Thriving with Migraines, from a Patient’s PoV

Hey you. Yes, you! Before you proceed, read this article if: 

1. You’re suffering (or expecting you suffer) from migraines, and want to read how others handle the condition and thrive with it, personally and professionally.
2. You have an employee, a relative, a partner, or a friend, who is experiencing migraines, seeking to find out how to help people with occasional or chronic migraines.
3. You don’t mind the extreme personal touch on this article, since it’s a topic I am sensitive about. Neither that it is more than 4000 words long (yes, I had a looooot of things to write here). 

Feel free to proceed still, nevertheless. I mention the key points to respect your time before investing it – thank you for reading!

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All my blog posts are highly personal. Yet, still, this might be the most personal one to date. 

And it ain’t related to marketing either.

It comes from the deepest part of my soul.

The story starts one day, back in my teenage years. When I notice something I never felt before. 

A terrible pain, right in the head, in my right temple. An intense, throbbing distress. Tied up with an unbearable nausea. 

Lights were hurting me like never before. Sounds were acute, pinching me constantly in my ears. 

I never felt something like this before, and my parents got so scared that brought me to the hospital in an instant. 

A bit less than a week passed in there, running all kinds of tests: MRIs, blood tests, allergy tests, you name it. Staying in a room with five other girls and their moms – and sadly, my mom included, to make it even more awkward for my teenage self. 

But all the tests came clean. Nothing came out of the ordinary. The “worst” have been averted, leading the doctors to a singular outcome. 

I got diagnosed with migraines: the first of the many. 

It shaped me as a person. Plenty of examples of how, but here are some.

• How I would end up sleeping next to a bucket after each day in the last year of high school since my nausea would get so strong I was always on the verge of throwing up. 
• How I would skip parties, try to sleep regular hours, always leave for the suburbs before midnight (like Cinderella, yes), or face the bitter consequences throughout my college years.
• How I would ache horribly while serving in the Greek army, sometimes with more migraine than migraine-free days consecutively.

And the list goes on and on. 

And now? 

I am 29, but migraines continue to plague me. 

So let me tell you some things ’bout it. And by some things, meaning 4000 words worth of tips and info on the condition. 

Strongly suggest you use the content table for this one – let’s go!

What is a migraine? (And no, a migraine is not a headache)

“Oh, you have a migraine? Yeah, I get one of these headaches, they suck”.

Yes, that’s a common response. Have you been tempted to use it? Have you said something similar to a migraine sufferer?

Listen, I understand – you try to be empathetic. But in empathy, you view the issue from the other’s person shoes and eyes, not yours. 

Starting then from the common misconception: that migraines are vastly different from headaches. We’re talking about a neurological disease. For a more scientific explanation, how about you hear it from the doctors below? 

For a more personal explanation, migraines affect each person differently – but I sometimes wish it was only about the pain. It’s more than that.  

In my case, the pain is there – 90% of my current episodes have the left side as their epicenter. But it is how the pain makes me feel that is important to understand. 

Sounds scratch me, piercing me through like knives.

Lights overwhelm me. 

My motivation gets depleted. 

My speech is even somewhat slowed and slurred since half of my brain is occupied thinking of the discomfort. I think and act slow, lethargic even. 

And I lack a warning aura, like 20-25% of us have. What we call an aura is a pack of symptoms (in many cases visual), that might precede a migraine. But for me, once I get the pain, it is done and dusted – mam migrene (showing off my newly acquired Polish A1 skills).

In some cases, this can go on for days. My record is ten days of constant pain. When did I have this record? Well, I started writing these lines when I had it! 

How can a migraine start? 

It can start for a variety of reasons. We usually call these reasons triggers. 

And you bet that there is a spectrum of them, depending on each case. 

For me, when I was younger, I could get one from sleeping less (or from occasional partying, skipping meals, and not drinking enough water. But I tracked these causes down, and changed my habits, leading to fewer episodes down the road. 

But there is strong seasonality in my case, which I noticed here in Poland more than ever. When the weather is changing rapidly, this is when migraines hit me harder. And, coming from a mild Mediterranean country, transitioning to Polish weather changes was, and still is, very rough.

I tried cutting down caffeine and alcohol entirely – the first one failed to benefit me (and I was craving coffee so much), so I skipped it. 

However, there can be so many others, such as: 

• Food-related: exact foods when consumed, ex. cheese, spicy foods, processed foods. 
• Lifestyle-related: lack of exercise, lack of sleep, skipping meals, dehydration, alcohol/tobacco consumption, caffeine withdrawal/overuse, etc. 
• Stress-related: stressful events or stages of life contribute enormously negatively. 
• And so many more. 

Treating Migraines? Not so simple.

Here, let me remind you that I am not a doctor. If you are suffering from migraines, seek professional help – and there is help for you, so don’t lose hope!

Instead, I will tell you my journey with the condition. Sprinkling some credible added sources on top. 

WebMD explains it well – doctors are still unsure of migraines. You can get it genetically, and that’s how I probably got it. Thanks, Dad, because the early 20s baldness genes were never enough in the first place!

The treatment depends on the severity of the issue from the patient, but there are two pills ahead: acute and preventive treatment. 

For patients that have infrequent, low-in-number migraines (you lucky dogs), it’s simply a matter of having the medications with you to prevent the migraine from expanding. You get the aura or you catch the migraine in its early stages, and you have a strong chance of escaping with your day intact. That’s the acute treatment, and here are some examples. 

What about the preventive treatment, then? Well, if you’re having a significant number of episodes per month, you might be looking to have less. No, I am not saying zero. The primary goal of the therapy is literally to lessen the amount and intensity of migraines. Enough, so that medication remains strong (i.e. you don’t get used to it, thus losing its efficacy), and you manage to get away with your month much easier than before. 

So, how about preventing migraines? The role and many faces of preventive treatment.

For preventive treatment, here’s what I tried. No, honestly, tried all of them and more: 

• (Experimental) Medical Treatment: There is no clear reason why migraines exist – thus, no clear therapy! Instead, based on previous cases, some medications might help, but not certainly. For example, I’ve tried pills that lower the blood pressure, that focus on people with Vertigo or Seizures, and beta-blockers, among others. You don’t have to have the problem these meds are usually prescribed for, it’s just that for a significant chunk of people, they acted preventively. But for me, this stage didn’t work, so… 
• Botox rounds: Yes, no joke. Botox can help by numbing the nerves and decreasing the frequency and intensity of migraines. It still has to be done by a neurologist in most cases, and it features more injections than for cosmetic purposes. If experimental treatments won’t aid, then this is the next step for many cases. Anyway, I know what you’re thinking, and it’s affirmative – it also helps with your wrinkles. 
• Physiotherapy: The most recent one I’ve tried is physiotherapy. This one can help a lot if the migraine is associated with tension in the neck, which I am searching for currently. 
• Cutting down coffee, processed foods, and alcohol: I was still getting migraines, so the first two I reintroduced. Was never a huge fan of alcohol anyway, so I got the opportunity to skip it entirely.
• Acupuncture: People (and health professionals, backed by research) swear on acupuncture’s efficiency in dealing with migraines. I’ve tried having a session, but the experience I had – one of the most surreal ones in my life – created strong negative connotations to myself. But I will try it more in the future to see how it goes.
• Oxygen therapy: A doctor in Greece asked me to try this, but after some sessions, it didn’t bring me much comfort. You essentially breathe oxygen directly through a mask, that’s all. 
• Dietary Supplements: M-A-G-N-E-S-I-U-M. Everyone is prescribing magnesium. But also other vitamins (D, B12) can help patients. It doesn’t always benefit me. But still worth trying. 

And there are many, many others – in my lifespan, I must have consulted more than 20 neurologists, plus many other professionals. In short, do what you feel helps you best – even if it is a placebo, given that migraine can start from psychological reasons, it might help. Most importantly, do your research, consult real professionals with a strong track record on the disease, and try to keep a healthy lifestyle. 

Which brings me to the SEEDS method. 

SEEDS Method for Migraines – Working towards a healthier lifestyle.

SEEDS is yet another acronym. Seriously, how come we’re not sick of those already? 

Anyway, this one is useful at least. It stands for Sleep, Exercise, Eating, Diary, and Stress – all of which are vital factors for the disorder.

Let’s see them one by one briefly: 

• Sleep: Prioritize sleeping enough (7-8) hours, and stick to a schedule. 
• Exercise: Don’t be a couch potato. Go for walks, do HIIT/Tabata workouts if you lack the time, and be active in general. 
• Eat: Don’t skip meals, snack (healthily) during normal meals, hydrate, and skip processed foods as much as you can.
• Diary: I underline it – it’s a life-saving, mandatory step. Start noting down, either on paper or within specially designed apps (such as Migraine Buddy), when you have a migraine. Add as much info as possible: pain centers, pain intensity, duration, potential triggers, other symptoms, and medication received. It allows you to keep track of your episodes, and find the real triggers. And you’re making the life of your physician much easier!
  • Tip: I do this by keeping a physical journal just before sleeping. It helps me get away from mobile devices before sleeping, which helps me sleep easier. Journaling is generally a key tool for self-management & self-improvement, so highly recommended for lots of reasons!
• Stress: As mentioned above, stress is hazardous for migraines. Managing anxiety, by reducing its triggers, meditating/mindfulness, undergoing therapy, etc. should be on your watchlist. 

I skipped all the scientific stuff, as the blog is already running long. Here’s more info on it. 

Preparing for a migraine, so that you catch it early on.

Whatever you do to prevent it, you may still get a migraine. It’s a fact of life, living with this ugly condition. 

Here are my five favorite tips here, in your quest to avoid them: 

• Always have meds with you: It sounds self-explanatory, but there are more than a handful of times that I was caught lacking (meds), which led to serious episodes. Wherever you go, if you’ll be away from home for at least an hour, get your meds with you. If you feel like an episode is incoming, and you’re not overusing your medication (typically 4-6 per month), many doctors advise taking them in this stage to catch it early on – but still, consult your physician on the matter. 
• Be mindful of auras/presymptoms: Always take some time to check if you’re feeling ok throughout the day. Sometimes, you might even wake up in a challenging mood, so be alert for anything that foreshadows an episode (again, journaling will help you with that). 
• Know your triggers: Keep away from things that trigger you, especially within days that you suspect of having a high possibility of an episode. 
• Seek a calm environment: This works as a preemptive tactic as well. Since light and sound hypersensitivity are both common symptoms of migraines, you try to avoid going into a sensory overdrive. 
• Practice relaxation techniques: Mindfulness is key here. Breathing exercises can aid you with stress management, hoping to prevent a migraine episode before it occurs. 

But even with the best prophylactic strategies… shit happens. So, if it does:

Welp, I have a migraine – what to do now?

Repeat after me: the pain will pass, my friend, and life will continue as normal. Do not let despair take over! 

You should already have a neurologist/doctor to discuss a plan with you on how to go away with them. Why go through this by yourself?

And during the attack, you’re waiting for the medicine to kick in – which may not do at all, especially if you got it a tad too late. That happens to 20% of my cases. 

There are ways to manage it a bit better. Here are my favorite ones to date: 

• Stay in a calm environment: It is almost unavoidable now – if a migraine is in full force, the more you stay in a noisy, bright place, the more you ache and deteriorate. 
• Stay away from electronic screens as much as possible: Don’t strain your eyes any further, especially if photophobia is one of your main symptoms. 
• Try to relax/sleep: Relaxing is non-negotiable, as the more tense you stay, the worse it gets over time. What I find helpful is taking a prolonged hot shower, sitting down, and focusing on my breathing. Relaxation techniques apply strongly here as well. (Power) Napping may also aid you.  
• Apply hot and cold compresses to the head: After a hot shower, I usually wear my migraine relief mask, kept in my freezer at all times. It contains a gel that stays cool for some time, and the sudden hot & cold shift eases some symptoms. 
• Consider stretching exercises: The video below is an example of some stretches you can do to ease the pain, but of course, there are plenty of others. 

There are other supporting ways. They failed to bring significant changes to me, but I hope they do to you. 

• There are plenty of tracks with weird sounds for migraines (such as this), but for me, they rarely work. 
• Applying tiger balm in the applicable temple helps for a moment, but makes my episodes even harder later on. 
• Eating strongly flavored foods with plenty of salt/acidity has helped some people – in some of my cases, eating the blue hot Takis (I ain’t even joking is crazy) immediately lowered the pain. Still testing this hypothesis to ensure if it helps or not. 
• Applying pressure/massaging on the spot makes my symptoms worse, so I skip it. But massage can benefit you, from a person or these massaging machines. 
• Herbal medicine, such as ginger tea, and essential oils, such as lavender or eucalyptus, can be somewhat useful. 

If a migraine is persistent (lasting more than three days) or intense, seek professional help immediately. Going to a hospital is a scary experience (at least for me), but I still had to do it twice in my life. 

Once again, there is help for you, and the attack is always temporary. 

I don’t have migraines, but a person in my life has one. How can I help them? 

Start by never telling them you get headaches as well. That’s rule #1. 

All jokes aside, props to you for caring enough – you’re a great human being, random reader!

Here are the best tips I could give you. Apply them if they are also willing to accept your assistance, eh?

• Educate yourself: If you haven’t read all the above and skipped to this part, I advise you to start from the top. The first part is to see the paranoia of the condition from a patient’s PoV, which I try to convey. Of course, read more articles about this so you can have more credible sources. 
• Communicate (empathetically): ask about their symptoms and how their episodes unfold, as each case is distinguishable. Most importantly, ask them how they can help. It’s one of those cases where you have to wear their painful shoes to comprehend their situation. Solid opportunity to practice empathy! 
• Provide Emotional Support: people with chronic migraines can get really moody during an episode, so do not undervalue your power here. Even a warm embrace, a warm act, even your warm words can be so valuable. Show that you care, because care goes a long way to someone desperately aching. 
• Help them with their plan: Make sure they write down their episodes, discuss their treatment progress, and help them identify their triggers. Again, if they’re feeling comfortable with the idea. Having a migraine buddy is so vital to not get mental with the disease. Be this buddy for them!
• Encourage them to seek professional help: Last February to April were the second worst months for me in terms of migraines (nothing will surpass the army with chronic migraines, nothing), and because I was solely by myself in a foreign country, I got desperate enough that I stopped trying anything new, “What’s the point?” was what I assumed. Retrospectively, that was the stupidest thing I could have done, and without my current partner, Ola (whom I unironically met exactly after the worst migraines I had in March 2023), I would probably still do it. She refused to see me suffer and pushed me to find new ways to help myself – which I did. It may not have brought definite results yet, but there is improvement. It just shows how much a person can help in someone else’s life, doesn’t it? 

But how to help if I am this person’s manager/employer?

Words can’t describe how lucky I was in the past to have managers who understood my problem – many of whom were having migraines themselves, so they fully understood the issue. 

Still, there’s a favorite in this case, most probably my favorite manager generally. Let’s call her D.

I’ll focus on her style as being the best for my case, but to my other previous managers S., R., A., and M. – be blessed for showing so much understanding on my issue, never asking why and making me feel shitty for what I am facing. A warm, cordial thank you from the bottom of my heart. 

When I started, D. asked me about anything she should know in advance, and we discussed my case. She reassured me from the very beginning that I should never fear saying what I have, to always let her know accordingly, and she will ensure I am accommodated. There was a health-first policy in her team. 

Now, people who know or have worked with me can back this up – when I have a migraine, I don’t just give up. If the pain is up to moderate, I keep pushing on, but I am upfront with my colleagues about expectations – that I will be a bit slower than usual. Kudos to myself for not following my advice. Braaavoo. 

If she would catch me having a migraine – and she was good with noticing the signals – she would jokingly kick me out, then would seriously ask to take care of myself. She did say once “Nope, you’re not participating in this with a migraine, got get rest, byeeee”, then proceeded to kick me out of an online Teams meeting, which was quite comedic.

She would never ask me uncomfortable questions about my issue. 

She trusted me that I had everything in order. The world would continue turning if I skipped some extra hours. 

And, of course, I would repay that trust. If I were to miss a day, I would make certain I am laser-focused to cover the ground lost. I make sure everything’s in order. 

She was so effective in supporting me that I ended up a top performer that year – in my first year ever for the firm. With a significant amount of episodes that year as well. 

And that’s what my focus is before I start with the tips: we’re not lazy asses (unless someone’s pretending to have migraines, to whom I wholeheartedly ask to go f* themselves). We can’t help it. We can work hard. We know what’s up and feel very sensitive about it. So that’s where you should be focusing on. 

All of the above personal tips also apply here, depending on the level of familiarity and the relationship you have with the person. However, here are the most crucial additional parts of a manager: 

• Communicate on how to assist: Communication is key, as each case is different, so I’ll repeat it here as well. In cases of occasional migraines, you might not even need to do anything – it’s just a matter of knowing that this might happen and help if it does. 
• Aid with working arrangements: Remote/Hybrid policies can help, but with the 2024 trend going away from such models, providing a calm environment for employees with migraines is crucial. Open offices can be hazardous, so if the role has to be on-site, then try your best to accommodate accordingly (ex. with a calm, low-lit office space). Flexible leave policies, ex. leaving for some hours because of an attack but covering them at some other time (which is something that many of us would do by default anyway) is useful to have as an official, acceptable-from-the-company option. 
• Promote a healthy work-life balance: Of course, if possible. There will be periods that work is work, over hours are needed, things are tough. Still, communicate clearly about the person’s capabilities and ensure it’s not for a prolonged period. This should be common knowledge and applied to all your employees anyway – no need to stress why this is critical, right?  
• Actively reassure them it is OK: We feel much worse than you think we feel about it. We wish for a normal life, but it is what it is. Actively, empathetically showing your care on this, is something that I believe 90% of people with the condition will value immensely. 
• Respect Privacy: Never discuss this with your employees if they are not comfortable with it. And never discuss it with someone else without the employee’s permission. At least in the EU, this is considered personal information, so it can even lead to legal implications. 

I have occasional/chronic migraines, but I still want to thrive professionally. What can I do?

Listen. 

Or actually, read. This is a blog article, dumb Michalis, what listen? 

Life… life ain’t fair. It isn’t, ok? 

You have this issue, vigorously trying to kick it off with anything’s on your toolbox. 

And I get it – I have disastrous migraines. Frequent ones too, in my case mostly during Fall & Spring. 

I’ve tried so many things from when I was a teenager, as you saw above. The only thing bringing me some better results was SEEDS and Botox, which lessened the migraines’ intensity. 

But as the world keeps spinning around, stay active and moving. It sucks, but you have to keep trying, and sometimes try even harder than others, to cover for lost ground. 

Still, you can do it. 

The first and most important tip is not to give up. NEVER give up. 

And then, consider these: 

• If possible, make applicable career choices: You can’t expect to be a rockstar putting out 100000 Decibels to the masses without suffering the consequences. Ok, this is an extreme example – but if that’s your dream, still try to follow it as I believe in you! But in your case, seek career paths that accommodate what you have. Pursue remote/hybrid opportunities. Go freelance to give yourself the flexibility you require. Refrain from hiding the problem under the rug if the problem persists.
• Proactively discuss this with your employer/manager: Let them know as fast as possible, and never wait to have an attack to tell them. If you have a problem, they should know. Otherwise, think of it from their side: doesn’t it feel somewhat too suspicious and weird to hide it until the last moment? And if they show zero tolerance & understanding? Honestly, quit if you can afford it. I am serious. It’s a health matter, so I can’t believe a situation that this translates well to the employer. 
• Practice mindfulness and stress management: Stress is normal – it means you care. Managing stress with migraines is a must, though. Learn the proper techniques to calm yourself down, and to be fully aware of how you feel during the day. 
• Keep a healthy lifestyle: Be responsible about your health situation. I remember having a friend once with migraines, that would complain after she was getting migraines from partying hard the last day. Love and care for yourself because who else would? 
• Create a support network: Join relevant groups. Ask friends and colleagues to be your migraine buddies. Try to build a web of reliable columns for your situation, to keep strong when the time needs you to be. 

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That’s it from me.

Or, I guess, I’ll end up with a personal note.

It’s hard to forget sometimes, and it feels arrogant to say it out loud.

But I still am proud of myself for doing so many, with this extra hurdle.

We all have hurdles, and it’s a matter of overcoming them. You should be actively proud of your accomplishments too.

I’ll never forget Tyrion’s line from Game of Thrones, no matter how badly they ended the show.

Be proud, no matter what you are facing.

Never give up. Keep pushing on!