Anita (name changed), a 34-year-old software engineer, had severe headaches for nearly 10 years. The attacks occurred three to four times a month, often forcing her to lie down in a dark room for hours.
“I thought it was stress,” she recalls. “Painkillers helped only a little, and I missed many important meetings.”
When she finally consulted me, she was diagnosed with migraine. With the right treatment, including preventive medication, sleep regulation, and trigger management, her attacks reduced dramatically.
“Now I may get a mild headache once every few months,” she says. “It changed my life.” Stories like Anita’s highlight an important message: migraine is treatable.
For millions of people, a headache is just an occasional inconvenience. But for those with migraine, it can be a disabling neurological condition that disrupts work, family life, and daily routines.
Migraines are one of the most common brain disorders in the world and a leading cause of disability. Globally, around 15 per cent of people suffer from migraine, but the prevalence in India appears to be even higher, about 25 per cent in some studies. That means over 200 million Indians may be living with migraine.
Despite this enormous burden, migraine is often misunderstood or dismissed as 'just a headache'. It is a complex brain disorder that deserves proper diagnosis and treatment.
What is migraine?
Migraine is a neurological disorder characterised by recurrent attacks of moderate to severe headache, usually affecting one side of the head. The pain is typically throbbing or pulsating and may last from 4 hours to 3 days if untreated.
Migraine attacks are often accompanied by other symptoms such as:
• Nausea or vomiting
• Sensitivity to light (photophobia)
• Sensitivity to sound (phonophobia)
• Visual disturbances such as flashing lights or zigzag lines (called aura)
Some people experience warning symptoms hours before the headache begins. These include fatigue, irritability, or food cravings.
Migraines affect women more than men
One striking feature of migraine is the gender difference. Women suffer from migraines about three times more often than men.
Hormonal fluctuations, especially estrogen changes during the menstrual cycle, play a major role. Migraines often worsen around menstruation and may improve after menopause. The peak age for migraine is between 30 and 45 years, when women are juggling careers, families, and multiple responsibilities.
Migraine in children
Migraines are not just an adult problem. It can begin in childhood or adolescence. In children, migraine attacks may be shorter and may involve pain on both sides of the head rather than one side. They may also present with abdominal pain or vomiting. Migraines can affect school attendance and performance, making early recognition important.
Common migraine triggers
Migraine attacks are often triggered by lifestyle factors. Common triggers include:
• Irregular sleep or sleep deprivation
• Skipping meals
• Stress or emotional changes
• Dehydration
• Bright lights or strong smells
• Excessive screen time
• Certain foods, such as chocolate, cheese, or processed foods in some individuals
Triggers vary from person to person, so identifying personal triggers is important.
How migraine is diagnosed
There is no specific blood test or brain scan for migraine. Diagnosis is usually made based on typical symptoms and history using international criteria. Brain imaging is needed only when the symptoms are unusual or when doctors suspect another cause of headache.
Treatment: Relief and prevention
Migraine treatment has two main goals:
1. Acute treatment (during an attack)
Medicines taken early during an attack can stop or reduce pain. These include Paracetamol or NSAIDs, triptans or gepants (migraine-specific medications) and anti-nausea medications. Early treatment usually works better.
2. Preventive treatment
If attacks are frequent (for example, more than 4 per month), preventive medications may be prescribed. These may include beta-blockers, anti-seizure medications, antidepressants and calcium channel blockers.
Newer migraine therapies
In recent years, migraine treatment has seen exciting advances. New drugs targeting CGRP (calcitonin gene-related peptide), a key molecule involved in migraine, have shown remarkable effectiveness in preventing attacks. Other options include Botox injections for chronic migraine and neuromodulation devices that stimulate nerves to reduce pain.
Lifestyle measures that help
Many patients can significantly reduce migraine attacks through simple habits. These include maintaining a regular sleep schedule, having meals on time, staying well hydrated, managing stress (Yoga or meditation), limiting excessive caffeine and screen exposure and exercising regularly.
Migraines can be painful and frustrating, but they are manageable. With proper diagnosis, lifestyle changes, and modern treatments, most people with migraine can lead healthy, productive lives. The key is simple: don’t ignore recurrent headaches and seek medical advice.
The opinions expressed in this article are those of the author and do not purport to reflect the opinions or views of THE WEEK.
