How to tell you're having a migraine (part #1)

migraine is type of headache that may occur with symptoms such as nausea, vomiting, or sensitivity to light. In many people, a throbbing pain is felt only on one side of the head. Warning symptoms when get migraine, called an aura, before the actual headache begins. An aura is a group of symptoms, including vision disturbances, that are a warning sign that a bad headache is coming.

Nearly 30 million people in the United States have migraines, and three times as many women as men have them.

Migraines are pulsating headaches, often on one side of the head. Physical activity may intensify the pain, but symptoms can vary from person to person and from one attack to the next.

"In patients who have migraines, we're going to treat all of their headaches as potential migraines," says Anne Calhoun, MD, partner and cofounder of the Carolina Headache Institute, in Chapel Hill, N.C.

Aura
Some people with a migraine experience aura.

The most common auras are visual, such as flickering lights, spots, or lines. "You may see a little jagged line...that will develop some cross hatches, and it might sort of move in a curved direction," Dr. Calhoun says.

Auras typically last between five minutes and an hour, with a 60-minute "skip phase" before the headache pain sets in, she says.

Some patients have auras without a migraine-type headache or any headache at all.

Depression, irritability, or excitement
Mood changes can be a sign of migraines.

"Some patients will feel very depressed or suddenly down for no reason," Dr. Calhoun says. "Others will feel very high." Dutch researchers recently reported a possible genetic link between depression and migraines, especially migraines with aura.

Data presented at the American Academy of Neurology 2010 annual meeting suggests that moderate or severe depression increases the risk of episodic migraines becoming chronic.

Lack of restful sleep
Waking up tired or having trouble falling asleep are common problems in people with migraines.

Studies have shown an association between lack of restorative sleep and the frequency and intensity of migraines.

When migraines strike, it's tough to get a good night's sleep. "A lot of people will have insomnia as a result of their migraine," says Edmund Messina, MD, medical director of the Michigan Headache Clinic, in East Lansing. This inability to sleep can be the start of a vicious cycle, as research suggests that lack of sleep can also trigger migraines.

Stuffy nose or watery eyes
Some people with migraines have sinus symptoms, such as stuffy nose, clear nasal drainage, droopy eyelids, or tearing, Dr. Messina says.

One large study found that, among people who complained of sinus headaches, nearly 90% were having migraines. (The study was funded by GlaxoSmithKline, which makes migraine medicine.)