Why health experts say you should take your headaches seriously during the holidays

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There's no doubt the COVID-19 pandemic adds stress to the hectic holiday season.

In addition to the extra cooking, cleaning, gift-buying and decorating, Americans may have to worry about scheduling COVID-19 tests before travel or ordering extra masks for family members.

The to-do list seems all the more daunting when a pestering headache just won't go away. Health experts urge people not to dismiss headaches as they could be migraines that require treatment.

"Migraine is one of the most commonly misunderstood, misdiagnosed and mistreated disorders on the planet," said Dr. Christopher Gottschalk, professor of clinical neurology and director of headache medicine at Yale School of Medicine. "The thing that causes people to miss the most time in work, relationships and life is migraines."

While there's no evidence to indicate migraines occur more frequently during the holidays, experts say, they can impact some of the most important activities and cherished moments.

"They may be getting a headache while they're doing their Thanksgiving preparation and try to wish it away until it's so bad that they can't function and then they're in trouble," he said. "No one has let them in on the secret that you can treat a migraine if you have the right tools."

Why do we get headaches? What does a migraine feel like?

The most common type of headache is called a , said Dr. Jan Brandes, director and founder of the Nashville Neuroscience Group and a member of the National Headache Foundation board of directors.

The foundation defines this type of headache as a dull, non-throbbing pain involving both sides of the head where the degree of severity remains constant. They can be triggered by multiple issues layered together like lack of sleep, increased stress, hunger, medication overuse, alcohol or too much caffeine intake, Brandes said.

A tension-type headache should not be debilitating or interrupt routine activities, and they normally go away when treated with over-the-counter pain relievers like ibuprofen.

If these traditional interventions don't work, Brandes said, that headache may be mild migraine.

"A lot of the times, it's the mild migraine that masquerades as a tension-type headache," she said. "If that's treated early, it could prevent it form escalating and eliminate a lot of pain."

A migraine is defined as having at least five headache attacks lasting four to 72 hours, according to the National Headache Foundation. Migraines can cause severe throbbing pain or a pulsing sensation usually on one side of the head and is often accompanied by nausea, vomiting or sensitivity to light and sound.

A migraine occurs when excited brain cells trigger a nerve to release chemicals that irritate blood vessels and cause them to swell on the surface of the brain, the foundation said.

Migraines most commonly occur in women between the ages of 25 to 55, say, as fluctuations in estrogen before or during menstrual periods, pregnancy or menopause may trigger headaches.

A migraine attack can also be triggered by a change in sleep-wake cycle, missing or delaying a meal, medications, bright lights, excessive noise, stress or underlying depression, according to NHF.

Some people experience migraines with aura, visual or like flickering lights or feeling numbness, or difficulty putting words together.

But not everyone who has a migraine experiences these symptoms, health experts say, which often leads people to dismiss their migraine until their pain worsens.

"In about 40% of migraines, it's like a tension-type headache that involves both sides of the head," she said. Visual or sensory changes "is seen in about 20 to 25% of individuals and they don't have it with every attack but it's the most talked about thing when it comes to migraines."

Other ways to know if you have a migraine

Some people believe tiredness or dehydration can cause a migraine, Gottschalk said. But evidence shows these symptoms may be of an imminent migraine.

The symptoms of the first stage of a migraine, called the prodome, can be confused for a migraine trigger. Other warning signs include mood changes, neck stiffness, food cravings, fluid retention and constipation.

It's important to learn your individual warning signs, Gottschalk said.

"The headache reliably causes these symptoms first before the pain starts, so recognizing those symptoms becomes an opportunity to intervene," he said. "Pay attention to the warning signs, take a seriously and don't let it get out of control."

Chronic migraines are defined as occurring 15 days or more in a month, health experts say. They urge Americans who experience this to see their doctor for medical intervention, which often involves medication.

Other strategies can help reduce stress and prevent a migraine, Gottschalk said. He recommends breathing exercises, meditation, a 30-minute walk, stretching exercises, reading a book or preparing a relaxing bath.

"When a migraine gets triggered, it's important to control stress," Brandes said, especially during the holidays.

Why it's important to seek help

NHF estimates more than 37 million Americans suffer from migraine and health experts say many spend decades dealing with the pain instead of seeking medical attention.

"There's this leftover notion that developed in the 20th century that headaches aren't really a medical problem ... People have been taught to dismiss (them)," Gottschalk said. "It's a sociological problem that's being imposed on what turns out to be the most common medical disorder in women."

The Food and Drug Administration has approved three over-the-counter products to treat migraine, but if these aren't effective, health experts say patients may benefit from prescribed medication.

These medications are most effective when taken early in an attack and can enable a patient to return to normal functioning after a few hours.

"It is really absolutely amazing how many people have who don't get treated until it turns into something miserable," Brandes said. "Diagnosis has dramatically helped so many individuals, so it's important to see someone to help you decide if now is the time to think about preventive therapy."

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