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Migraine: a complex puzzle

Migraine: a complex puzzle
  • With no infallible cure or clear cause, migraine affects nearly six million people in Spain

When you are diagnosed with migraine, a neurological condition that is far more than a headache as it is so intense and complex, you find yourself in a cycle of uncertainty and impossible rules to follow.

You don't know when this crisis, which affects your work, family and personal life for hours (sometimes days) is going to occur. Yet at the same time you are also warned to make sure you get enough sleep (does everyone do that religiously every day?), not to miss meals (what if you have a problem at work and eat late?), go to bed and get up at the same time (no, you can't have a lie-in at weekends), avoid sudden changes to routines (what if you're going to travel?), limit certain foods (cheese and chocolate are the usual suspects), avoid loud noise (no more nights at the disco) and don't even think about having a glass of wine with friends unless you want to unleash the perfect storm.

And this storm, of course, doesn't always let you know it's going to happen, and when it does, not everyone is able to control it. Not with drugs or different therapies. It is completely unpredictable.

Six million people in Spain are engaged in a battle with this illness, and around 80 per cent of them are women, mostly aged between 35 and 55. In other words, during the most active and fulfilling stage of their life.

Unknown and underestimated

Despite it being so common and the amount of research carried out, nobody has yet been able to come up with a treatment for migraine which is absolutely infallible and universal. At present treatments depend on the doctor's assessment of the patient and range from common analgesics to the latest-generation 'vaccines', which act on the pain mechanism and are only available in the most extreme cases.

Nor does migraine have a clear origin. Nobody knows exactly what sets it off. If they did, they could attack it at base. It is so common that the World Health Organisation classifies it as the sixth most incapacitating illness in the world. Despite this, some people still see it as a minor or passing problem, an excuse used by those who want to avoid their obligations.

September 12th was International Migraine Day, and during this week several information campaigns have also taken place to raise awareness of the condition.

The description of migraine used at the start of this article is not subjective. It is supported by data from the principal associations and agents involved in studying it. Among all the studies, the latest survey by the Spanish Migraine and Headache Association (Aemice), stands out: it shows that stress is perceived as one of the main causes. Or to put it another way, 78 per cent of those who participated described it as such.

Specialists and therapies

If you suffer from migraines, it is important to see a neurologist who can evaluate your case and decide on the best treatment, but specialists have also begun to look at how tackling the psychological aspects may help.

The Spanish Neurology Society (SEN) says a scientific review was carried out into this some years ago and it came to this conclusion: "Relaxation and cognitive behavioural therapy for stress have proven useful. Therefore, they are techniques which should be considered for our patients." Now, they are taken into account whenever this factor could be a trigger.

"Stress can be a determining factor, but not in all patients," warn neurologists. However, if it is not known what triggers each migraine attack, learning how to control emotions and self-expression can be a useful way of dealing with it.

The latest therapies of this type consist of explaining the pain mechanism to the patient so they understand how it works and stop their body responding by using it as a defence mechanism. This is the so-called exposure therapy, which is applied in the case of phobias.

Psychology

Psychologist David Sojo uses it, and says that with work and over time it has helped many people who have found no relief with other types of treatment.

"Migraine is a warning signal, a type of alarm. It is a defence mechanism which is activated by the body, but in reality the threat as such doesn't exist, in the same way as with phobias," he explains.

The technique he applies consists of teaching the body "to respond differently to the start of a crisis". Instead of isolating oneself and ceasing all activity (which is often recommended for people when a migraine begins), it tries to 'normalise' the situation as much as possible until the body stops feeling threatened.

"You have to teach the body that its perceived threat doesn't actually exist," he says. He also says this therapy has helped 95 per cent of his patients.