A patient once told me she had spent fifteen years being told she was simply someone who got a lot of headaches.
She had learned to work through them, apologise for them and blame herself for them. When she finally sat in front of someone who recognised what was actually happening, her eyes welled up. Not from the pain, just relief.
That moment, repeated in different forms with hundreds of people, is why I do what I do.
I am a registered osteopath and I have spent 16 years working with people in pain, but headache and migraine became something close to an obsession.
To understand them properly I trained for two years at the University of Copenhagen and the world renowned Danish Headache Center and completed its international Master of Headache Disorders alongside neurologists, a brain surgeon and emergency medicine doctors.
Denmark is the home of headache medicine. The classification system doctors around the world use to diagnose every type of headache has its roots there, and clinicians travel from everywhere to learn at that centre.
To understand migraines properly Rosie Scott trained for two years at the University of Copenhagen and the world renowned Danish Headache Center
What I took away most of all was this: migraine is one of the most common, most disabling and most culturally poorly understood conditions we have, recognised as such by the World Health Organisation (WHO) and none of that is the fault of the people living with it.
Let me start with the thing people find hardest to believe.
Migraine is not a bad headache. It is a neurological condition, a genuine disorder of the brain and nervous system and the head pain is only one part of it.
An attack often begins a day or two before anyone feels a throb, with subtle warning signs: yawning, mood changes, food cravings, a stiff neck, needing the loo more often.
Around a third of people then get aura, the visual zigzags or blind spots, though aura can also show up as pins and needles or trouble finding words.
Then comes the pain, usually with nausea and a desperate need for a dark, quiet room, because light and sound genuinely hurt.
Even after the pain lifts there is the ‘postdrome’, the washed-out, hungover day that follows. Calling all of that a headache is like calling a storm a bit of drizzle.
Part of the problem is that there is no blood test and no scan for migraine.
A brain scan in someone with migraine is usually completely normal, which is reassuring because the diagnosis is made clinically, from the pattern of your symptoms and your history.
Around a third of people then get aura, the visual zigzags or blind spots, though aura can also show up as pins and needles or trouble finding words
The trouble is that migraine therefore has none of the visible proof we tend to demand before we take an illness seriously, and that invisibility is a large part of why it is so easily brushed aside, both by other people and by those living with it.
It is worth saying how heavy the burden actually is.
Migraine is one of the leading causes of disability in the world for people under 50, recognised as such by the World Health Organisation, and these are precisely the years when we are building careers, raising children, generally trying to pack life in while we are still young and least able to lose whole days at a time to the descending black cloud that is a migraine attack.
The Irish numbers are revealing in themselves.
The Migraine Association of Ireland puts the figure at around 500,000 people, roughly one in seven, and says only about half of them are ever actually diagnosed.
I would go further and say even that total is almost certainly not a true reflection of the numbers. It is an old figure and when an estimated 12 to 15 per cent of the population live with migraine, today’s numbers suggest the real figure is well beyond half a million.
An estimated 12 to 15 per cent of the population live with migraine
Migraine is the most common neurological condition in the world, and yet in a country the size of Ireland, hundreds of thousands of people are managing it with no diagnosis, no plan and very little understanding or support from those around them.
There is an Irish dimension to this that goes beyond the figures.
Migraine strikes hardest during the working years and too many people still feel they have to disguise it, phoning in with a vague excuse rather than admit to what they fear will be heard as just a headache and as such deemed flaky or work-shy.
The misunderstanding becomes a second illness layered on top of the first which is exhausting in its own right.
Changing this perception is even more vital because migraine does not stay static over a lifetime. This is one of the things I most wish were common knowledge.
What migraine looks like in a twelve-year-old is often nothing like what it looks like at 45. In childhood it may barely involve the head at all.
Some children get what we call abdominal migraine, recurring tummy pain and sickness with no obvious cause and only years later does the pattern reveal itself as migraine.
In adolescence everything is shifting; before puberty, migraine is roughly as common in boys as in girls, then, around the time periods begin, the two diverge sharply, and from that point migraine becomes about three times more common in women.
Migraine strikes hardest during the working years and too many people still feel they have to disguise it
This isn’t a coincidence as it tracks the rise and, crucially, the fall of oestrogen.
For many women, that hormonal link might be the whole story. Menstrual migraine, the attack that arrives like clockwork just before a period, is driven by the sharp drop in oestrogen rather than any food or stress.
Pregnancy might bring relief, particularly in the later months when hormones settle at a steadier level, which can be the first proper break some women have had in years.
But even this is by no means guaranteed and indeed pregnancy for some women can increase migraine attack frequency or severity.
And then comes perimenopause, which is frequently the worst chapter of all.
As oestrogen begins to swing unpredictably in the years before periods stop, migraine often becomes more frequent, more stubborn and harder to treat, exactly when women are least likely to be told that their hormones are the cause.
A recent 2026 review in the journal Headache confirmed how turbulent this transition can be.
The good news, or perhaps a bittersweet silver lining for migraine sufferers, is that things often settle once menopause is complete and hormone levels are low and stable.
For many women, that hormonal link might be the whole story. Menstrual migraine, the attack that arrives like clockwork just before a period, is driven by the sharp drop in oestrogen rather than any food or stress
Understanding this arc should change how we treat someone. It is also why so many women are dismissed, because a condition that behaves differently at thirteen, thirty and fifty might be easy to defer for later ‘if things get worse’ if you are only looking at a single snapshot.
So let me clear up a few of the myths I meet most often.
The first is the idea of triggers.
People agonise over the chocolate or the glass of red wine they had before an attack, but very often those cravings are the attack beginning, the prodrome changing homeostatic physiology making you reach for sugar, not the cause of it.
Blaming yourself for eating the wrong thing is usually both wrong and unkind.
The second is painkillers.
Taking for over-the-counter tablets to alleviate pain is the obvious, and correct, first line of treatment, but taken more than a couple of days a week can, over time, cause medication overuse headache, a nasty trap where the very thing you take for relief starts driving the pain.
The third is the culture of pushing through. We treat migraine as a personal failing to be hidden at work, when it is one of the leading causes of lost working days in the world.
And the fourth, for the men reading this, is that migraine is not a women’s problem you are exempt from. It is simply more common in women and men are often even less likely to seek help.
Taking for over-the-counter tablets to alleviate pain is the obvious, and correct, first line of treatment, but taken more than a couple of days a week can, over time, cause medication overuse headache
A fifth myth that is worth mentioning is aura without pain, sometimes called silent migraine, where someone gets the visual disturbance or the mental fog with little or no headache at all.
It is disconcerting, easily mistaken for something more sinister, but it goes to show just how many symptoms also go alongside migraine and should solidify the notion that it is far from ‘just a headache’.
What would I love every reader to take away? Migraine is treatable.
This is genuinely one of the most hopeful times in the history of headache medicine.
A class of newer preventive drugs, the CGRP treatments, was designed specifically for migraine rather than borrowed from other conditions and for some people they have been transformative. In Ireland they are available, though currently through a managed access route that means you have to have tried other options first.
Alongside the medication there is a great deal that helps: understanding your own pattern, protecting your sleeping and eating pattern, managing any neck and jaw tension that so often comes alongside with migraine, and being taken seriously by someone who knows the condition.
You should never have to simply endure the symptoms and advocating for yourself can be the first step.
Go to your GP and ask about migraine specifically rather than headaches, bring a simple diary of when your attacks come, 0-3 on how much it has disrupted your day and any medication you have tried.
Ask directly whether a preventive approach might suit you if you are losing several days a month.
That belief is what led me to build Erin Health, a platform designed to help people understand, track and manage their headaches in a way that adapts to them as individuals rather than handing everyone the same generic advice (still in development and not yet available in Ireland).
But the thinking behind it is exactly what Migraine Awareness week is about, giving people the knowledge and tools to stop suffering in silence.
If you have spent years being told you just get headaches, or if you love someone who disappears into a dark room and comes out apologising, please treat it as the real, treatable neurological condition it is. Half a million and almost certainly far more of you, deserve nothing less.
- Rosie Scott is a registered osteopath and holds the Master of Headache Disorders from the University of Copenhagen and the Danish Headache Center. She is the founder of Erin Health, see https://erin.health
