A drill in your head

I was very surprised today to learn that some people still believe that migraines are just like normal headaches. That they think that they're just very bad headaches, and you'll be grand if you take some painkillers and stop being such a wimp. "It's only a headache", after all, and lots of people get headaches and don't complain.

This makes me quite annoyed.

Let's get one thing clear: migraines are not headaches. That's like saying that someone with the 'flu just has a high temperature; it equates a symptom with the entire sickness. So someone suffering from a migraine attack will have a headache - but that's not the sum total of it, not by a long shot.

If you only get bad headaches that can be cured by over-the-counter medication like paracetamol, you do not get migraines. A bad headache and a migraine are not the same thing.

The cause of migraines hasn't been nailed down yet by scientists, although they have some strong theories. Check out the wikipedia page for a basic description. From the point of view of the sufferers, though, only one thing really stands out - although there are lots of similarities, there is an incredible variety in the range and degree of symptoms. Some people get nausea. Some see spots, or lights, or lines, or go temporarily blind. Some have motor problems, like shaking or tremors. Some have none of these, but instead get severe photophobia. The only symptom that always shows up is the headache.

Migraines are not random as well, although they may seem to be. They are caused by environmental factors, like foods, smells, weather, hormones, even sounds. Again, while there are similarities between sufferers, there's still a huge variety of triggers and none are universally consistent. Excessive light, stress, heat, lack of sleep - anything can be a trigger, and I know some people never learn what theirs are and essentially their attacks appear to be random.

Treatment is just as varied, unfortunately. Without a solid idea of what causes them, and with the variety in symptoms and triggers, treating them seems to be very hit and miss. A drug that works for one person may not work for another, and could make yet another even more sick. Meditation, certain diets, acupressure, and more all have mixed effects. Straightforward painkillers that you can buy anywhere tend not to work, or only have a very weak effect.

Diagnosing and treating a person with migraines is not easy, and plenty of sufferers have talked about dealing with doctors and nurses who don't believe that they are really, truly sick and in need of help. They're fobbed off with painkillers that won't work, or told that it's all in their head or something. It's truly shocking stuff, and it shows that the attitudes regarding migraines are not easily shifted. Hopefully, with the aid of the Internet, that will change for the better.

My own experience of migraines has been... painful, at times. I was diagnosed with the so-called 'common' migraines - those where you don't see spots or lines, also known as 'migraine without aura' - when I was about twelve. I can have several in the space of a month or so, and then none at all for another six months. I've long since learned that people frequently don't understand what's happening to me when I get an attack, and my worst fear is that something will happen to me during one where I'm not coherent enough to explain.

My symptoms begin from one hour to several hours before the headache sets in. I develop the awareness that I am in the initial stage, first of all. I experience increasing nausea, and pain in the right side of my head. I lose focus and clarity, and talking becomes difficult. As the attack progresses, I develop photophobia and feel alternatively hot and cold. I get dizzy. My muscles spasm and twitch; I become very weak, and moving normally takes great effort.

At the apex of the attack, the pain is... not like pain at all. It can't be described. You can say that it hurts, that it feels like a knife, but that's a pale shadow of the reality of it. It's focused into your head, it spreads in waves over your body and makes every breath agonising and blots out all thought, all memory, and you would give anything, ANYTHING, to make it stop just for a second... I can't speak. Forming words, and making those words come out of my mouth takes more effort than I can muster. I shake, randomly and uncontrollably, and I barely have the strength to stand up. It goes on for hours, and somehow I fall asleep.

I wake up the next day - and it's always the next day, if the attack is severe - and I'm exhausted, sore. My head still aches a little, my stomach still isn't right. I'll try to eat something but my appetite is gone, and I won't really feel well again until tomorrow.

I found my magic bullet a few years ago, after spending a long time overdosing on paracetamol to try to stop the pain. In Ireland, you can buy Nurofen Plus over the counter - it's a mix of ibuprophen and, more importantly, codeine. All I know or care about is that it cuts off a migraine no matter what stage of it I'm in; it can shut down the pain and the more severe neurological symptoms in less than an hour. I turn into a virtual zombie, because it makes me numb to everything - but I can still walk and talk and just about function normally. It's a small price to pay.

If you've never had a migraine, you can't comprehend what it's like. This is what they call 'a bad headache', what they claim is all in your head. This misinformation has to stop.