certain foods, for example chocolate, cheese, fried foods, citrus fruit, onions, tea, coffee, wheat flour, pork and seafood, are other common triggers.
Irregular meals, dieting or a long lie-in can provoke a migraine, probably because of the drop in the body’s blood sugar. Then a few biscuits or a sweet drink may be enough to stave off a full attack. It’s extremely important to make sure you always eat properly and pay attention to your diet. If you think you’ll have to go a long time without a proper meal, keep an emergency ration of a small snack of some sort with you.
Hormones can also play a part as far as women are concerned – some only have a migraine around the time of their menstrual period or if they are taking the contraceptive pill. Many find their migraines improve, or stop altogether, after the menopause.
To help you and your doctor pinpoint your special triggers, try to keep a diary, noting the day and time of your attacks, everything you eat and drink, meal times, daily activities, particular worries and, for women, the dates of your periods. If you think you are suffering from migraine or experience a migraine attack for the first time, consult your doctor for a proper diagnosis and advice on treatment. This will also reassure you that your migraines are not due to a tumour or to high blood pressure – two very common and usually quite unfounded fears.
Treatment will depend on the frequency of attacks and the apparent causes. Simply adjusting your habits may help considerably. Any medicines should be taken at the first sign of an attack, so always keep them handy. It usually helps to rest quietly in a darkened room in the early stages. During a migraine attack, the action of the gut slows down and painkillers may not be well absorbed. Some of the medicines available from your doctor speed up absorption as well as relieving the nausea and pain. Other drugs act by constricting the dilated blood vessels, but follow the instructions precisely as overuse can actually bring on a headache similar to migraine.
If migraine attacks are very frequent, your doctor may prescribe long-term preventive treatment, such as one of the drugs often used to control high blood pressure. Over the counter, you can buy painkillers . Remember that migraine is different from other types of headache in that it’s often accompanied or preceded by other symptoms already mentioned.
Anti-inflammatory medicines like aspirin and ibuprofen can prevent the release of prostaglandins and so are recommended for migraine – although paracetamol can help ease the pain of a headache, too. There are also tablets available over the counter which are especially designed to relieve a migraine headache. These can contain analgesics combined with buclizine hydrochloride or cyclizine hydrochloride – antihistamines to prevent vomiting and reduce nausea. Sufferers usually work out which treatment suits them best.
If stress or anxiety seems to be the underlying cause of your migraines, relaxation exercises or hypnotherapy may be helpful. And trying ‘alternative’ treatments like acupuncture is something I would recommend to anyone who has found no joy through traditional methods of coping with migraine.
You could not be blamed for wondering why acupuncture seems to have such a surprising success rate for so many completely different ailments and diseases. The reason is that it’s not just some ancient superstition that’s now available as a last resort. It works by triggering the brain to secrete its own chemicals, which function rather like natural painkillers or tranquillisers, so providing relief for sufferers.
Period-time migraines often respond to treatment with the hormone progesterone. Recent research has shown that a daily dose of a humble plant called feverfew (it looks like a miniature chrysanthemum and is now sold by many nursery gardens – the botanical name for the variety of feverfew you need is Tanacetum partheniutn) helps many people to control their migraine. Two or three leaves can be eaten in a sandwich sweetened with a little honey, and feverfew capsules and tablets are available from some chemists and health-food shops.
Hom-Bidor 1% Tablets, Migraclear, Migraleve Homoeopathic Remedies
Kali. Bich., Nat. Mur., Silicea
Herbal Labs Feverfew 125, Golden Health Feverfew (English Grains)