When we think of migraines, we typically think of adults. We think of the person who has to take the day off from work and spend it instead in a dimly lit room until the pain goes away. However, migraines can also affect children. In fact, approximately one in four adolescents suffers from migraines. Half of all migraine sufferers will have had their first attack by age 12. Migraines can keep a teenager from learning in class, completing their homework assignments, or spending time with their friends. Identifying migraines in teenagers may be the first step in getting them back to their normal lives.
Migraines are more than just headaches. To begin with, the pain in migraines is more severe, often described as sharp or throbbing. The pain can be on one side of the head or both. However, unlike your typical headache, a migraine is a neurologic condition with more symptoms than just pain. A migraine can also cause blurry vision, light and sound sensitivity, difficulty concentrating, nausea, and vomiting. It is often these other symptoms that limit an adult’s ability to work well. Similarly, a teenager with a migraine may struggle in class due to a combination of sharp pain, trouble concentrating, sensitivity to the lights in the room, and feeling nauseous.
In the age of cell phones and social media, teenagers are at a higher than ever risk of migraines. Blue light coming from cell phones by itself can trigger or worsen migraines. The stress and anxiety that come with browsing social media can also trigger a migraine. As with adults, stress, whether from classes, friends, or after school activities, can also trigger migraines in teenagers. With how early school starts and some teenagers preferring to fall asleep later in the night, a lack of sleep can also trigger migraines. With parents constantly pushing their children to get good grades, excel at sports, play an instrument, and get into a good college, these added stressors can also trigger migraines in teenagers.
When it occurs, a migraine attack can limit a teenager’s ability to learn in school, attend after school activities, and spend time with friends. Teenagers with migraines usually miss school twice as much as teenagers without migraines. Additionally, teenagers with migraines may worry about a migraine disrupting their lives at any moment, leading to worsening anxiety. Anxiety and stress can in turn lead to more migraines.
In adults, medications are the focal point of migraine treatment. However, research shows that medications for migraines do not work as well in the pediatric population as they do in adults. Teenagers are in the middle of that spectrum, and sometimes, a different approach is needed.
The best treatment is prevention. Identifying triggers, or situations that lead to migraines, can help a teenager avoid migraines all together. For teenagers, stress, especially at school, is the most common trigger. This stress can be related to class work, after school activities, difficulty with friends, or bullying. Another common trigger is lack of sleep. Many teenagers are not getting the full eight hours of sleep they need per night, and that can make it easier for the brain to have a migraine attack. Hormones, caffeine, alcohol, changes in weather, and certain dietary items can all be triggers for some teenagers.
One way to identify triggers is to keep a migraine diary. The teenager should identify the factors around a migraine every time one happens—how much they slept the prior night, if it was a stressful day, what food they ate before the migraine, and so on. Over time, patterns will emerge, such as lack of sleep, different foods, or certain kinds of stress leading to many of the migraine attacks. Some of these triggers can be completely avoided. Certain foods, such as chocolate, caffeine, or alcohol, can be removed from a teenager’s diet.
Not all triggers can be avoided, however. For those stubborn triggers, other strategies may be helpful. Stress, for example, is a regular part of every teenager’s life. When faced with stress, teenagers should be encouraged to pursue biofeedback, meditation, and exercise. Teenagers should also take care of the triggers they can control. By eating healthy, staying hydrated, and sleeping well, teenagers can keep the other triggers from pushing their brains into a migraine attack.
While we should try to prevent migraines from happening, there is still a role for medications. Acetaminophen, ibuprofen, and naproxen are all medications that might help stop a migraine attack. A neurologist may also prescribe triptan medications for this purpose. The teenager should not become reliant on these medications, however. Taking them every day can lead to medication overuse headaches. Instead, if a teenager continues to have multiple migraines per week, a migraine prevention medication may be needed.