Madalena Plácido does not remember her life before the migraine. It is part of the roughly 1.5 million Portuguese who suffer from this pathology – according to the Portuguese Headache Society. It is much “more than a headache,” “there is no understanding,” and worse, there is no cure for this debilitating pain that affects three times more women than men.
He was only ten years old when he had his first migraine attack and he didn’t understand “what was happening”. “With the onset of menstruation, it began to intensify. “You were 15 days a month,” recalls Madalena Plácido of the PUBLIC. That is, if you have had migraines for an average of half a month, it means that half of your year has been spent with this debilitating pain.
Now at the age of 28, thanks to adequate therapy, he is in a controlled phase of the disease with around five attacks per month. “I don’t know what it is like to live without migraines and to be afraid of them,” says the pharmacist, who is the president of MIGRA – the association of patients with migraines and headaches, founded in 2019.
But what exactly is a migraine? “It can be described as a throbbing pain in the middle of the head,” explains the President of the Portuguese Headache Society, Elsa Parreira. Pain, guarantees the neurologist, “does not tolerate stimuli”, “worsens with movements” and is disabling. It is known that it will have “a strong genetic component” but “we still don’t know what is causing it,” nor is there a cure. Yes, it is known, the expert emphasizes, that “the brain of people with migraines reacts more sensitively to stimuli”.
Madalena Plácido says that over time, the stimuli that can trigger a crisis and the first symptoms are perceived. They are extreme tiredness, difficulty concentrating, slow thinking. Then when the pain comes, nausea, vomiting, light intolerance, smells and movement occur. “It means that a heart beats in the head and we cannot get used to the pain,” describes the patient. In these moments he takes refuge in the darkness, in the silence.
In all “decisive moments” there is “fear of a crisis”, says the President of MIGRA. “On my wedding day, my only worry was a migraine,” he says. They don’t stop yourself from partaking in anything, but all planning your days revolves around migraines. “He only notices who has it,” he complains.
Clinical psychologist Sofia Andrade points out the “huge impact” migraines have on mental health. Most patients, like Madalena Plácido, do not feel understood and this is “very painful for him”. Psychological support is therefore very important in order to avoid a “severe state” of depression, anxiety and ultimately, the specialist explains, suicide.
The fact that migraines are a disabling disease creates feelings of guilt, notes Sofia Andrade. “I cannot live this because I am not understood,” explains the psychologist. This feeling affects self-esteem, often leads to isolation, “impairs the ability to dream and think about the future”.
The patient then enters a vicious circle. He gets into a depressed state because he is “not heard” and because he is in acute pain himself. This condition promotes a new crisis. Sofia Andrade explains that “the most important thing” is “going to the meaning of the pain” and working from there – the “pattern of the migraine story itself”, “the emotions and memories” that are responsible for the “intrusive thoughts.” “Are responsible to perceive. The cause of “hormone blocks and discharges” that “trigger the pain”.
A woman’s disease?
It is estimated that three times as many women as men have had migraines since puberty. The neurologist of the hospital professor Doutor Fernando Fonseca in Amadora, Elsa Parreira, explains that the disease is “strongly linked to female sex hormones”. There are women who only have migraines during menstruation or when their estrogen levels are lowered. As a rule, there is a significant improvement in pathology during pregnancy and menopause.
The President of the Portuguese Headache Society also points out the influence of hormonal contraception, which often “aggravates” migraine attacks. Madalena Plácido – a pharmacist by profession – suggests two alternatives for this situation: the continuous use of the pill, which avoids hormonal fluctuations, or the choice of non-hormonal contraceptive methods.
Far from being a disease only for women, however, migraines affect 1.5 million Portuguese – that’s more than 10% of the population. Madalena Plácido and Elsa Parreira leave behind some tips that can help those suffering from this debilitating pain. The main advice is to stick with the routines “since migraines are very routine”. Therefore, it is important to regularly lie down at the same time and keep the necessary hours.
The same applies to meals that, in addition to healthy habits, should almost always be consumed at the same time. Drinking plenty of water and exercising are also two allies in combating migraines. Elsa Parreira also emphasizes that you should avoid stress whenever possible and keep an eye on the triggering factors.
As soon as the migraine crisis is in place, it is important to react to the first symptoms and take the medication. Then try to rest in a dark, quiet place with no noise or light. Applying cold compresses to the head can also help. Madalena Plácido concludes with the advice “not to fight it”, as the tendency is “not to want the disease to take over our lives” but “it is important to rest” and the rest can wait.