If the word migraine makes you think of someone lying in a dark room with a cold cloth over their eyes, that picture is not far off. Migraine attacks can be genuinely disabling. They are not the same as a regular tension headache, and they deserve more than a shrug and a painkiller.
In my years of practice in internal medicine I have met many people who put up with these attacks for months or years, thinking there is nothing to be done. That is not true. While migraine cannot always be eliminated completely, the frequency and intensity can usually be brought down substantially with the right approach.
What makes a migraine different from a regular headache
A tension headache usually feels like a band squeezing around the head, and it is unpleasant but rarely stops you from functioning. Migraine, in contrast, tends to be a throbbing or pulsing pain, often on one side. It is frequently accompanied by nausea or vomiting, sensitivity to light and sound, and sometimes blurred vision. Attacks can last anywhere from four hours to three days.
The main types of migraine
Not all migraines look the same. Understanding which type you experience helps your doctor choose the right management plan.
- Migraine without aura is the most common. It is a moderate to severe throbbing headache with nausea, light sensitivity, or both, but no visual warning signs beforehand.
- Migraine with aura includes a set of neurological symptoms, usually visual, that appear shortly before the headache. You might see zigzag lines, flashing lights, or a temporary blind spot. Some people get tingling on one side of the face or hand.
- Chronic migraine means headaches on 15 or more days per month, with at least 8 of those meeting migraine criteria. This is the stage where early medical advice can make the biggest difference.
- Menstrual migraine is linked to hormonal shifts around the period. It is often more intense and longer lasting than other migraine episodes.
- Vestibular migraine causes dizziness, unsteadiness, or vertigo alongside or instead of the headache.
Common migraine triggers
Triggers are not the same for everyone, but certain patterns show up often enough to be worth watching for.
- Irregular sleep, both too little and too much, is one of the most consistent triggers.
- Skipping meals or going long hours without eating, especially in hot weather.
- Dehydration, which is easy to underestimate in Indian summers.
- Stress itself or, paradoxically, the let-down period after a stressful stretch (weekend migraines).
- Strong smells such as perfume, paint, or petrol fumes.
- Bright or flickering lights, including prolonged screen time without breaks.
- Certain foods and drinks, though this is highly individual. Common culprits include aged cheese, processed meats, alcohol (especially red wine), and excessive caffeine.
Keeping a simple diary of your headaches, what you ate, how you slept, and what was happening that day, can reveal patterns your doctor can act on.
When to see a doctor
You do not need to be in the chronic range before getting help. See a doctor if your headaches are getting worse or more frequent, if over-the-counter painkillers are no longer enough, if you are taking painkillers more than two or three days a week (this can itself cause rebound headaches), or if the attacks are affecting your work, studies, or daily life.
Certain symptoms need immediate attention. If you experience a sudden, explosive headache unlike anything you have had before, sometimes described as a thunderclap, that is an emergency. Call 108 or go to the nearest hospital. The same applies if a headache comes with a high fever, stiff neck, confusion, seizures, weakness on one side, or trouble speaking.
What a doctor can do
Your doctor will first confirm that what you have is indeed migraine and not something else that needs a different workup. From there, treatment broadly falls into two tracks. Acute treatment addresses the attack when it happens. Preventive treatment, usually a daily medication taken for several months, aims to reduce how often attacks occur. The choice of medication depends on your specific pattern, other health conditions, and what you have already tried.
Lifestyle adjustments, regular sleep, regular meals, adequate water, managed stress, and identifying personal triggers, remain the foundation. Medication works best alongside these habits, not as a replacement for them.
Migraine can weigh on your mood over time, and if that is the case, please know that support is available. You can reach the free national Tele-MANAS mental health helpline at any time on 14416 (or 1800-891-4416). If you or someone near you is in immediate danger, call 108 or go to the nearest hospital.
A word from our clinic
I am Dr. Deepak Gaikwad, an internal medicine specialist with 29 years of experience, practising at Prudent International Health Clinic in Viman Nagar, Pune. If migraine attacks are interfering with your life, come in for an evaluation. We can look at the pattern, rule out other causes, and put together a plan that makes the episodes less frequent and less severe. We are open all 7 days, 9 AM to 9 PM, with walk-ins welcome. Call or WhatsApp us on +91 70287 22200 to book a consultation. For current pricing, call the clinic on +91 70287 22200.
