All brains are complicated, but if you have migraine, yours is unique. That’s not mere flattery! Your brain is wired in such a way that it’s more susceptible to stimulation than other people’s brains. What causes migraine disease in the first place is likely a combination of a few key risk factors.
You have your father’s eyes, your grandma’s smile – and, unfortunately, your mom’s headaches. Heredity plays a part in predisposition to migraine, although so far, the exact mechanism is unclear. One rare form of migraine (hemiplegic migraine) was traced back to a single genetic mutation, but the predisposition to “common” migraines is the complex result of multiple genetic factors. When doctors ask patients for their family history, however, the genetic component becomes clear:
- 90 percent of people with migraine have a family history of migraine.
- If you have a first-degree relative (mother, father, sibling) with migraine without aura, you have 1.9 times increased risk of having migraine without aura, and 1.4 times increased risk of migraine with aura.
- If you have a first-degree relative with migraine with aura, your risk of having migraine with aura increases by a factor of 4.
- Depression in your family is also a migraine risk factor. Migraine, anxiety and depression are often present together and are believed to share genes.
Migraine is a predominantly female disorder. That very fact is, sadly, a reason why migraine has not always been taken seriously, but instead shrugged off as an imaginary “women’s complaint.” However, it seems clear that having an adult female body is a major risk factor for migraine predisposition. Consider this:
- Before puberty, both boys and girls have similar incidence of migraine.
- In adulthood, three times as many women have migraine than men.
- 85 percent of people with chronic migraine (at least 15 headache days per month) are female.
- Men who transition to women with sex hormones develop more migraine.
- Possible explanations for women’s susceptibility point to the effect of sex hormones, as well as their fluctuations (such as during menstruation, pregnancy, and menopause).
Once you’re predisposed to migraine due to your DNA and/or gender, you’re extra-sensitive to certain environmental stimuli, which are what seem to tip you over into an actual migraine episode. These changes to our internal or external environment can include weather, stress, and a shift in hormones. We often call these factors “triggers.”
Other environmental factors can modify your genetic tendency to migraine. Early childhood psychological trauma or a past history of concussion may predispose you to more severe migraine, for example.
There’s much that science doesn’t yet know. But one clear conclusion emerges from the picture thus far: You are not at fault for your migraine; what causes migraine are factors that were always beyond your control. So if you’re tempted to get caught up in the self-blame game, even for a moment, remember that your body was made this way. You’re complex and sensitive, all the way down to your genome — and you are not alone.