How To Tell If You're REALLY Having Migraines + When It's Time To Get Help

A frequent question I hear from my patients is “how do I know if I’m having a migraine?”

If you're someone who's ever suffered from a migraine, you’re probably thinking “trust me, you’ll know if you’re having one!" And, as a neurologist who has treated thousands of migraine patients (and suffers from them myself) the difference between a migraine and a regular tension headache seems very clear to me, too.

But this is not always easy, and headache doctors don’t always agree on any particular headache patient. So, if you’re experiencing your first one or you’ve never been diagnosed as a “migraineur," recognizing your head pain as a migraine can be confusing.

A less common, but a surefire sign that you’re experiencing a migraine is if your headache is preceded by an aura, or sensory symptoms. The most prevalent type of auras is visual disturbances such as flickering lights, spots or zigzag lines called fortification spectra. Auras last anywhere from 5 to 60 minutes and are completely reversible.

For many migraine sufferers, a migraine is an inconvenience but not a debilitating condition. They use various coping strategies, prevention techniques and over-the-counter drugs to get through the migraine episode and never see a doctor about them.

But for others, these techniques are not enough. The migraine headaches themselves are debilitating and the treatments they are using aren’t enough. Sometimes, migraine becomes intractable. That’s when a person needs a headache specialist.

How many migraines should you experience before you see a doctor? How bad do the migraines need to be to warrant medical attention? What if you're still not sure if what you're experiencing is a migraine?

You can begin to answer these questions by keeping a headache diary. For every headache you have, document when the headache happened; the symptoms you experienced with the headache (for example, aura, nausea, etc.); foods, drinks, or medications you had before the headache began; and any activities you participated in prior to the onset of the headache.

This information and any patterns that develop from it will help give you a more concrete idea of how often you’re experiencing migraines and a clue into what could be triggering them. Note whether you have problems sleeping or have neck problems too. This is important info for your headache doctor to consider when treating you.

A neurologist or headache specialist will be able to help differentiate a tension-type headache from a migraine as well as take a medical history and perform a complete neurological examination, both extremely important in the successful treatment of headaches. Using this information, they can start understanding what's triggering your migraines, evaluate the underlying contributory factor, and set up the best plan for treatment and management.

Overall, the main thing to remember is if your headaches are disrupting your life, it’s time to take control. Pay attention to your symptoms, listen to your body, and know that migraines aren’t something that just have to be suffered through.