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- Herausgeber: John Wiley & Sons
- Sprache: Englisch
Listen up and lock down today's best migraine pain solutions
Haven't you spent enough time juggling schedules and cancelling events when headache pain sidelined you? You can put those days behind you with up-to-date information on the when-why-how of migraines and a whole-of-body approach to micromanaging them. Migraines For Dummies supplies the answers you've been looking for in the form of straightforward explanations and reliable advice to help you tackle symptoms, avoid triggers, and find the best medical support. You'll explore new drug therapies, including prescription meds, over-the-counter drugs, nerve stimulators, and alternative remedies. Plus, learn how to reduce migraine frequency by tweaking diet, sleep, and exercise. Updated with the latest research, this Dummies guide shows you how to balance medical care and lifestyle adjustments to fix that aching head of yours and upgrade your quality of life once and for all.
- Resolve migraine pain with new neuromodulation devices that trick your brain
- Identify foods and lifestyle habits that trigger your migraines
- Discover great ways to manage migraines in early, middle, and elder years
- Find out how to avoid the mistake of doubling down on medications
Millions suffer from migraines. That's why it's key to stay on top of developments in diagnosis and treatment. If you or someone you love wrestles with headaches on a regular basis, let Migraines For Dummies deliver topnotch ideas that will change your life forever.
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Veröffentlichungsjahr: 2025
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Migraines For Dummies®
To view this book's Cheat Sheet, simply go to www.dummies.com and search for “Migraines For Dummies Cheat Sheet” in the Search box.
Table of Contents
Cover
Table of Contents
Title Page
Copyright
Introduction
About This Book
Foolish Assumptions
Icons Used in This Book
Beyond the Book
Where to Go from Here
Part 1: Getting Started with Migraines
Chapter 1: Understanding Migraines
Knowing What Migraines Are — and What They Aren’t
Identifying the Common Types of Headaches
Understanding Why Headaches Hurt
Personalizing Your Treatment
Handling Family and Work Issues
Chapter 2: Navigating Your Migraine Symptoms
Looking at the Big Three Symptoms: Auras, Sensory, and Stomach Issues
Encountering Other Migraine Symptoms
Using Quick Fixes
Chapter 3: Identifying Your Migraine Triggers
Journaling the When, Where, and How of Your Headaches
Understanding Inherited Migraines
Cleaning Up Your Environment
Spotting the Villains in Your Diet
Identifying Exercises That Make Your Head Hurt
Keying in on Other Migraine Triggers
Deactivating Your Most Problematic Triggers
Part 2: Seeking a Proper Diagnosis
Chapter 4: Distinguishing a Migraine from Other Headaches
Sorting Headache Types
Getting a Grip on What Goes on with Migraine
Identifying Variations on the Migraine Theme
Growing Your Awareness of Medication-Overuse Headaches
Debunking Common Migraine Myths
Chapter 5: Turning to Your Doctor for Help
Asking for Answers
Figuring Out Whether Your Primary Care Doctor Is Up to Speed on Migraines
Turning to a Headache Specialist
Preparing to Meet with Your Headache Doc
Chapter 6: Having Your Head Examined and Developing a Treatment Plan
Huddling with Your Doctor
Testing for Clues to Why Your Head Hurts
Devising a Game Plan to Ratchet Down Pain
Part 3: Eradicating Your Migraine Pain
Chapter 7: Getting Relief without a Prescription
Counting on Over-the-Counter Medications
Avoiding the Side Effects of Taking Too Many Over-the-Counter Drugs
Exploring Supplements and Vitamins
Chapter 8: Tackling Pain with Prescription Drugs and More
Looking for Relief in All the Right Places
Fighting Back: Abortive or Acute Medications for Migraines Already Under Way
Stopping Migraines Before They Start: Preventive Meds
Trying Other Possible Treatments
Choosing a Delivery Method
Calling on Superhero Medications
Quelling Nausea
Chapter 9: Checking Out Alternative Remedies
Sampling Neuromodulation Devices
Getting Relief through Mind-Body Methods
Experimenting with Behavioral Headache Bashers
Examining Alternative Physical Treatments
Micromanaging Your Treatment Program
Part 4: Committing to Lifestyle Changes
Chapter 10: Acknowledging the Power of Dietary Triggers
Identifying Migraine-Inducing Parts of Your Diet
Pulling the Plug on Migraine Foods
Chapter 11: Exercising without Triggering a Migraine
Loosening Migraine’s Grip with Movement
Avoiding Exercise That Spawns Your Migraine Attacks
Chapter 12: Eyeing Environmental Enemies
Investigating Your Environment
Kicking Troublemakers Out of Your Home
Finding Everyday Experiences Painful
Checking Your Surroundings
Preparing a Safe Space
Chapter 13: Fixing Disordered Sleep
Waking Up to Sleep Issues
Defining and Treating Sleep Disorders
Improving Your Sleep by Changing Your Behavior
Part 5: Sharing Your Migraine Truth
Chapter 14: Living the Good Life as a Migraineur
Handling the Migraine Blues
Feeling the Freedom of Ditching Pain
Weighing the Risks and Rewards of Going Out Versus Staying In
Socializing Smartly
Responding When People Don’t Believe You Have Migraines
Chapter 15: Keeping a Cool (Migraine) Head at Work
Minimizing Migraine in Your Workplace
Coping with Attitude and Agony
Staying Positive While Fighting Migraines
Working through Periods of Disability
Part 6: Brainstorming Special-Situation Migraines
Chapter 16: Spotting Dangerous Headaches
Responding Fast to First-Ever and Worst-Ever Headaches
Treating Thunderclap Headaches
Chapter 17: Understanding Hormone-Linked Migraines
Understanding Why Migraines Plague Women
Combating Menstrual Migraines
Spelling Relief or Trouble: Oral Contraceptives and Migraines
Tackling Migraines While You’re Pregnant and After Childbirth
Ditching Migraines in Menopause
Chapter 18: Helping Little Ones Conquer Big Headaches
Recognizing the Signs
Disarming Triggers
Treating Kids’ Headaches
Keeping It Real While Staying Positive
Chapter 19: Coping with Sex Headaches
Examining Sex-Related Headaches
Having a Candid Chat with Your Doctor
Managing Headaches without Giving Up Sex
Chapter 20: Dismantling Stress-Related Migraine Attacks
Mastering Techniques for Calming Your Mind
Rearranging Priorities to Scuttle Stressors
Chapter 21: Mastering Migraines as You Age
Experiencing Less Migraine Pain as You Age
Heeding Wisdom on Migraines
Seeing Your Doctor for Help
Understanding Secondary Headaches That May Come with Aging
Monitoring Eye Issues and Atypical Head Pain
Part 7: The Part of Tens
Chapter 22: Ten Things You Can Do for the Migraineur You Love
Treat Their Pain Like It’s an Existential Crisis
Stay Cheerful
Crank Up Your Compassion
Don’t Cajole Them into Activity
Serve as a Social Secretary
Take Charge of the Kids
Handle Work-Related Phone Calls
Call for Help When Headaches Escalate
Deliver Special Tea or a Smoothie
Downplay AI Advice
Chapter 23: Ten Ways NOT to Treat a Migraine
Go Off Your Program
Double Up on Migraine Meds
Believe Crazy Claims
Keep Taking a Drug That Isn’t Working
Gut It Out So That You Can Go Out
Stuff Yourself with Tons of Food
Try a Sun-and-Fun Remedy
Doctor-Hop
Foster a “Sick-Person” Reputation
End Up As an Emergency Room Frequent Flyer
Index
About the Authors
Connect with Dummies
End User License Agreement
List of Tables
Chapter 4
TABLE 4-1 Migraine Myths and Realities
Chapter 10
TABLE 10-1 Ingestible Potential Migraine Triggers
List of Illustrations
Chapter 3
FIGURE 3-1: Your headache journal can help your doctor treat your migraines.
FIGURE 3-2: Caffeine, red wine, over-the-counter medications, and birth control...
Chapter 4
FIGURE 4-1: Charting the course of a migraine.
Chapter 16
FIGURE 16-1: Act F.A.S.T. if you see or experience signs of a stroke.
Chapter 18
FIGURE 18-1: Keeping a basin near a migraine-stricken child is a good idea.
Guide
Cover
Table of Contents
Title Page
Copyright
Begin Reading
Index
About the Authors
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Migraines For Dummies®, 2nd Edition
Published by: John Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030-5774, www.wiley.com
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Introduction
Amazing times for migraineurs! Although you may not be able to imagine using the word amazing in the context of migraines, this book brings you life-changing truths and upbeat ideas in an inviting format to enlighten you and the other 39 million Americans living with migraine today. Although no cure is available, people with migraine are experiencing a promising time of migraine management, with more targeted migraine medications as well as a deeper understanding of how to sidestep problems that cause headache pain and nausea. In short, your prospects for fewer missed workdays and an increased amount of “fun time” are within your reach simply because so many viable answers are at hand. Precise targeting of migraines makes an enormous difference, so it is well worth your time to zero in on the parts of living with migraines that have plagued you thus far. Finally, you can banish the shadowy downsides (pain and nausea) and revel in life’s abundance of sunny opportunities.
Indeed, being one of 39 million migraineurs elevates your ability to find the exact takeaways from this book that can benefit you tremendously, because there’s nothing like heightened awareness to make a person pay attention. Ideally, by the time you’ve accessed the information in this book that is the most relevant to your life, you’ll be well equipped to troubleshoot your migraines effectively and compartmentalize them into a small corner rather than a front-row position that dictates everyday choices. With the right strategies at hand, you’ll downsize the role of migraines, which puts you well on the road to a healthier, happier life — the kind you’ve often wished were yours.
In this book, we tell you about the many excellent advances in migraine treatment that include more effective medications and new delivery systems (nasal sprays, injections) that work better and have fewer side effects than older medications. Some new prescription drugs are designed specifically for migraine treatment and prevention, as opposed to medications used in the past that were created for other medical conditions. We also spotlight the cool new wearable neuromodulation devices that you can use to stimulate your nervous system and reduce migraine pain.
Along with having a knowledgeable migraine doctor to answer questions, you can be proactive by avoiding food triggers, staying hydrated, maintaining healthy sleep patterns, and avoiding everyday antagonists. We showcase an array of treatment ideas along with the latest and greatest medications for a reliable toolkit to handle migraine auras, pain, and nausea. You can stave off many migraine attacks by working with your body (not against it) and by your heightened awareness that your brain is unusually sensitive to stress, noise, smells, weather extremes — as well as the foods you designate as triggers. Truly, moving away from a migraine-anchored lifestyle is now a realistic goal — one that will allow you to feel and look every bit as effervescent as you are inside.
About This Book
You, a person with migraine or a supporter of one, need this book because it has easy-to-access information that you won’t find easily online or in other headache books. Serving as a handy reference book, Migraines For Dummies, 2nd Edition, is the most user-friendly how-to-feel-better book on the market today. Easy-access organization and practical hints make For Dummies books the go-to source they have been for decades, and Migraines For Dummies treats a tough topic with tender loving care because its authors know whereof they speak.
The following will help you make the most of this book:
This book is divided into parts that work as freestanding units, so you can skip around and zero in on the information you need immediately. No need to read the book chronologically because all segments are little treasures for the taking. Understanding
Chapter 15
doesn’t require building on knowledge from
Chapters 1
-
14
. So if, for example, you’re looking for information on children’s headaches, you can go straight to
Chapter 18
. If you’re experiencing new and different versions of head pain now that you’re 65, take a look at
Chapter 21
.
A must-read is the food-triggers section (
Chapter 10
), which recommends developing a personal list of “foods to avoid” by keeping a diary of foods and beverages that lead to head pain. For example, red wine or food with MSG may be taboo for you — or not. Food triggers are individual things, so no one list fits all. Even if your twin sister who has migraines isn’t bothered by any foods other than sharp cheddar cheese, you, another migraineur, have identified numerous foods and beverages that give you migraines.
Foolish Assumptions
Because you chose this book, we feel comfortable in making certain assumptions about you, as a reader. For instance, we think that you probably know more than most people about headaches, and you’ve probably sampled a number of remedies for head pain.
Also likely is that you haven’t found the dream solution for your migraines because you’re obviously “still shopping.” On that note, you may already have a firm migraine diagnosis — or maybe you’re still trying to figure out whether having your disorder confirmed would help you in any respect.
You may have struggled in the past with people’s minimizing of your migraines. In reality, some coworkers and relatives find it strange for a headache to affect you so dramatically. It’s also hard to live with the general attitude that your head pain is “fake news.”
In the work arena, you’ve struggled with whether taking off work with a painful headache is unwise, so you try to soldier through it and then worry about producing subpar work on those days.
Because headaches run in families, you may find yourself overcompensating when you have a migraine, especially if your own childhood was compromised by having a parent whose suffering affected you and your entire family: missed special occasions, concern for an “ill” dad or mom, and other issues.
In pain fighting, you’ve had mixed experiences, leaving you generally dissatisfied with the information you’ve read up to this point.
All these types of experiences put you in the perfect space for receiving new input that can improve your life and reduce the number of days that intractable pain sidelines you. We bring you reassurance, tips, and encouragement along with concrete information on all aspects of migraine management.
Icons Used in This Book
Throughout this book, icons in the margins highlight certain types of valuable information that call out for your attention. Here are the icons you’ll encounter and a brief description of each.
The Tip icon marks tips and shortcuts that you can use to make migraine management easier.
Remember icons flag information that you especially want to keep in mind. To siphon off the most important information in each chapter, just skim through these icons.
This icon signifies technical information that you may want to skip over, or you can use it to deepen your understanding of this ailment.
The Warning icon tells you to watch out! Importantly, it alerts you to urgent symptoms that should send you hurrying to a doctor or emergency room for evaluation.
Beyond the Book
In addition to the abundance of migraine information and guidance that we provide in this book, you get access to bonus help online at Dummies.com. Check out this book’s online Cheat Sheet by going to www.dummies.com and entering Migraines For Dummies Cheat Sheet in the Search box.
Where to Go from Here
This book doesn’t require you to read all the chapters in linear order; you can peruse it in any order you want. Good places to begin, however, are these:
Chapter 2
ushers you straight to the nitty-gritty information you need ASAP: coping with symptoms.
Chapter 3
is another good launchpad because it tells you how to identify what may be triggering your migraine attacks.
For detailed information about medications for treating migraines, go to
Chapter 8
, which deals with both prescription and nonprescription meds.
And, finally, if the psychological aspect of migraine management is a major concern for you, prioritize
Chapters 14
and
15
.
Part 1
Getting Started with Migraines
IN THIS PART …
Get familiar with all aspects of migraines.
Find out how to navigate your migraine symptoms and master them.
Identify migraine triggers that disrupt your super-sensitive system so that you can avoid those successfully.
Chapter 1
Understanding Migraines
IN THIS CHAPTER
Getting a take on migraines
Identifying common types of headaches
Understanding why your head hurts
Personalizing your treatment plan
Juggling family and work issues related to migraine
When you get past the initial shock of having migraines, a symptom becomes a vivid “notification” that it’s time to pull out your cache of weaponry. Whether your go-to answer is a prescription medication, a nerve-stimulating device, or a lifestyle alteration, you’ll know exactly how to smooth your way to a healthier place.
This book supplies the tools you need to banish pain and other symptoms. We share treatments from both medical knowledge and lived experiences. The takeaways apply to children, teens, Millennials, middle-aged people, and older adults, and we’re excited to share insights that will make your life infinitely better.
Granted, migraines are complex. Just when you think you’ve conquered the beast, triggers team up and deliver blockbuster pain that reminds you that migraine attacks are changing targets. Obviously, that variability makes self-care key, and the sooner you are diagnosed and develop a plan, the better. Then, when nature tosses your head a grenade, you can stage a powerful defense.
Migraine enlightenment is magically freeing. People with migraine love days that are headache free, and we’re here to hand you the golden ticket to subduing the dragon for the rest of your life. This chapter gets you started by providing an overview of common types of headaches and how to approach working with them.
Incidentally, you may have noticed our reference to “migraine” in place of “migraines.” Both the singular and plural are acceptable usage today, but you’ll impress your doctor by referring to having “migraine,” which is the version currently endorsed. Either way, the condition hurts — but we’re here with lots of help!
Knowing What Migraines Are — and What They Aren’t
A migraine is an intense, recurring headache, but each occurrence isn’t always debilitating, and it’s usually manageable. The trick to living with migraine is to pinpoint your migraine triggers and find medications and lifestyle changes that get you right back in the game. In short, you don’t have to suffer from FOMO (fear of missing out) if you stay well-informed.
What migraines are
A common myth states that any bad headache that is disabling and excruciating must be a migraine. But the truth is that although some migraine attacks are very severe, others are mild to moderate. Tension headaches, too, can be extremely painful, as can red-flag headaches caused by serious problems such as a hemorrhage (bleeding) in the brain.
Migraine symptoms are different in different people. The uniqueness of the symptoms, in fact, is one reason that some people with migraine end up living for years without effective medication because they don’t even know that their headaches are migraine related. Some experts estimate that many people with migraine would benefit from preventive medications that reduce severity and frequency, but only a small percentage take advantage of these prescription options.
For example, you may assume, based on what you’ve heard, that the headaches you get can’t be migraines because you don’t experience the symptoms you’ve heard from those old wives of “old wives’ tale” fame. The truth, however, is that migraines have a wide variety of symptoms, and not everyone has classic symptoms. Many people experience migraine symptoms for years before going to a doctor to be diagnosed, and that is unfortunate because so many solutions are available.
Although we go into more detail about migraine symptoms in later chapters, the symptoms of migraine include but are not limited to the following:
Throbbing or pulsating pain that is usually on one side of your head.
Pain that ranges from moderate to severe.
An aura that occurs prior to a migraine. An
aura
is typically a visual disturbance of zigzag lines or flashing lights, and it lasts from a few minutes to less than an hour. You may also experience numbness or tingling of the face and hands. Most people with migraine don’t experience auras, but those who do have a variety of visual symptoms, some of which are alarming, like temporary partial loss of vision in one eye.
Lethargy and malaise.
Nausea, vomiting, or both; sensitivity to light, smells, or sounds (or all those); lack of appetite.
The following are features that many people with migraine have in common:
You come from a family of people with migraine, who may include your parents, grandparents, and siblings.
Your headaches last from about four hours to three days.
Sleep usually helps you feel better.
Your headache frequency can be several times a week, once a month, or even less often than that. A day or two before your headache, you may experience any of the following: yawning, frequent urination, drowsiness, irritability, and euphoria. After a headache, you may feel like you have a pain hangover — you’re tired, you don’t feel hungry, and your thinking processes seem slower.
A migraine is essentially a headache and more. Because the normal functioning of your central nervous system is disrupted during a migraine, all body systems are affected. As a result, you may be bothered by sounds, smells, and lights. Your scalp may feel tender. Your feet and hands may be cold.
Symptoms of migraines vary in each individual, so don’t assume that your headaches aren’t migraines just because you lack auras or other classic symptoms. More people with migraine don’t have auras than do. You may have generalized head pain instead of the classic one-sided misery. Further, many people with migraine have never experienced visual disturbances, nausea, or vomiting. Tell your medical experts about your symptoms, and let them identify the kind of headaches you’re having and determine what can be done to wipe out the pain.
About 42 percent of people with migraine inherited a proclivity for it, according to the latest estimates. But you still can take charge of your nervous system by limiting your exposure to triggers. For example, factors that combine to affect your nervous system are certain foods, stress, disordered sleep, and lack of movement. Handle these factors properly, and you may reap the big win of fewer migraines. If migraine runs in your family, a predilection for migraine attacks is part of your genetic material, and you can’t run away from it. In all likelihood, migraine is due to combinations of multiple genes that cause a person to tend to have migraine attacks. (Chapter 3 has more on the genetics/migraine connection.)
What migraines aren’t
The other main types of headaches have symptoms that are different from those of migraine — but sometimes symptoms overlap, making diagnosis difficult. (See Chapter 4 for information on headaches that people often confuse with migraine.)
Some signs that your headache isn’t related to migraine:
You feel a tight band of discomfort around your head.
Your shoulder and neck muscles feel knotted.
You have headaches only after sex or physical exertion.
Your headaches are getting steadily worse.
Identifying the Common Types of Headaches
Consider the following indicators of these headache types:
Migraine:
The key symptoms are a throbbing head pain that’s typically one-sided, intensity that’s moderate to severe, and a lengthy duration (a migraine attack can last from a few hours up to several days). Activity may make you feel worse. You may have accompanying nausea and vomiting, and/or sensitivity to light and sound. If you suffer from migraines, you usually have headaches on a regular basis.
Tension-type headaches: A common headache in people who have migraine, depression, or both, this type of headache presents with a dull ache of mild to moderate pain. The pressure is on both sides of your head, and it comes on slowly.
If you feel pain on both sides of your head, or like a band around the head, including the forehead and back of your head — and if the pain feels more like tightness than it does a throbbing or pounding — you probably have a tension-type headache. You don’t have vomiting or auras with this kind of headache. Tension headaches can occur very frequently (even daily) and are sometimes very painful. Such a headache may last 30 minutes to a week. Triggers are disordered sleep, sunlight exposure, dehydration, alcohol consumption, stress, and long periods of gazing at a computer or cell phone.
Cluster headaches: This headache is characterized by sudden and severe piercing pain on one side of the head. These headaches come in clusters — appearing during several consecutive days, weeks, or months, and then disappearing, only to come back months or years later. Cluster headaches can come and go five or six times during a day. They’re usually short-lived, lasting from 15 minutes to two or three hours each time.
With a cluster headache, you may have a droopy-looking eyelid or sweating on the side that hurts, and you may find that moving around makes you feel better. Typically, cluster headaches aren’t accompanied by nausea or vomiting. Pain usually occurs behind or around one eye. The eye may tear up or become red, and the nostril on this same side may run or feel congested.
Medication-overuse headache: With a medication-overuse headache, many people with migraine experience a sinking fear that the pain will never go away. Piling on with too many pills is the cause of this kind of persistent migraine. A medication-overuse headache results from regularly overusing one or more drugs that you take for acute or symptomatic treatment of headaches and thus inadvertently cause a vicious cycle of pain. It may occur from taking a medication for more than 10 to 15 days per month. Essentially, the pain makes you start thinking, “One pill didn’t help, so maybe two will.” At that point, you would try almost anything. You just want the pain to go away. By the way, if you’re using abortive (acute) medications often, you may want to talk to your doctor about adding a preventive medication to your regimen or changing your preventive med to reduce your migraine attacks’ severity and frequency.
The critical part of ensuring that you never again induce a medication-overuse headache is to “keep your head about you” despite the incessant discomfort. Don’t get so frantic that you abandon common sense.
Always follow your doctor’s orders in taking headache medications.
COMPARING MIGRAINES WITH AURAS TO ONES WITHOUT
According to the American Migraine Foundation, a relatively small percentage (25–30 percent) of people with migraine experience the signals or symptoms called auras (visual disturbances, speech problems, distortions of smells and sounds, numb hands and lips). Some people with migraine have auras occasionally, whereas others have never had that symptom at all. (See more on auras in Chapter 2.)
According to the International Classification of Headache Disorders, 3rd Edition, a person with migraine without aura has at least five attacks that fulfill these criteria: a headache lasting 4 to 72 hours (untreated or unsuccessfully treated); this headache has at least two of the following characteristics: (1) it’s located on one side; (2) it pulsates; (3) the pain intensity is moderate to severe; (4) it’s worsened by, or causes avoidance of, routine physical activity (walking or stair-climbing); and (5) during a headache, at least one of the following happens: nausea, vomiting, or both; phonophobia (aversion to loud sounds); and photophobia (aversion to bright lights). A last criterion for diagnosis: The patient’s symptoms are not better explained by another ICHD-3 diagnosis.
A person experiencing migraine with aura has at least two attacks with symptoms occurring in one or more of the following categories: visual, sensory, speech and/or language, motor, brainstem, retinal. The migraine with aura has at least three of the following traits: At least one aura symptom spreads over about 5 minutes; two or more symptoms occur in succession; each aura symptom lasts 5 to 60 minutes; at least one aura symptom is one-sided; at least one aura symptom is positive (seeing flickering zigzag lights or feeling pins and needles); the aura is accompanied by a headache, or a headache follows the aura within 60 minutes. And finally, the headache is not better explained by another ICHD-3 diagnosis.
Understanding Why Headaches Hurt
Migraine is a neurological disorder — a “brain problem,” which is interesting because the brain itself cannot experience pain. According to the National Institute of Neurological Disorders and Stroke, migraine is a health condition, and symptom episodes comprise a migraine attack.
The hallmark throbbing pain that makes a migraine feel like someone is hammering your head appears to come from an imbalance in the hormone serotonin that causes an electrical change in the brain. Although no one fully understands migraines, some experts believe that the pain is related to serotonin levels in the brain and abnormal excitation of the cells of the nervous system — an event that occurs when a food, a stressful event, high altitude, or another trigger upsets your serotonin production. In a nutshell, migraines arise from underlying problems with your brain’s neurotransmitters.
Migraine pain differs from the intensity of other headaches because a person with migraine has hardwired hyperexcitability in the brainstem, and that genetic quirk heightens neuron activity. Sensory stimuli — weather, sounds, smells, lights, certain foods — can lead to a migraine attack by activating your genetically overactive neurons.
Obviously, you’re the biggest stakeholder in migraine development because you allow (or disallow) exposure to triggers. Your central nervous system is programmed to generate migraines; hence, you are logically the Zen master, who has some power to calm brain-dwelling neurons and thus avoid or reduce headache pain.
Personalizing Your Treatment
Diagnosing and treating migraines may require an investment of time, money, patience, trial and error, journaling (to discover triggers), and a strong working relationship with a doctor who diagnoses the causes of headaches.
You fare best with assistance because getting to the bottom of headaches is complicated. Too many people with migraine flounder around for years without coming to any conclusions or finding medications that eliminate pain. (See Chapter 6 for more about headache diagnosis.)
After you’ve been diagnosed with migraine, you can take a proactive stance by putting remedies to work and implementing lifestyle changes. Basically, you find ways to keep a migraine from forming whenever possible, and you stand ready with an action plan when pain does hit. You probably have noticed that certain foods, activities, sounds, or smells trigger a migraine attack. However, an attack may not occur every time you eat aged sharp cheese or take a strength-and-conditioning class at the YMCA. Typically, it takes several triggers to generate a migraine attack. You never know if or when, but a heightened awareness of your triggers helps you avoid migraine development. (You can find out more about food triggers in Chapter 10; exercise triggers in Chapter 11; environmental triggers in Chapter 12; and sleep-habit triggers in Chapter 13.)
Aspects of migraine management include: finding the right doctor and creating a treatment strategy; working to eliminate triggers; handling family and work issues; and understanding special-situation migraines, such as ones associated with hormonal changes, life stages, stress, and exertion. Plus, it’s important to familiarize yourself with red-flag headache signs that should send you scurrying to the emergency room.
Sometimes migraines are manageable. Just figure out your headache triggers and rearrange certain aspects of your lifestyle, and you’ll be on the road to sending your headaches to the B-team bench, where they’ll languish and rarely take a starring role again. Many people with migraine need a medication that knocks out the pain. Others choose alternatives such as yoga, head massage, or one of the new neuromodulation devices. (See Chapter 9 for more about these devices.)
Call on your A+ patience when you start sampling migraine treatments. Although you may get lucky and find that the first medication your doctor recommends works perfectly, the more common route is a trial-and-error period of testing medications.
Migraines are quirky. If they weren’t, doctors would be able to recommend the one super-sized honcho power-pill, and there would be no need for a book called Migraines For Dummies. In truth, migraine headaches and symptoms come in as many varieties as there are materials in a fabric store. That makes them difficult — but not impossible — to treat. After you personalize your migraine game plan, you’re halfway to the goal line.
Handling Family and Work Issues
Getting a handle on family and work issues associated with migraines can greatly improve your living-with-migraines existence. For one thing, you will not have to miss as much work or school after you zero in on ways to manage symptoms. At the same time, though, the chronic nature of migraine means that you always need to be prepared to deal with a headache that strikes when you’re outside the home. Have an arsenal of techniques ready to go.
Having good “people skills” for migraine management is important because some of those who don’t have migraines cannot relate to the sometimes-debilitating nature of headaches.
If head pain were your only problem, you would be looking at a very different kind of malady. But everyone associated with a migraineur is affected by the chronic nature of the affliction. It’s therefore up to you to set the tone for handling issues with family, friends, supervisors, and coworkers. Basically, you either establish yourself as a capable, reliable individual who just happens to have headaches, or as a disabled person who wants everyone to jump and show massive amounts of sympathy when a headache strikes.
DEALING WITH BEING MISUNDERSTOOD
You may have trouble relating to folks who are skeptical when you say your head hurts. You may also feel indignant, thinking, “Hey, wait a minute — shouldn’t I be the one expecting empathy?”
Outsiders often look askance at migraine attacks, and you really can’t expect someone who is a stranger to migraines to grasp the level of pain that can come with one. Most people who are migraine-free view migraine headaches in one or more of the following ways:
With skepticism: They assume that you’re a hypochondriac, and that makes them dismissive.With empathy: They’re sorry that you must suffer and wish they could help.With disinterest: They don’t want to hear about your migraine pain.With anger: They’re mad when you call in sick and your migraine inconveniences them.With confusion: Children, for example, have trouble understanding why a parent sometimes gets sick and can’t do things for them, or why family activities are cancelled.Taking these possibilities into consideration will help you deal with colleagues and relatives in a happier, more consistent way. In return, you’ll get better treatment because those close to you will know what to expect.
Today, people with migraine absolutely benefit from targeted treatment methods that offer abundant reasons for celebration. You have more options than your parents or grandparents had when nursing a migraine attack, and these expanded options can make life easier and more enjoyable.
Consider these highlights of today’s overall migraine picture:
Drug options for treating migraines are superior to ones formerly available. Today’s medications are more effective because some are migraine-specific.
In 1993, the introduction of the first triptan migraine drug in the United States improved the migraine-treatment picture dramatically, and by 2025, seven triptan medications had been FDA approved for fighting migraines. (See Chapter 8 for more details on prescription drugs.)
Healthcare providers take migraines seriously. They can help you eliminate lifestyle triggers that can aggravate your highly sensitive nervous system. Hence, a person with migraine may be able to reduce dependency on medication.
Alternative therapies can complement your primary migraine-management plan.
Overall, people have more informed attitudes about migraine.
Migraine treatment is smart, savvy multitasking at its best. You can nip a headache in the bud with fast-acting medications. This upgrade makes all the difference in the world, and when you add it to other new coping ideas, you truly put yourself in the driver’s seat.
With the recent addition of exciting calcitonin gene-related peptide (CGRP) antagonists and triptans to the roster of migraine medications, migraineurs now have a wealth of ammunition to aim at head pain. Indeed, today’s wonderful wellness climate delivers huge benefits for those of you formerly plagued by migraines. In this book’s pages, you’ll discover how simple it is to get back to the wonders of living well — healthy, happy, and lifted up by yet another empowering Dummies book!
Chapter 2
Navigating Your Migraine Symptoms
IN THIS CHAPTER
Looking at auras, sensory sensitivity, and stomach problems
Troubleshooting other migraine symptoms
Trying quick solutions
Migraine types are as diverse and multifaceted as our gene pools, so it’s challenging to sort through the scads of symptoms and zillions of ideas on how to deal with symptoms. In this chapter, we help you find the approaches that provide you with migraine relief, as well as actions you can take to relieve the symptoms beyond the hammering pain. You also need to be aware of those cursed medication-overuse headaches (headaches that occur when you take too many medications), and how to avoid having one of those monsters.
Other chapters in this book go into more detail about all these topics, but this chapter gives you a bird’s-eye view of migraine symptoms and introduces you to a formidable arsenal of quick fixes that you can have ready to fire.
Looking at the Big Three Symptoms: Auras, Sensory, and Stomach Issues
The Big Three — auras, sensory sensitivity, and nausea — are the most common symptoms of migraines. Because you’re reading Migraines For Dummies, 2nd Edition right now, chances are excellent that you already have some experience with this devilish trio, or at least one or two players.
Not all migraines come with auras. Moreover, not all migraines come with nausea and vomiting. But these symptoms are ones that many migraineurs (people who experience migraines) face.
Previewing an aura’s light show
Visual and perceptual disturbances can accompany a migraine headache, and this happens to about 20 to 30 percent of the people who experience migraines. Typically, an aura starts up to an hour before a migraine headache begins. You may have a heightened sensitivity to smells. Some people experience numbness in their lips, hand, or even leg on one side of the body, or have trouble speaking. Some experts theorize that auras arise from an excitation of brain cells and a wave of nerve signals firing through body parts other than the brain.
With different types of auras, you can experience
Visual anomalies such as
White or colored squares, circles, or triangles that appear to be moving
Zigzag lines around a dark center, shooting stars, or flashing lights
Diminished field of vision (you see only half of your usual field) or blurriness
Don’t be afraid to describe your “sightings” when you’re being evaluated by a doctor. You can be sure that neurologists and many other doctors are familiar with the strangeness of auras.
Temporary visual disturbances can also occur with other medical conditions, such as retinal detachment (a serious eye problem that an ophthalmologist — an eye doctor — needs to evaluate immediately). Symptoms of retinal detachment are seeing flashing lights and having a sensation of a shade or curtain obscuring your field of vision in one eye. Don’t panic, but do seek a doctor’s help as soon as possible. A jarring visual development is not something you should ignore or postpone addressing. So the first time you experience a new visual symptom, you should go to an emergency room or get urgently evaluated by an ophthalmologist.
Physical and other sensory anomalies such as numbness in your face, lips, mouth, or hands
Dizziness or a spinning feeling
Food cravings or loss of appetite
Weakness or feeling faint
Auras, which usually last 20 to 40 minutes, precede a headache — almost like the ding-ding-ding of a railroad-crossing bell warning that something scary is on its way. However, auras are also unpredictable. Just because they come before a headache doesn’t mean that they can’t pop up during a migraine. In addition, you may experience an aura without a headache. Sometimes an aura lasts throughout a headache. Auras come in a wide range of intensity, from minor annoyances to frightening, hallucinogenic-type horrors. In fact, some migraineurs say that they would accept the headache pain if they could only bypass the aura.
In headache stages, the prodrome is the period preceding a headache. It’s defined by warning signs such as dizziness, nausea, or yawning. (For more information about headache staging, see Chapter 4.) In the prodrome stage, some migraineurs experience decreased appetite, fluid retention, irritability, and restlessness.
The type of headache formerly called a classic migraine features an aura before or with the headache. Only a small percentage of people with migraine experience this “classic” symptom. In contrast, a common migraine doesn’t feature an aura, yet the vast majority of migraineurs experience this aura-less migraine. Both terms — classic migraine and common migraine — are out of date. Now these headaches are called migraine with aura and migraine without aura.
Coping with sensitivity to light, smell, and sound
Your head is pounding, and you desperately want to get away from bright lights, bad smells, and loud noises. This onslaught of hypersensitivity is common among migraineurs and makes your migraine pain a double or triple whammy. Some people are bothered by only one or two of these problems, but the whole offending trio can hit others.
Lights
Light sensitivity is such a common migraine symptom that it’s in the top tier of symptoms and is usually a part of a migraine. Sensitivity can range from a mild reaction to a complete aversion to any kind of light. Fortunately, there’s a simple remedy: Retreat to a dark room and lie down if necessary. If a dark room isn’t an option, look for a spot with low light.
Smells
Smells may bother you before or during a migraine. You may be ultrasensitive to cooking odors. Very rarely, you may even smell bad or pungent odors that don’t exist. Your nose may run constantly, which may lead you to mistake a migraine for a sinus headache.
Finding perfumes and cigarette smoke obnoxious isn’t unusual for a person with migraine. Strong odors can make your pain worse, so steer clear of smells that are hard to handle. Use an air purifier to neutralize odors, or infuse a room with a pleasant smell, such as lavender.
Sounds
Much like finding smells bothersome, you may wince when you hear a loud noise. During a migraine, you may find all kinds of sounds unbearable. As is the case with staving off smells and lights, your remedy is avoidance. Get away from the source of the problem.
Unfortunately, avoiding noise and insisting on a quiet home can dampen the atmosphere of your house. Some migraineurs use earplugs or headphones, but if having devices on your head worsens the pain, these aren’t viable solutions.
Combating stomach issues
You may have a migraine plus the unwanted bonuses of nausea and vomiting.
These stomach problems sometimes result from chemicals your brain releases during a migraine. Diarrhea and other changes in bowel habits can be troublesome, too. About half of all migraineurs experience stomach problems.
If you have to cope with nausea and vomiting, along with head pain, you may benefit from injections, pills, or suppositories that combat stomach woes. These aids work quickly and can make you sleepy — both of which are welcome effects. (Chapter 8 has more information on medications for nausea and vomiting.)
The only good thing to say about the nausea and vomiting that can accompany migraines is that this phase sometimes signals an easing of head pain. On the other hand, for some folks, stomach symptoms are forerunners of the worst pain of the headache’s course.
Other gastrointestinal problems you may experience are diarrhea, constipation, and stomach cramps. You may even find that your stomach has become almost paralyzed, which can cause you to have nausea and vomiting, rendering the oral medications meant to fix the problems useless. This delayed emptying of the stomach is called gastroparesis. In these cases, it is important to discuss with your doctor non-oral medications that can bypass the gut, such as nasal sprays, injections, or suppositories.
Encountering Other Migraine Symptoms
Although the Big Three — auras, sensory sensitivity, and stomach problems — are the symptoms that plague many migraineurs, other folks have their own individual troublemakers. Migraine symptoms are erratic, and we don’t have statistics on how many people experience which symptoms, but many people do have the Big Three plus some of these symptoms:
A pale, flushed, or very red face
A tender scalp
Bloodshot eyes
Blurred vision
Cold hands and feet, or a feeling of being hot all over
Dizziness or a feeling of spinning
Food cravings or a total loss of appetite
Some people with migraine experience a personality switcheroo, exhibiting raw personality traits. Feeling absolutely miserable, a migraineur can turn into a difficult person who won’t talk and later wonders why he was so irritable.
If you’re the one acting like your own evil twin, some alone time is a good idea. On the other hand, if a person you know with migraine is showing a rough side, give that person space (and grace). Thankfully, the negativity will end just as soon as the headache subsides.
Using Quick Fixes
Here are some dietary or lifestyle upgrades that may help relieve pain and ward off migraines:
Drink plenty of water. A typical healthy person should try to down eight to ten 8-ounce glasses a day. Dehydration often sets the stage for a migraine.
Keep a quart (or liter) of bottled water on your desk, or somewhere handy, so you can avoid having to “guesstimate” your water intake. Drink this water during the day and then drink more water in the evening. If you’re exercising a lot and sweating profusely, or if the weather’s hot, increase the amount of water you drink accordingly.
Don’t make the mistake of saying, “Oh, I drink lots of tea and diet soda, so I get enough liquid.” Those beverages are not water substitutes.
Set up a meal plan.
Eat regular meals and healthy snacks, and never skip meals.
Eliminate alcohol.
Try decreasing and then eventually eliminating alcoholic beverages.
Stop smoking.
If you’re not already participating in a smoking-cessation plan, find a hospital outpatient program that will help you achieve this critical health goal — or you can work with your doctor on a stop-smoking plan. People who experience migraine with aura are already at slightly increased risk for stroke, and smoking increases this risk further.
Purify your diet:
Eat fruits, vegetables, and other natural foods, and avoid foods with preservatives and MSG (monosodium glutamate). Some migraineurs benefit from a plant-based diet that includes plenty of fresh vegetables. (See more about food triggers in
Chapter 10
.)
Okay, so you’re ready to nail headache hooligans in 60 different ways. Meanwhile, what are you supposed to do about the pounding in your skull that’s making it hard to work and participate in other life activities?
What you need are quick-fix solutions to help you navigate hard times while you seek answers to successful long-term migraine-busting.
Screech! Here’s how to relieve pain with simple lifestyle soothers:
Make sleep your new best friend.
Try to get the same amount of sleep each night. Strive for regularity in the times you go to bed and get up. Most people need seven or eight hours of sleep per night, but not everyone. Typically, when you can sleep as long as you want and wake up naturally, the number of hours you clock will be what your body likes. Also, you must remember that getting about the same number of hours per night on weekends is important — or you may develop a migraine from erratic sleep.
Use relaxation techniques.
Stress and anxiety can trigger headaches, so try to master skills that will help decrease the toll that stress takes. Breathe deeply and meditate.
Massage your head.
When you feel a headache coming on, try the method that works for some migraineurs: Apply light pressure to your temples, your head, and the spot you feel pain radiating from.
Apply pressure to the right body points.
Find the tight and sore spots in your neck and shoulders and press them firmly with your fingertips for several seconds. (
Chapter 9
addresses acupressure.)
Use compresses or ice packs.
Both hot and cold compresses may be helpful when you have a migraine attack. An ice pack’s numbing effect usually helps dull your pain. Relaxing muscles is the job of a hot pack or heating pad, and sometimes these can provide a surprising amount of comfort.
When you use an over-the-counter or a prescription migraine med, make sure that you don’t take it more than two days a week. If this medication schedule leaves you in pain, talk to your doctor about what to do. Otherwise, you may create a medication-overuse headache, and if you’ve never had one, take our word for it: They’re awful. Avoid fly-by-the-seat-of-your-pants self-medicating. That approach can take you to a pain place that you don’t ever want to visit.
Keep your optimism at a fever pitch. Find your way toward a higher plateau, where you can live less painfully. Migraineurs do it all the time.
Chapter 3
Identifying Your Migraine Triggers
IN THIS CHAPTER
Journaling your headaches
Understanding inherited migraines
Cleaning your environment
Spotting dietary villains
Identifying forms of exercise that make your head hurt
Keying in on other migraine triggers
Deactivating your most problematic triggers
When unknown ogres pound your head, you’ll try almost anything to get relief. But before you grab a random remedy, keeping a journal to track the specifics of your diet and lifestyle will help your doctor help you. Targeted troubleshooting can spotlight ideal ways to handle your unique migraines.
Personalized migraine-fighting truly empowers you, and this chapter covers some elements to consider and track in your journal. Factors to account for include forms of exercise that generate head pain, foods that trigger headaches, sleep patterns that wreak havoc, and elements of travel that upset your applecart. On trips, your body must adapt to airport ups and downs, new cuisines, weather changes, novel activities, and high altitudes. Even slight changes can disrupt your system and kick off pain. Weigh travel’s risks against the rewards by considering the effects of differences in sleep, food, routine, and fun. A proactive plan offers peace of mind, so always pack your know-how on subduing pain.
Journaling the When, Where, and How of Your Headaches
You probably never figured that someday you would be sitting around making notes on things you do, eat, drink, smell, and hear just to figure out what contributes to your migraines. Journaling is a great way to align your thoughts on cause and effect, and just a few weeks of journaling can reveal valuable information for you and your physicians to use to create an action plan. For a ready-to-go itemizer, copy the journal in Figure 3-1.
Another handy option for migraine journaling is the app called Migraine Buddy.
Whatever method you use to journal, view it as an intensive search for the Trigger Terrors that get together and conspire against you.
When starting a journal, follow these basic steps:
Keep your journal with you everywhere you go.
Record what you eat and drink, where you go, what you do, what the environment is like, as well as weather changes, quality of sleep, stressors, and more.
Refer to Figure 3-1 for specifics of what to include in your headache journal.
Write down the details — when your migraine started, what it felt like, and so on — and the pattern and intensity of the pain you experience.
A pain pattern may be a migraine that occurs every four to five days and lasts about three hours each time.
Note the remedies you try and how effective they are.
Journaling may strike you as time consuming and maybe a little boring, but if it can put you back in the Game of Life, feeling effervescent and with a head free of pain, it’s surely worth the minutes you devote to jotting down pain patterns and triggers.
A trigger is anything, whether internal or external, that sets a migraine attack in motion. Typically, you must make a judgment call (“Is this a trigger or not?”). Suspected triggers don’t wear banners that say, “Hey, we’re here to mess with you!” Plus, a specific trigger may not cause a headache every single time; instead, a specific combination of factors may be the catalyst.
FIGURE 3-1: Your headache journal can help your doctor treat your migraines.
At the end of a headache day, make a notation next to any item in your journal that seems to contribute to the development of a headache within 30 minutes to a few hours afterward. Track four or five separate headache days. Things that appear to be triggers may be coincidences, so recording information on many headaches helps reduce the number of likely culprits.
