Splitting headaches: Understanding the aura, fear, and pain of the migraine

by Kait Fowlie

It starts with an ‘aura,’ a visual disturbance involving shimmering and missing pieces. Gradually, the aura impedes sight entirely, and disorientation takes over, making basic communication impossible. That’s when the headache starts.

These sensations constitute some of my first memories. I’ll never forget standing in the hallway on my way to school one morning and telling my mom she only had half a face. At the time, this was as worrisome and baffling for her as it was for me, and what followed were many attempts to understand the strange and volatile event that just kept happening. Most of my childhood memories are characterized by confusing trips to doctors, countless prescriptions, and a persistent fear that I’d turn a corner to see a half-faced person standing there.

If I had a hard time trying to articulate this experience when I was a child, it hasn’t gotten any easier 15 years later. “Unless you know someone who suffers with migraine you likely have no clue how debilitating it can be,” explains Dr. Christine Lay, of the Women’s College Hospital. “Headache is poorly diagnosed and managed because it is under-taught, with the average medical student getting only four hours of training over four years! So, doctors on the front line have been left ill-equipped to manage these disabling conditions.”

Currently, there’s no cure for the disease, perhaps in part because symptoms vary greatly from sufferer to sufferer. Some people are able to identify triggers (cheese, wine, lack of sleep) and for others, myself included, attacks are seemingly random. Generally, a sufferer can manage migraine by being mindful of their daily habits. “Lifestyle factors such as hydration, nutrition, exercise, and sleep routine are important. Equally important is to be honest with yourself about ongoing stressors or anxiety/depression — even if mild — as left unmanaged these can aggravate headaches,” explains Dr. Lay.

Taking note of the patterns that occur around times of an attack is a common starting point to finding a solution. Beyond that, most migraineurs need more help than what they can provide for themselves. The wait for good help can be long. I waited over a year to see Dr. Lay, but it was worth it. The Women’s College Hospital’s Center for Headache is Ontario’s only medical centre dedicated solely to headache diagnosis, treatment, and prevention. A patient can expect a comprehensive, one-on-one examination where there’s no such thing as a stupid question. All of mine were answered in a way that satisfied the discouraged child in me, who has lived in fear for a long time.

The Centre for Headache at the Women’s College Hospital caters to a niche demographic that requires specialized attention. “Migraine is three times more common in women than men and we think one of the primary reasons is hormones, particularly estrogen,” Dr. Lay explains. Many women may not be aware, but the way we experience stress, a prominent migraine trigger, is significantly different from the way men do. Studies have proven that higher levels of estrogen amplify the stress response in some areas of the brain: When exposed to stress, female lab rats’ ability to learn and function normally proved impaired, and that of male rats didn’t.

Rising above the threat and fear of migraine started with equipping myself with the right information. As Dr. Lay explained, this means being honest with yourself about the one factor many believe to be the root cause of illnesses ranging from canker sores to cancer: stress. There’s no need to keep migraines in the dark. “Empowered by knowledge, migraineurs can gain control of their headaches,” says Dr. Lay. Resources like the Center for Headache truly do illuminate the lives of sufferers.