Alicia Wolf, creator of The Dizzy Cook, lives with migraine – an incredibly common condition affecting 37 million people in the U.S. It's also one of the most misunderstood. One of the most common misconceptions about migraine is that it's "just a bad headache."
The Dizzy Cook is a migraine-friendly recipe resource and support for people who live with the condition. It helps debunk misunderstandings that can have real consequences. Wolf lives with vestibular migraine, which often centers on vertigo, dizziness, and sensory symptoms more than headaches. Because Wolf didn't always have head pain, doctors at first overlooked migraine as the cause.
"Migraine is a neurological illness," she says. "But when it doesn't fit the stereotype of someone lying in a dark room with pounding head pain, it's easy to miss."
When migraine is left untreated, it can become more frequent, more severe, and harder to control. What may begin as occasional attacks can shift into chronic, stubborn symptoms that get in the way of daily life.
Wolf is among the many who hope to raise awareness about migraine so that diagnosis and treatment can come faster for those who have it.
"There's a lack of neurologists who truly understand my type of migraine," says Wolf. "My hope is that we create more awareness for all types of migraine."
Fact: Migraine Is a Neurological Disorder on a Spectrum
Most people's first thought when they hear you have a migraine is that you have a bad headache. But migraine is a complex brain disorder that can involve a wide variety of symptoms, not just pain.
During a migraine attack, you may have nausea, vomiting, sensitivity to light and sound, worsening pain with movement, brain fog, difficulty concentrating, and visual or sensory problems, says Abby Metzler, MD, an associate professor of neurology at the University of Minnesota.
"Head pain is one feature of the disease, but it's only a part of the picture," she says. Symptoms can begin hours before the pain, with mood changes, fatigue, neck stiffness, or food cravings – and linger the day after, leaving exhaustion and slowed thinking.
The umbrella of migraine disorder includes many different types, including migraine with aura, migraine without aura, vestibular migraine, chronic migraine, and hemiplegic migraine. Although they all fit the criteria for migraine disorder, they can present very differently.
For example, hemiplegic migraine causes a temporary weakness or even paralysis on one side of your body and can feel very much like a stroke. And in Wolf's vestibular migraine attacks, her sense of balance is completely thrown off.
"I can barely walk in a straight line, I run into walls," she says. "It feels like I'm walking on marshmallows."
But not only is the condition a spectrum in terms of its symptoms, it's also a spectrum for each person who lives with the disorder. Wolf says each of her attacks shows up differently.
"Some days, I have these vertigo attacks that are completely debilitating," she says. "I have to be on the floor. I cannot function. And then there are other attacks that come in that are more like ear-plugging, head pressure. I don't feel good, but I can still move throughout my day."
No matter what the symptoms of migraine, says Wolf, one thing is clear.
"It's a disability for everyone," she says.
Fact: Triggers Aren't Universal (and Don't Cause Migraine)
Triggers are a widely misunderstood part of migraine, Metzler says.
"A trigger is not the same as a cause," she says. "Migraine brains are sensitive, and triggers are things that can tip a vulnerable brain into an attack."
Also, while some triggers are more common than others, your triggers will be unique to you. Wolf says she often hears people say they drastically restricted their diets after their doctor gave them a handout of foods to avoid. They're overwhelmed, she says, and revert to eating the same limited foods every day as a result.
"But that's not really what a migraine diet is about," says Wolf. "It's supposed to help people figure out their personal food triggers."
That can take time, too, says Metzler, because triggers are often additive.
"Poor sleep, stress, hormonal changes, and dehydration together may provoke an attack when one of those alone wouldn't," she says.
So on a high-pressure weather day when you're under a lot of stress and haven't gotten a lot of sleep, alcohol may kick off a migraine. But on another day, you may be fine having a glass of wine with dinner.
"Completely avoiding every possible trigger can shrink your life and increase anxiety," says Metzler. "Headache journals and tracking can help, but the goal isn't to eliminate everything. It's to notice patterns and reduce the biggest, most consistent triggers, while maintaining quality of life."
Fact: You Don't Have to (and Shouldn't) 'Push Through' a Migraine
Because migraine presents differently across a spectrum, you might think your migraine "isn't as bad" as someone else's, and you should be able to just power through your symptoms. But Wolf encourages learning to recognize and treat migraine when it's happening instead of dismissing it in hopes that it will just go away.
"I mean, is it ideal to have to step out of life? Of course not," she says. "As a mom, I want to be there for my kids, and as a professional, I want to be on time and do the best that I can. But I just try to tell myself everyone's going to be all right. We're all going to live. The kids can watch extra TV. It's going to be OK. Because that's all you can do, is just try to switch to survival mode and get through it."
Treating at the first sign of a migraine can make a real difference in how severe your attacks are, too, says Metzler. Pushing through can make your symptoms worse and prolong your recovery.
"Early treatment works better," she says. "Treating an attack early is often more effective than waiting."
Fact: Migraine Language Matters
Instead of saying "I get migraines" (which sounds like isolated bad headaches), Metzler says it's important to instead say "I have migraine." Not only is it more accurate, it helps improve understanding of the disease for other people, she says.
"In the medical community, we use the term migraine the way we use terms for other chronic diseases, like asthma, for example," says Metzler. "We wouldn't say 'I get asthmas,' but rather, 'I have asthma, so I get asthma attacks sometimes.'"
Language that reflects migraine as a neurological disorder and not simply occasional headaches is important to many people in the migraine community, says Wolf.
"We're trying to change the thought process around it as a community, in hopes that it will help others recognize it as a neurological disorder," she says.
