We all have days where we feel our head is so painful especially after stressful events or not enough rest or sleep. Headaches in some people can be very distressing to the extent of being unable to perform daily life activities or need to take leaves from school or the workplace. You should ask a doctor if you feel pain to your head or headaches that are not resolved with medications or home remedies. One of the common kinds of headaches that badly affect a person is chronic migraines.
Migraines are neurological diseases that involve nerve pathways and chemicals. Migraine is often described as a severe headache. Migraine is found to be the 3rd highest cause worldwide of years lived with disability. The changes in the brain activity affect the blood in the brain and its surrounding tissue. This alone causes ranges of symptoms such as nausea, dizziness, extreme fatigue and increased sensitivity to light, sound or smells. Headaches itself is the main symptom of migraines.
A migraine episode may occur in 4 different phases, even not everyone may experience these phases. This includes:
- Prodrome phase- Also known as pre headache phase. Painless symptoms that occur hours or days before migraine occur. This includes mood swings, food cravings and neck stiffness.
- Aura phase- Auras refers to sensory sensitivity that occurs before or during migraine. Aura typically affects a person’s vision, touch or speech. Examples of auras include blurred vision, numbness in the arm and slurred speech. About a third of those with migraine experience this phase. This phase usually lasts for 5 minutes but may last up to hours or more.
- Headache phase- Headache that is painful, ranging from mild to severe. Physical activity and exposure to light, sound or smell may worsen the pain. This may last for hours or even days.
- Postdrome phase- The pain subside and the patient may feel unwell. Some even say it is a migraine hangover as it feels similar to a hangover from alcoholic binge.
In most cases, people have migraine attacks once or twice a month. However, some people may have more migraine episodes more often. Migraines that occur more than 15 days a month for at least 3 months are considered chronic migraine. Chronic migraines are so frequent and severe that it poses a challenge to have a normal life.
Chronic migraine affects approximately 2 percent of the world population. Chronic migraine is estimated to be developed by 2 out of 100 people with episodic migraine (migraine that occurs fewer than 15 days per month). There are a number of medical conditions that can increase the tendencies to have migraines. This includes mood disorders such as depression and anxiety, obesity, chronic pain conditions such as fibromyalgia, asthma, sleep apnoea and postural orthostatic tachycardia syndrome (PoTS). Every person with migraine has different triggers but common ones include lack of sleep, caffeine and stress.
If you think you might have chronic migraine, it is important to speak to a healthcare provider. Diagnosis is usually made based on headache days. It is best for patients to keep track of the headache days as this can be great information for doctors in planning treatment. This means to include all kinds of headaches and does not necessarily count the severe ones only. Please avoid discounting the days that you think are not considered bad even when you already have the headaches despite being mild.
Since chronic migraine is definitely a great disability, knowing how to recover from it can greatly improve a person’s quality of life. You may take medications such as painkillers to overcome the pain. However, it is important to limit its use to avoid overuse of medication. There are effective migraine treatments available such as a class of drugs known as triptans. Most common triptans available are sumatriptan. While medications belonging to triptans can help alleviate the symptoms, there are drugs that are able to prevent migraines such as antidepressants, beta-blockers, antiepileptic and Botox.
Beside medication to overcome chronic migraine, there are things you can do on your own to further alleviate symptoms. Since migraine is known to be involving sights, smells or situations that could have triggered the headaches, it is best for you to avoid these. Keeping a headache diary can help identify triggers as triggers can be in many forms in daily environments such as loud noises, bright lights, strong scents, hunger, fatigue and food containing chocolate, aged cheese or MSG.
Apart from dealing with the physical pain that arises from chronic migraines, it is best for patients to also know how to deal with the emotional burden that comes along with it. Emotional distress can be cope with therapy such as cognitive behavioural therapy and biofeedback. Emotional distress is often the result of the feeling of helplessness and hopelessness when unable to find effective ways to manage chronic migraines. It is best to see a psychiatrist or psychologist that can help you address the emotional burden.
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