There is on profound difference between episodic migraines and chronic migraines and that is chronic migraines are Chronic Pain.
I once had an employer who had episodic migraines and because of this she believed that she could relate to me with my chronic migraines. I hoped this was true myself because it was so very difficult to get people to understand this was Not a headache. She got that part. Indeed she understood that completely. But because of that she couldn’t comprehend how I could function in the pain, and therefore how could I in fact be in pain. How could I function one day and not another? Why couldn’t they find treatment that would work? Why didn’t I do enough to treat myself? Why was it so complicated in my case?
Fact is episodic migraineurs do not need to know all the ins and outs of migraine research and treatment if they get them rarely. She had no idea 4% of migrainuers get chronic migraines. She thought I was some weird anomaly. She thought I had to be doing something wrong and that treatment was simple. When treatment for chronic migraines is a rather complex thing. She ended up not exactly empathetic to my cause, but I hardly blame her. I had untreated daily migraines and was missing a lot of work. No one likes an undependable employee.
The point isn’t about episodic migraineurs and what they do or do not understand about chronic migraineurs…because we are all migraineurs. And we all understand the fundamental migraine experience.
The point is chronic migraines are Chronic Pain and that is a whole new set of rules to play the game under. No more take a triptan and sleep the migraine off. No, it is trying to live your life With migraines. Because they take up more than half your days… or all of them for people like me. We can’t treat them all with abortives, which means we have untreated migraines sometimes. Like any other chronic pain condition we have to learn to endure the pain. We often have to learn to even function through levels of it. If we are lucky enough we can dampen it a little, which is a good thing. If we are very lucky a penetrative helps with frequency and intensity.
Nevertheless we are not hiding in the dark… we walk among you with our hats and sunglasses and migraine balms and medication filled bags. Trying to live our lives. And people inevitably say, “I don’t know how you do it.” And there is on simple response to that. “We have no bloody choice.” This is our life. We must find a way to deal with the suffering, live in the pain gaps and, every so gently, live our lives.
I could say to you the pain constantly haunts my existence. And it does. I could say there were times I simply could not bear it. And that is true. But it is my life to live and I cannot waste it being afraid of the pain.
With chronic migraines it is your constant companion. It affects every aspect of your life. There will be impact. And impact. And compromises. And more compromises. The pain has a radius… it will affect your loved ones, your family, spouse, children and friends. Yet it is an invisible disability. People will call it a ‘headache’. They won’t believe you should miss work for it. They will believe you are just trying to get out of work. They will believe it isn’t nearly as painful as it is. They certainly won’t believe you can be Disabled from Migraines. Nor that you can function with them, even if you have to, they will believe you must be lying that you have them. Because like I said, how can you function one day and not another? The stigma is profound with migraines.
With episodic migraines though if you get them rarely enough you’ll get sympathy. People will say go home and rest. You must be in pain… look at you. And you will take that triptan and sleep it off and be fine. It won’t interfere with your life, work, loved ones, ambitions, goals, existence and social life. And you would Never imagine functioning with it. If your boss told you to keep working without migraine treatment with a full-blown migraine? You would complain to Someone about that business.
It isn’t that the pain is better… the pain is the same. It is that it is about chronic pain. And chronic pain is a different game.
And the risk is… anyone with episodic migraines could go chronic. Or high episodic, which has the exact same impact as chronic. There are certain risk factors like obesity, starting out with higher frequency, allodynia… and others. But the tipping point can just happen. One day you are managing well with a condition you Think is simple and one day you are trying to function through daily pain.