By: Kathy Hubbard
Migraine is often misunderstood, and often misdiagnosed. Or worse yet, undiagnosed. It’s a neurological, disabling disease that affects close to forty million people in the U.S. Although the most common symptom is head pain, it’s not your run-of-the-mill headache.
Dr. Amaal Starling is a neurologist at Mayo Clinic who specializes in headache disorders. I found a video she posted on Mayo’s website. In it she says, “There is a lot of stigma around migraine. That it’s just a headache and that it’s no big deal. It affects each person differently with a wide range of disease severity. Some have infrequent attacks, but others may have frequent disabling attacks. Expecting someone to push through or just take your mind off of it is never good advice.”
Healthline’s website agrees. They say that a migraine episode is much more than just a bad headache. Although symptoms vary from person to person they can include intense headache pain, nausea, vomiting, neck pain, general aching, irritability or sadness, sensitivity to sounds, smells and light, and changes to vision.
“Migraine can be episodic or chronic. If you experience migraine pain 14 days per month or fewer, doctors classify the condition as episodic. If you experience the pain 15 days per month or more and have other migraine symptoms on most of these days, doctors consider it chronic migraine,” Healthline says.
Dr. Starling says that migraine affects one in five women, one in sixteen men and one in eleven children. It’s believed that hormonal differences are most likely the reason migraine occurs more frequently in women. And interestingly, when it occurs in children, it more often affects boys than girls.
“Certainly genetic and environmental factors play a role in the development of migraine disease. And since it is genetic, it is hereditary. Meaning if a parent has migraine, there’s about a fifty percent chance that a child may develop migraine as well,” Dr. Starling says.
Healthline says that experts believe certain factors trigger a migraine episode. The list of triggers is extensive. It includes some food and drink such as beverages that include alcohol or caffeine, preservatives and artificial sweeteners. But what I found more interesting is that skipping meals can be a trigger, exercising when you haven’t in a while can also be a trigger, and dehydration, even in the slightest, can bring on an attack.
“Up to 75 percent of women with migraine report that attacks develop around the time of their periods, others report migraine episodes during pregnancy or menopause. Birth control and hormone replacement therapy, for example, can also trigger or worsen migraine attacks. But sometimes, these treatments may actually reduce migraine headaches,” they say.
There are four stages of migraine, prodrome, aura, headache, postdrome. Dr. Starling explains that “some people may get prodrome symptoms, the beginning of a migraine attack. These can be subtle warnings such as constipation, mood changes, food cravings, neck stiffness, increased urination, or even frequent yawning. Sometimes people may not even realize that these are warning signs of a migraine attack.
“In about a third of people living with migraine, aura might occur before or even during a migraine attack. Aura is the term that we use for these temporary reversible neurologic symptoms. They typically build up over several minutes and they can last for up to an hour. Examples of migraine aura include visual phenomena such as seeing geometric shapes or bright spots, or flashing lights, or even loss of vision.
“Some people may develop numbness or a pins and needles sensation on one side of their face or body, or even difficulty speaking. At the end of a migraine attack, you might feel drained, confused, or washed out for up to a day. This is called the post-drome phase.”
There is no cure for migraine. Your primary care provider will make a clinical diagnosis based on your symptoms. There are two main types of treatment, acute and preventive. The first addresses the symptoms, the second aims to reduce the frequency, severity and duration of migraine before they occur. The medico will give you all the options.
If you don’t have a primary care provider, Bonner General Health Family Practice can be reached at 208-265-2221. New patients, including those on Medicare and Medicaid, are accepted.
Kathy Hubbard was a charter member of Bonner General Health Foundation. She can be reached at [email protected]. This article was written for publication in the Bonner County Daily Bee on June 24, 2026.