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23 Parts of Migraine Attacks We Don't Talk About Enough

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Though migraine is one of the most common conditions in the world, it’s also one of the most misunderstood.

Migraine is a complex neurological disease with multiple subtypes, each causing a wide range of unique symptoms. Contrary to popular belief, migraine is not “just a headache,” nor is it a condition that should be brushed off as “no big deal.”

Too many myths persist about migraine, and it can be frustrating, hurtful and isolating when loved ones don’t understand what it’s like to live with migraine. To help shine a light on some of the overlooked and misunderstood realities of the disease, our Mighty community shared aspects of migraine attacks that aren’t talked about enough.

Migraine attacks can vary widely and affect people in so many different ways. If there’s an aspect of your migraine that doesn’t get enough awareness, let us know in the comments below!

Here’s what our community shared with us:

1. Migraine can be ever-changing and unpredictable.

Migraine is full of surprises. Attacks can come on at unexpected times and occur at seemingly random intervals for no apparent reason. Each episode may also look different. One migraine attack may last several hours and respond to ice and over-the-counter pain medication. Your next one could last for weeks, and not respond to any of the medications or treatments you try. Migraine can be a tricky condition to pin down.

The fact that it keeps changing on us! It’s not necessarily the exact same every time; so no, we’re not making this stuff up, we’re not ‘crazy,’ we’re not adding wacky symptoms we saw on TV or the internet. It. Keeps. Changing. Sometimes it responds to ice. Sometimes it responds to a warm shower or hot coffee or an icy can of coke. Sometimes the rescue meds help; sometimes they might as well have been sugar pills! Sometimes we think we have a handle on our triggers and sometimes it flares for no known reason. Sometimes we are in constant chronic, non-stop, intractable pain for years and we will suddenly get a pain-free hour, a pain-free day. And no — we are not lying about the rest of the pain just because this happens for no known reason! And yes, the doctors get as frustrated as we do. If people could just get a hint of how [frustratingly] unpredictable this disease can be and of how changeable it can be from day to day, intense episode to episode, or year to year over the course of a lifetime — maybe that would help a bit. (sigh) – caporter001


2. Living with migraine can affect your personal relationships.

It’s challenging (and, at times, impossible) to keep up with your social life and personal relationships when you’re in the throes of a nasty migraine attack. If you struggle with light sensitivity, the last thing you probably want to do is look at your phone, and engaging in conversation while your head is throbbing and you feel dizzy or sick is likely not at the top of your list either.

As a result, dealing with frequent or prolonged migraine attacks means you may not be able to spend as much quality time with friends or loved ones. This can make it difficult to nurture a relationship – especially if the other person doesn’t understand what you’re going through.

My migraines affect my personal relationships. I’m the one that ruins the fun because the TV is too loud, the lights are too bright, and makes every car ride silent. It’s tough when people want to share something with you, but end up resenting you at the same time. – robintisabird


3. Going to the ER isn’t always helpful.

To ER or not to ER… If you’ve reached an unbearable level of your migraine attack but your doctor isn’t available, you may decide to seek emergency care. However, many emergency rooms are not equipped to help patients who are having an acute flare of their chronic condition. It can be frustrating if the ER is unable to help you – not to mention painful if you cannot find relief from your symptoms. Talk to your doctor what course of action you should take if you need emergency care for your migraine.

For me it’s if I end up going to the ER. I will try all my meds first and wait a couple of days suffering from my bed. But when I am to that point that I can’t move my head because it will feel like it’s going to explode I need to go in. Just getting there is a horrible experience. I feel like I have to teach the staff on how to treat me every time. No I don’t want opioids. I tell them that first. And even though they have my records I have to tell them what to give me each time. Last time I got sent to the ER instead of urgent care because the physician was nervous about giving me the meds. So that cost me $100 to be wheeled across the hall. Where the nurse gave me the meds instead. Do they not cover migraines at all in medical school?? – packerbaby


4. Nausea/vomiting is a common symptom.

One of the greatest migraine struggles is taking medication for your pain, then trying not to throw it back up 10 minutes later. Nausea is a common migraine symptom, and for some, it may be even more disabling than the pain or other symptoms. Migraineurs may experience retching or vomiting in addition to nausea – it depends on the individual and the particular migraine attack.

A huge wave of nausea is my first sign of a migraine beginning. The worst one I’ve ever had was the night and first day after moving into a new house. The removal men couldn’t understand what I was saying about where to put stuff, apparently I was talking gibberish. Fortunately they understood because one of the men’s wives got migraines so bad she was often hospitalized with them. I’ve had a migraine attack every other day this month so far, thank God my migraine tablets work, but only if I take them soon enough! – KarenMichT

The retching. Once you’ve repeatedly thrown up and have gotten rid of everything in your stomach, then the retching starts. And it doesn’t stop for ~30-60 minutes. It’s like you have electrodes on your brain firing off signals you can’t control and it’s making not just your stomach violently retch, but it feels like your whole entire torso is severely convulsing. And every time it happens (which can be pretty much constant), it makes the intense throbbing headache pain all that much worse. Migraines can be a very violent type of pain. And then when it’s finally all over, sometimes I’m so weakened by all the retching that I can barely even stand back up again. This is why I’ve kept a stool in my bathroom for the last 26 years. It gives me something to sit on when I’m throwing up and it also makes it easier to stand back up again too. – Preston W.


5. Migraine is not ‘just a headache.’

There’s a common misconception that a migraine is “just a bad headache.” While headaches can certainly be painful and debilitating, it’s important to realize that migraine and headache are two different conditions. Migraine is a neurological disease with multiple subtypes that can each result in a wide range of symptoms. Apart from head pain, common migraine symptoms may include nausea, vertigo, dizziness, fatigue, aura or gastrointestinal issues.

What gets to me is when others think it’s just a ‘headache.’ I’ve been told I can’t handle pain and that’s why I think it’s bad. They don’t understand there are times my migraine medications don’t work. I basically have to try to keep going like nothing is wrong. I also have epilepsy and it’s scary when a migraine comes on because it could be a migraine or a possible seizure. Migraines are so complex and there are so many symptoms that go along with them. They can last days, even weeks. There is no easy fix. – synnymarie

It is not ‘just a headache,’ it takes over every aspect of your life, and we have to add things and avoid other things to our daily routines to try to prevent an attack and to cope before, during and after the inevitable attacks. Most people just don’t understand. – alohawavesprincess1

For me it’s the fact that people frequently think it’s ‘just a bad headache.’ Which it’s not. I get nauseous, heartburn, inability to swallow, dizzy, low energy, and am unable to think. Which makes doing anything (especially when I was in school) difficult. Then there’s the fact that the exhaustion lasts more than just the day of the migraine. – Eryn M.


6. Living with migraine can be isolating.

Migraine symptoms often require people to ride out the attack in a dark, quiet place. While this may be necessary for your health, it can also be lonely. Even if you are physically by yourself, know you are not alone. Migraine is one of the most common conditions, affecting more than 12 percent of the global population. There are millions of people out there who “get it,” and our community is here to send you support whenever you need it.

The depression and isolation. I have some form of chronic headache or migraine every day. I go days without speaking to anyone because I can’t stand noise or sound. – Cyrynda W.


7. People with migraine may be sensitive to lights and sounds, especially during an attack.

Sensory sensitivity is common among migraineurs. Sensory stimuli can trigger a migraine attack or aggravate symptoms of an attack that is already underway. People may be sensitive to either natural or fluorescent light, but bright and flashing lights tend to be particularly troublesome. Sounds can also be problematic.

My migraines are accompanied by sound sensitivity as well as light sensitivity. I have one right now and the sounds of my neighbor hammering on a doghouse, while simultaneously yelling at the dog, and the riding mower that’s doing all our lawns, are about to kill me. And, I’m meeting a friend for a winery tour and lunch in about an hour. I’m not going to let this pain keep me in bed and miss this! – downnotout

Sensory overload, every little noise or sound is excruciating. – charly_nz

‘Just get into it’… I can no longer even attempt to go to live gigs that involve flashing lights or lights that are turned in the audience. While my friends are rocking out, I’m covering my face and looking for the exit. Or running out to vomit. They put signs up at venues warning of strobe effects, but you’ve already paid big money for tickets by the time you see the sign. – elsie24


8. Not all migraine attacks involve pain.

It is completely possible to experience a migraine attack without any head pain. This type of attack is often known as a silent migraine, but may also be referred to as an acephalgic migraine, amigranous migraine, migraine aura without headache and migraine equivalent. A silent migraine occurs when a person experiences any of the “typical” migraine symptoms (such as nausea, sensitivity to light or sound, aura, etc.) – but without any head pain. People with migraine may also move through the four typical phases (prodrome, aura, headache, postdrome) but skip the headache phase, thus experiencing a migraine attack without head pain.

Silent migraines are my newest ‘manifestation’ of symptoms. It’s really difficult to explain to someone about your inability to pull up a common word, do simple math, or remember the exit you always take. Someone will realize I’m off and I say I have a migraine, they act like because it isn’t painful yet I am making it up. These symptoms can last weeks prior to the actual pain. Along with that is seeing spots or blobs in my vision, numbness in areas of my face. I thought I was having a stroke the first time it happened. It may not hurt but the grinding of gears to make my brain try to work is exhausting! – coveredbook

The concept of a migraine without head pain. Since starting Botox treatments I frequently suffer several other migraine symptoms but the head pain is absent or minimal. – pamz4


9. Migraine with aura can cause visual, sensory, motor or neural disturbances.

There are multiple migraine types that can involve aura, though only about 25 to 30 percent of people with migraine experience this symptom. An aura, sometimes known as a “warning sign,” is a series of sensory disturbances that happens before a migraine attack, and usually lasts for about 20-60 minutes. These may include vision disturbances (e.g. seeing flashes or stars), sensory changes (e.g. feeling tingling or numbness) or speech or language problems (e.g. slurring or being unable to produce the correct words).

Visual disturbances, it can be like looking through a kaleidoscope and every color and shape is too bright and painful, even with your eyes closed. – charly_nz

I often will lose my vision temporarily when I get an aura. I have had to pull over off the road. Then it passes in around 30 minutes. – michelered2012

It’s good these days there’s so much on the internet to educate and help. Some people with migraines smell bad odors that aren’t there, phantom odors that make them nauseous. It’s difficult to explain to people who don’t have a migraine that a room, or a newspaper, furniture, might smell terrible. When the migraine leaves so does the bad smell. It’s inexplicable. – nettlecoats7


10. Some people experience phases of a migraine attack, including prodrome (the ‘warning’) and postdrome (the ‘hangover’).

A migraine attack can involve up to four phases, though not everyone experiences every phase, and each migraine attack can look different. The phases are prodrome, aura, headache and postdrome, and each involves a unique set of symptoms. The prodrome phase can begin hours or days before other phases and may cause aphasia (difficulty finding words or speaking), yawning, fatigue, mood changes, neck pain, food cravings and more. The postdrome phase is often described as a “migraine hangover.” The conclusion of the headache phase may be followed by fatigue, lowered mood levels and poor concentration.

Many migraines have a ‘prodrome’ and a ‘postdrome’ phase. So when I’m stumbling and weird and confused, sometimes it’s a warning one is coming. When I’m exhausted and confused afterwards, I’m not just complaining. Just because I’m not telling you about the pain, doesn’t mean that my migraines aren’t affecting my behavior. It’s a much more complex condition than people think. – sullivmau

It took me a long time to figure out that the seemingly random episodes of despondency and feelings of depression that would show up for a day or so were actually postdrome. It finally clicked and it now seems so obvious since it kicks in a few hours after the migraine pain goes, but it’s not like I do my best thinking right after a migraine (or before, or during—so sometimes, like never, sigh). – karenh

I feel more should be aware of what I call ‘the aftermath’ of it when the pain and sensitivity are finally gone and I no longer feel sick to my stomach. I still feel so off and out of it. I can’t focus on anything and I’m exhausted. Although I mostly take meds and hide in bed till it’s over, I still have a recovery process to go though. – annieoakley5

I wish people understood the ‘hangover’ that occurs after a migraine. When you’ve fought your way out of bed and into work after a migraine – you feel like you’ve just gone 10 rounds with Mike Tyson and don’t remember much of the last three days and it feels like you’ve gone on the biggest drinking binge of your life, but everyone expects you to just be fine and healthy and back to normal because your migraine has ‘gone.’ It’s not always appreciated how draining being that ill and in that much pain has an affect on your body. – khutes

The aftermath! I’m exhausted and it still affects everything. Brain fog, lack of coordination, weakness, no appetite, and sensitivity both emotional and physical. It takes awhile for my body to recuperate. The worse the attack the longer the recovery time. – k8tcat


11. Migraine can affect your mental health.

Living with any type of chronic pain condition can take a toll on your mental and emotional well-being. It is normal to struggle with feelings of depression, anxiety, grief, fear, hopelessness or anger when pain and symptoms are a constant. If caring for your mental health is challenging because of migraine, know you are not alone. Check in with others on The Mighty and share what you’re going through – we’re here for you.

Migraines screw with my mental health. After a week of migraine, I’m trying to talk myself out of suicide. – Christine Z.

I feel depression is often overlooked and an uneasy topic as a side effect of migraines. Obviously in the long run because chronic migraine lowers your quality of life but also acutely. When I’m having an attack there is often a period of a couple of hours when I am so severely depressed and hopeless and can’t think straight. Often before the pain subsides. – Gabi E.

If you or someone you know needs help, visit our suicide prevention resources. If you need support right now, call the National Suicide Prevention Lifeline at 1-800-273-8255, the Trevor Project at 1-866-488-7386 or reach the Crisis Text Line by texting “START” to 741741.


12. There are different types of migraine.

When many people think of migraine, they might associate it with severe head pain and perhaps some nausea or light sensitivity. It’s often assumed that all migraine attacks look the same but that couldn’t be further from the truth. The International Classification of Headache Disorders (ICHD-3) identifies multiple types and subtypes of migraine, each of which involves unique symptoms and diagnostic criteria. It’s important to recognize how varied and complex migraine can be.

I think one thing that is missed by healthcare professionals and most of us is that each attack can be incredibly unique and we can have multiple headache/migraine types. It doesn’t matter that we can ‘treat’ them all with the same medications – that don’t work much anyway. But understanding when allergies/sinus inflammation are playing a big role in the pain vs. a nutrient deficiency can help us actually treat the pain and have attacks occur less often. – Alex T.


13. The duration of a migraine attack can vary.

Just as not all migraine attacks are created equal, their duration is not always constant. How long a migraine attack lasts can depend on multiple factors, such as the type of migraine you have and how many phases of the attack you’re experiencing. For some people, a migraine attack may last a total of a few hours. For others, it could last days, weeks or months.

Definitely the fact a migraine can often last for days at a time – they’re not just a half day headache. – justamanda


14. Some people with migraine are sensitive to scents and fragrances.

In addition to light and sound sensitivity, some people with migraine may find that they are “scent-sitive” to odors and fragrances. Certain scents, such as perfume, cigarette smoke or strong food odors, may trigger an attack or worsen symptoms.

I feel selfish saying this but I wish more people were aware that chemical sensitivity can trigger migraines. If you spray air freshener in a public bathroom to try and cover up that you pooped, when I need to use that bathroom it can set off pain for days. People have tried to help by turning down the lights, which is a thoughtful idea, but the accommodation I actually need is for them to not use scented chemicals. – Cat P.

Someone mentioned chemical fragrances. I can’t handle perfumes, colognes, air fresheners, Lysol and so on. They can aggravate a migraine as well as cause one. Even in scent-free areas, people still use them. If people can’t go unscented, use friendlier fruit scents like berry, cucumber, or watermelon. – lash


15. People with migraine may experience guilt about various effects of their condition.

Unfortunately, guilt can creep in when you’re prioritizing your needs as a way of managing your migraines. Maybe you feel guilty about canceling plans with your friend… again. Or perhaps you feel guilty that you have to spend the day managing your migraine instead of spending quality time with your kids. There’s no reason you have to feel guilty about any of the effects of migraine, but if guilt is something you struggle with, you’re not alone.

The guilt. I have only been dealing with migraines since September or so, and it has caused me to miss so many classes and events… and I often can’t offer a good explanation. It makes me feel guilty that I’m letting people and myself down. – Chelsea H.


16. Migraine can cause cognitive issues, including ‘brain fog.’

Migraine has been associated with cognitive dysfunction, including poor memory, inability to focus, cognitive processing speed and intellectual impairment. People with migraine may refer to these cognitive symptoms as “brain fog,” a type of cognitive dysfunction that typically involves memory problems and a lack of mental clarity. Studies have found that these cognitive symptoms are especially prevalent during the prodrome and headache phases, but can persist into the postdrome phase of a migraine attack.

Slower processing speed. I think this is a symptom that is overlooked a lot. Things make take longer [to] process in your brain. Like having a casual conversation with someone but taking slower to reply because you’re not fully comprehending what is happening ‘fast’ enough. It’s similar to brain fog I guess. People tell me to ‘snap out of it’ or ‘get with the program’ but… I can’t. Like no matter how I try I physically cannot do it. – ella66

Besides the usual pain (sinus, behind the eyes, pounding head, nausea, dry mouth, and a mesh net with spikes being twisted tighter and tighter until the meds work) I have cognitive/processing problems. I often have to read things out loud to ‘get it.’ I also don’t always understand what people are saying to me (another type of processing problem). Before a migraine starts my warning sign is I become overly ‘chatty’ and loquacious. – vectormom

Brain fog. I forget everything I’ve been asked or told when the pain is bad and then people are frustrated and think I wasn’t paying attention. I quite literally black out on pain and can’t remember anything other than the deafening throbbing. – charlierou


17. Vertigo is a lesser-known (but severe) symptom of migraine.

Some people with migraine might experience lightheadedness, but vertigo is a unique (and sickening) symptom. Vertigo is a spinning sensation that, unlike dizziness, makes you feel like either you or your surroundings are moving. Migraine-associated vertigo is known as vestibular migraine, which causes symptoms such as nausea, vomiting, dizziness or lightheadedness, in addition to vertigo, and may or may not involve a headache. About 40 percent of those with migraine experience vestibular symptoms such as vertigo or dizziness at some point, which may occur before, during, after or totally independent of a migraine attack.

Vertigo that accompanies migraine and can even be before one isn’t talked about enough. For me that vertigo is so severe, has caused falls, and was life-threatening twice. While there are a lot of good answers already, I am more afraid of that vertigo than the actual pain of the migraine sometimes. – thepinkrobots

I was diagnosed with Meniere’s disease… then the diagnosis was changed to migraine more than a decade later. – blueeyedwhitecat


18. Wondering when your next migraine attack might occur can be very anxiety-inducing.

Migraine is a chronic disease, which means even between attacks, you still technically have the disease. Though you probably would love to spend your symptom-free days thinking about anything other than migraine, the reality is that many migraineurs may harbor fears or dread about when their next attack will strike. It’s challenging to “live in the moment” and “focus on the now” while also preparing yourself to potentially experience an attack on any given day. If you experience anxiety about when your next attack will happen, check out these 12 things you can do to fight “flare fear.”

The anxiety in between migraines. You know another one is going to come, you just don’t know when. I go to bed wondering, will I wake up in the middle of the night with one? Will I wake up with one? Will I feel like I’m having a good day and then, bam, get one?? That’s the worst for me, other than the migraines themselves obviously, you just don’t know. It’s so frustrating and debilitating and isolating. – chronically_positive

I have constant anxiety about when I might get a migraine. When something special is coming up I worry that I’m not going to be able to do it because of a migraine. – bethclark2013


19. Pain medications don’t always help the pain, and they often don’t help other migraine symptoms.

When you’re in the midst of a migraine attack, one of the most frustrating things to hear a friend or loved one say is, “Just take some ibuprofen!” Many people assume that pain meds are the answer to migraine – whether that means over-the-counter meds or high doses of doctor-prescribed painkillers. While pain meds can certainly help some migraineurs manage their symptoms, they’re by no means a “cure-all.” Sometimes they help, sometimes they don’t. People with migraine may need to work with their medical team to find a combination of treatments that helps with their symptoms.

For me, it feels as though a white-hot poker or a lightsaber is being driven through my eye and out my occipital bone. I’m on high doses of pain medication, daily, due to chronic illness, so the pain is somewhat dulled unless the light comes on or someone speaks above a murmur. I wish people understood that while medication does dull the pain, it doesn’t stop the effects or increase my cognitive ability, and does nothing to dull the sensitivity. – themetatrongirl


20. Having an unpredictable disease does not mean people with migraine are ‘flaky.’

It can be upsetting for both parties when a person has to cancel last minute because of a sudden migraine attack that’s keeping them in bed. Some folks with migraine may hesitate to make plans at all because they’re never sure how they’ll feel the day of the event. But even if your friend has canceled or missed out on plans because of their migraine, it doesn’t mean they’re “flaky.” It simply means they have a chronic, unpredictable disease, and are doing what’s best for their health.

I am currently on day 337 of current episode. In my experience, I wish people didn’t think I cancelled plans because I’m flaky. In fact I rarely make plans so I don’t have to cancel. I’ve been fired twice and have lost friends. – Shannon M.

I can’t work full-time due to migraine, PTSD, anxiety etc. I cancel plans at the last minute often. So people give up inviting me places. So I give up booking anything in advance. I’ve had people accuse me of making up sudden-onset migraines as an excuse to not do something. You know who your true friends are after years of this. – elsie24


21. Migraine affects people of all ages.

Although migraine most commonly affects people between the ages of 18 to 44, the disease can affect children and older adults as well. According to the American Migraine Foundation, approximately 8 percent of children experience migraine. Though children can display “classic” symptoms of migraine, such as head pain, many kids typically have symptoms like vomiting and stomach pain, which may be signs of abdominal migraine.

Children. People don’t realize children can have migraines. My daughter has had migraines since she was 6 years old. I would gladly take her migraines so she doesn’t have to suffer. – emmemagnolia


22. A migraine attack isn’t always preceded by ‘warning signs.’

People with migraine may experience the prodrome and/or aura phase of a migraine attack, which involves symptoms that can serve as “warning signs” that the headache phase is approaching. However, not everyone experiences these first two phases. Sometimes the headache phase can set in rapidly, seemingly out of nowhere, offering a person no time to prepare.

My migraines have been coming on out of the blue. I can be perfectly fine one minute and then pretty much incapacitated the next. I used to have warning signs and these really suck! People think I’m faking since I had been fine a minute before. – Gwen B.

How fast they can actually come on and things like strong perfumes and other odd sensory items can trigger them. – food4liz


23. Migraine attacks vary in severity but can be debilitating.

Every migraine attack is different, and you likely experience attacks that range in severity. However, it’s important for other people to realize that migraine can truly be debilitating. Migraine is considered the sixth most disabling disease in the world, and more than 90 percent of migraineurs are unable to work or function during an attack. When someone says they have migraine, know they aren’t referring to a little bit of head pain. Their disease and symptoms need to be taken seriously.

One effect that often gets overlooked or isn’t talked about very much, is that migraines are debilitating. There are many people who don’t understand the differences, between a migraine and a headache. They assume that all we need are minor over-the-counter pain pills, as if we are just choosing to lay around and suffer, believing there are simple solutions to our problems. – indigo-soul

People don’t realize how debilitating migraines are. Why so much work is missed because of migraines. I personally have missed several days of work because of migraines and I don’t think they’re taken seriously. They’re not just bad headaches… the same way a vast gaping wound, isn’t just a small scrape.
People need to recognize migraines as a chronic illness. – zamer1230


If you struggle with migraine attacks, know you are not alone. Our migraine support group is here 24/7 to offer support, tips, distraction and encouragement. 

Getty Image by bunditinay

Originally published: June 28, 2019
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