This is the title of a recent documentary by director Susan Styron. Its mission is to reduce the stigma of migraine, often wrongly stereotyped as a lifestyle disorder of nervous white middle-class women. Migraine, in fact, is a complex, genetically determined neurological disorder, the second most important cause of disability, after low back pain. It is more common than diabetes and asthma combined. World-wide, one billion people are affected.
It is much more than a headache. Brain connectivity is disturbed. There may be a prodrome, generated in the hypothalamus; an aura, emanating from the visual cortex; the headache pain, caused by activation of the trigemino-vascular nucleus which projects to the cingulate gyrus, the brain’s pain center. Often, the headache is followed by a daylong postdrome, described as being hit by a truck.
Attacks can last 72 hours, and a migraine sufferer with 10 attacks a month never feels normal. Depression and isolation follow. Stigmatization leads to lack of empathy and even ridicule from family, friends, co-workers, employers. Families affected by migraine develop “compassion fatigue” when their partner or mother goes into a dark room for days again.
The film also explores the spiritual and creative element of the migraine aura. Think of Lewis Carroll’s Alice in Wonderland or Georgia O’Keefe’s paintings of her headaches. Thomas Jefferson wrote the Declaration of Independence after six weeks of headaches.
This is an ambitious documentary. Try to watch it.
See the review by Jules Morgan in Lancet Neurology, February 2020.
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