An Easy Understanding of Migraines

What are Migraines? 

Migraines, often confused with severe headaches, are a complex neurological disorder. A headache is usually just one of the symptoms of a migraine. Other symptoms include nausea, dizziness, fatigue and, increased sensitivity to external stimuli like sound or light. Migraines are usually phasic in nature, although not everyone might experience every phase of a migraine. The prodrome phase, more often than not, is characterised by painless symptoms. One can expect to experience mood swings, food cravings, and stiffness in the neck. The aura phase, though not everyone experiences auras, involves sensory disturbances before or during a migraine attack. Auras are marked by blurred visions, blind spots, numbness in the arms, and slurred speech. Then there’s the headache phase. One can expect to feel pain in this phase, sometimes very intense and sometimes mild. Exposure to light, certain smells, and sounds could exacerbate the pain. Finally, the postdrome phase is one where the pain lessens but people might feel a sense of confusion or exhaustion. 

Let us dive a little deeper to better understand migraines. Our brain is made up of nerve cells and neurons that communicate via neurotransmitters and electrical signals. These communications are disrupted during a migraine, resulting in its characteristic symptoms. To start with, Cortical Spreading Depression (CSD) waves travel across the brain’s cortex, triggering a series of neurovascular changes. Then, the Trigeminal Nerve System is activated, causing a cascade of events that finally results in a migraine. The trigeminal nerve releases vasoactive peptides like ‘calcitonin gene-related peptide’ (CGRP) and ‘substance P’. These peptides cause inflammation and blood vessel dilation, creating a throbbing sensation that results in the pain so often associated with migraines. The central nervous system then becomes more sensitised as the migraine develops, making one more susceptible to pain or other environmental triggers, such as light or noise. 

Migraine Triggers

Various triggers might eventually lead to a migraine, though not all affect everyone in the same way. Often, an attach is set off by particular types of food. Some foods that might induce a migraine are aged cheese, caffeinated drinks, alcohol (particularly red wine), processed foods high in preservatives, and food with MSG. There are also a range of mental factors that could contribute to a headache, stress being the most insidious. Stress usually leads to a spike in cortisol levels and high cortisol levels lead to a chain of events that causes migraines. Hormonal changes contribute to migraines too. Fluctuating oestrogen levels might result in migraines, especially for women during menstruation, pregnancy, or menopause. Environmental factors, a more well-known trigger, could stir up a migraine as well. Especially in instances where someone is exposed to bright lights, loud sounds, or strong odours. Interestingly enough, both too much sleep and too little sleep might trigger migraines as well. 

Risk Factors of Migraines

Certain factors make some people more susceptible to migraines. A leading underlying factor is family history and genetics. If your family members have a history of migraines, the chances of your suffering from migraine are higher. Age plays an important role too, with the onset of migraines usually in adolescence. Gender weighs in on migraines as well, with women at a higher risk. Other medical conditions might contribute to an increased likelihood of getting migraines. For example, depression and chronic anxiety are common culprits. Dealing with migraines effectively means understanding what risk factors might be playing up so you can address them effectively. 

Treating Migraines

People commonly choose to treat their migraines with over-the-counter medication like ibuprofen and aspirin. Those suffering from chronic and more debilitating migraine often lean on medications like triptans, beta-blockers, anti-epileptic and antidepressant drugs. Other treatments include botox injections or CGRP-inhibitors. Over-the-counter options usually come with side effects that might require additional medication to combat them. Fortunately, there are therapeutic options with little to no side effects one can consider. Some people opt for alternative therapies for migraines like acupuncture or chiropractic care. Others might consider options like biofeedback, an alternative therapy used to manage conditions like chronic pain, anxiety, and more. Ayurvedic remedies work wonders for migraines too. One could tackle the many crippling symptoms of migraines using herbal preparations, marma therapy, and panchakarma therapies like nasya, shirodhara, and other panchakarma procedures.

More recently, cannabinoid medication is being considered for migraines. Cannabinoids interact with receptors in the endocannabinoid system to effect various changes in the human body. The two primary cannabinoids found in cannabis are delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD). Both CBD and THC help modulate pain and inflammation through the endocannabinoid system. In particular, CBD's antagonistic effect on GPR55 (G protein-coupled receptor) causes a rise in neurotransmitters that block or prevent certain chemical messages, helping migraine and seizure patients calm their brains. A major advantage besides the efficacy of cannabinoid treatment is its high safety profile compared to other interventions.

Given migraines are a complicated neurological disorder, treatment usually requires a multifaceted approach to alleviating its debilitating symptoms. It helps to understand the specific triggers and risk factors while choosing the most appropriate treatment options. Correct diagnosis is key, given migraines are often mistaken for headaches. And with a range of treatment options available, talking to a doctor is crucial. It is ill-suggested to determine the most appropriate treatment on your own.