Migraine is a disease that not only manifests itself with headaches but also presents many other incapacitating symptoms such as photophobia, sonophobia, nausea, vomiting, lack of concentration, drowsiness or neck stiffness, among others . All these symptoms alter the quality of life of those who suffer from it, to the point of causing almost permanent discomfort, subjective memory loss, depression or anxiety.
However, the truth is that migraine continues to socially isolate those who suffer from it – more than 5 million people in Spain, 80% women – and stigmatizes them. Why? Because, as Sonia Santos , head of the Neurology Department at the Lozano Blesa University Clinical Hospital in Zaragoza, explains in this interview, there are still many people who believe that those who suffer from it are responsible for their own pain, thus causing these patients to feel isolated in their family, social and also at work.
Most people define a migraine as a severe headache. However, a migraine is much more than that. What is it?
Of course! When you have a migraine, your head hurts, but what characterizes migraines from other headaches is that they are incapacitating . Why? Because in addition to pain, patients generally have photophobia, that is, they are bothered by light, and sonophobia, because they are also bothered by sound. In addition, they may have nausea, vomiting, and, in many cases, problems concentrating and finding the right words. All of this makes migraines have a great impact on the quality of life of those who suffer from them!
Why does society still seem to underestimate its real impact?
One of the reasons is that migraine is much more characteristic of women than of men , and that in itself means that it is sometimes underestimated. Another reason is that many patients have lived closely with them because their mothers or grandmothers have suffered from them, and they accept them as a condition and a trait of their family that they have inherited.
Do migraines have a hereditary component?
In up to 60% of cases there is a family component ! The bad thing is that in many cases the habits that these mothers and grandmothers had for treating migraines are also inherited, which basically consisted of turning off the lights, getting into bed and waiting for the pain to subside.
And are migraines generally treated well these days?
The disadvantage is that, in many cases, patients do not want to tell their colleagues that they have a migraine . For example, in job interviews or to their colleagues, because migraines generate a lot of stigma. We are talking about a disease that causes pain, sometimes two or three times a week and… of course… it is difficult to ask for help so often in the workplace! On a social level, it is not unusual for patients with migraines to end up isolated because they often have to give up social activities.
Isolated and stigmatized: Why are people who suffer from migraines stigmatized?
This stigma comes from the fact that many people believe that those who suffer from migraines are responsible for having the pain. Many people stigmatize themselves because they feel that those around them blame them for having migraines because they have not managed stress well, because they have not taken a painkiller in time, because they have not slept well… They blame themselves, they feel singled out and that makes no sense! And on top of that, there is no test that can tell us whether a patient has a migraine or not; the diagnosis is based on the clinical history and the examination.
And how can we fight against this stigma?
Often, in our consultations, we treat not only patients with migraines, but also their partners or children, so that those closest to us assume that we are dealing with a disabling disease and that the patient is not making it up. Patients often feel that those around them do not understand them! We often trivialize the pain! And people have to know that with an anti-inflammatory, it is often not even possible to alleviate it.
What can we do to raise awareness about the impact of migraine?
Patients ask us to listen to them, not to hear them. And in my opinion, these patients must also be able to reconcile themselves with their illness and ask for help . With the treatments we currently have, we are not going to cure them, but we will improve their quality of life.
So… migraine can’t be cured?
There is no cure! The brain of a migraine sufferer is born like this, with this predisposition. There is no curative treatment, no matter how much is published on social media. There is no treatment that cures migraine. I insist that in neurology we cure very little, but we greatly improve the quality of life. We can reduce and decrease the number of days of pain, or improve the intensity of the pain or the response to painkillers, but we do not cure. However, it is important that the patient tries to avoid triggers such as stress, and factors that increase pain. In the case of women, hormonal alterations play against them and, in the face of that, little can be done.
Can it at least be foreseen?
If the patient is able to identify the symptoms that can occur with a migraine, such as mood swings, impaired concentration, yawning, drowsiness, stiff neck, photophobia, sonophobia, etc., then they can start treatment a little earlier so that the response to pain is better , and stay in places with little noise and little light. When we say that migraine is disabling, we do not only mean the pain and its symptoms, but because many times these symptoms begin up to 48 hours before.
Are migraine patients at higher risk of suffering from other types of diseases?
Migraine is not related to cognitive decline , but it is true that patients with chronic migraine, with almost daily pain, have the feeling of not being themselves. Migraine causes discomfort, impaired concentration, subjective memory loss, and it must be taken into account that some more basic treatments can also have side effects on blood pressure, heart rate, mood… So having a migraine increases the chances of having some diseases such as anxiety and depression.
Is there a component in our DNA that makes us more prone to suffer from them?
No, there are many studies on the anatomical and functional level on this subject, but there is no conclusive data. There is more talk of hyperactivity or hypersensitivity of the brain.
How many people suffer from migraines in Spain?
In Spain, it is estimated that more than 5 million people suffer from this disease , which represents 12% of the population, approximately 80% of which are women. Experts have identified the most common profile of migraine sufferers in Spain as a middle-aged woman with episodic migraine and in a situation of family and work development.
