Courtney White was a 23-year-old med student the first time she experienced a migraine attack. “I didn’t panic because I knew exactly what it was,” the now 31-year-old, who is a neurologist and clinical assistant professor at Thomas Jefferson University Hospital in Philadelphia, tells SELF. Dr. White witnessed her mother living with the pain of migraine when she was growing up—and she eventually learned about the neurological condition in med school. “The next steps were very clear to me,” she says. “Go see a doctor and get treatment.”
But her appointment didn’t go as expected. “I was very knowledgeable and knew what treatment I wanted but I wasn’t taken seriously,” Dr. White says. “It was like: ‘Oh here’s this little med student who thinks she knows everything.’” It wasn’t until Dr. White was 26—three years after her initial symptoms began—that she started a treatment plan that offered some degree of relief. At 31, she was finally diagnosed with chronic migraine and received treatment that’s helped her become nearly symptom-free. Ironically, it was the same treatment she asked for back when she was 23. “There I was, actually knowing a lot about migraine, and I was still being dismissed,” says Dr. White. “If I had to struggle, imagine someone who doesn’t even know what migraine is and what treatments are available.”
Unfortunately, like many chronic conditions, migraine symptoms—which can range from debilitating head pain to nausea and dizziness—are often dismissed by general practitioners. Dr. White mainly chalks this up to a lack of education. “Med schools generally only spend four hours over the course of four years talking about migraine,” she says. “So most doctors don’t know how to appropriately diagnose and treat it.”
When migraine has taken over your life and you’re desperate for help, it can be hard to drag yourself to the doctor, let alone determine if they’re the right fit for your needs. Here are some signs that your health care provider isn’t taking your migraine symptoms seriously enough:
“I can’t tell you how many times I was told I was just being hysterical,” Karen Tartt, 34, a bartender based in San Francisco who has had vestibular migraine—a form of migraine characterized by dizziness and vertigo—since she was 11, tells SELF.
Alicia Wolf, 36, who also deals with vestibular migraine and is a patient advocate with the nonprofit Miles for Migraine, had a similar experience. “Multiple doctors told me I was just anxious and depressed; they said it was all in my head and nothing was wrong,” the Dallas resident tells SELF. “They made me feel like I was going insane.”
Having your symptoms dismissed—especially when it comes to pain—can be especially common for people of color. “There’s a long history in the medical world of Black and brown bodies being viewed as biologically and genetically different from white bodies,” explains Dr. White. The inaccurate thought process, which is rooted in racism and medical bias, included beliefs that Black and brown skin is “thicker,” which implied that people of color don’t feel as much pain—a symptom that has led to the systematic undertreatment of Black Americans.
You’ve finally gotten an appointment to see a doctor, but you feel like they’re just talking at you (or over you) and not listening to what you’re saying. This happened to Wolf on many occasions so she started bringing her husband to her appointments. “I noticed when he was there, they took me more seriously,” she says. “But they would only talk to him, which was frustrating. I was like: I’m smart. I can understand. Why won’t you listen and talk to me?” If you feel like your doctor isn’t hearing what you’re saying, that could be a sign they aren’t taking your concerns seriously.
Unlike other health conditions in which something like a blood test can help your doctor make a diagnosis, there is no single test to determine if you have migraine. To diagnose the neurological condition, a doctor will ask about your symptoms and medical history, and they may do a physical examination, according to the Mayo Clinic. “Testing is only done to rule out other conditions,” explains Dr. White. For example, if your symptoms are unusual or suddenly become severe, your doctor may order an MRI or CT scan of your brain to make sure they aren’t being caused by a tumor or bleeding in the brain. If those tests come back normal, that’s a good thing. “Tests are supposed to be normal for migraine,” says Dr. White. “And there’s no test for pain so how could someone say you’re not feeling it?”
If your doctor puts all the onus on you—saying things like, “You just need to learn how to manage your stress” or, “You need to exercise more”—that’s a big red flag, says Dr. White. “Anxiety and depression can worsen migraine but they don’t cause it,” she explains. So while it’s true that making healthy lifestyle changes like decreasing stress, getting plenty of exercise, and staying hydrated can help you manage your migraine symptoms, it’s still a genetically inherited disease, which means sometimes the attacks are simply outside of your control.
The thing about migraine is there’s no silver bullet solution—it can take a lot of trial and error to figure out what works for you. If, after trying a few treatments, your doctor tells you there’s nothing more they can do for you, that’s a bad sign. “There’s no running out of treatment options with migraine,” says Wolf. “There are so many new medications and devices coming out, plus natural things you can try. They may not work separately but together they can; it’s about finding the perfect mix.” Your doctor should be willing to fight for you and not stop until they get you at least some degree of relief.
What can you do if your doctor isn’t taking your migraine symptoms seriously?
In a perfect world, you would just find a new doctor, but that’s not always a possibility. As a career bartender, Tartt rarely had health insurance. “At one point, I did have it and I started treatment but then I lost it and had to stop because it was too expensive to pay out-of-pocket,” she says. Access to care can also be a big issue. Wolf had to drive 16 hours, paying for gas and hotels along the way, to finally see the specialist who diagnosed her with vestibular migraine. “I come from a privileged background where I could afford to do that but a lot of people don’t have that luxury,” she notes.
If you think your doctor isn’t taking your migraines seriously—but they’re your only option at the moment—there are things you can do to try to get them to help you. Consider these tips to get the care you need and deserve:
“It’s helpful for doctors to see the pattern of your migraines and how they’re affecting you over time,” says Dr. White. On days you have a migraine attack, write down your symptoms, including your pain on a scale of 1 to 10, what medication you took (and whether or not it worked), plus how it impacted your day. (Did you have to call in sick to work? Cancel lunch with a friend?) Your doctor won’t be able to argue with these data points, says Dr. White. “Talking about your level of pain can be subjective, but this sort of info is objective,” she explains.
Apps like MigraineBuddy and Ctrl M make it easy to track your migraine symptoms, and you can also simply take notes in your phone or jot them down on an inexpensive notebook or calendar.
Seeing your doctor, especially if you feel like they’re in a rush or if it’s your first appointment with them, can be overwhelming. You might understandably freeze up or forget what you wanted to talk about if you’re feeling a bit anxious—that’s where a friend or family member comes in. “They can remind you of your questions and even take notes for you,” says Wolf. Knowing someone who has your back is in the room with you can also help you stay grounded in your goals and stand up for yourself if needed.
Don’t just tell your doctor you’re in pain—tell them how it’s impacting you, suggests Dr. White. For example, you could say: “I had to stop working and go on disability” or “I missed my cousin’s graduation.” For Tartt, her migraine attacks affected her work. “People tried to tell me to stop bartending but I didn’t want to,” she says. “It’s a big part of my identity and who I am.”
The more specific you can be about the toll migraine has taken on your life, the more likely your doctor is to be empathetic. If they’re still not getting it, let them know. Dr. White suggests saying something like: “I don’t feel like you’re hearing me. What can I do to better explain how this is affecting me?”
Look at credible websites like the Mayo Clinic, Cleveland Clinic, American Migraine Foundation (AMF), and the National Institute of Neurological Disorders and Stroke (NINDS) for information about migraine, and don’t be afraid to show your doctor an article or study that you think could be helpful. “You could say: I read about this, and as a partnership, I want to understand more. What do you think?” suggests Dr. White.
Another way to find trusted resources is to check the partner list of nonprofits. For example, the AMF has a list of vetted nonprofits and blogs where you can find credible information, personal stories, and advocacy tips related to all types of migraines.
You’re not alone in your experience. “There are a lot of people out there dealing with the same thing as you but you just don’t know about them,” says Wolf. A good way to feel less alone—and get the emotional support and validation you need—is to join a support group or become an advocate with a nonprofit like Miles for Migraine or the Coalition for Headache and Migraine Patients (CHAMP). “Talking to other people with your condition can be really helpful,” notes Dr. White.
“I know how defeating it can feel when your doctor isn’t helping, but don’t give up,” says Wolf. “There is someone out there who will understand you and be able to help you.” If you reach a point where it’s clear you need a new health care provider and you have the ability to access one, Dr. White suggests searching the United Council for Neurologic Subspecialties, which has doctors who are board-certified in headache medicine, meaning they have passed a rigorous test demonstrating they are an expert in their field. You can search by city and state to find a specialist near you. “It can be exhausting to find the right doctor but totally worth it,” says Wolf.
For Tartt, a first-generation American born in Seoul, South Korea, the key to getting the care she needed was finding a doctor who was closer to her life experience and understood her goals. Seeing a female doctor of Asian descent made a huge difference for her. “She actually took me seriously and gave me everything I needed, like the tests and referrals I wanted,” says Tartt. “She was the first person that ever said she believed me.”
Anecdotally, Dr. White agrees that working with a doctor who shares your background can lead to better health outcomes. Unfortunately that’s not always possible—and it shouldn’t make a difference in your care. “When I train other doctors, I try to instill in them that the patient wouldn’t come to you lying,” she says. “They have symptoms, and you’ve got to believe them.”
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