How to Know a Headache from a Migraine

April Daniels Hussar,SELF magazine

Does your growing to-do list -- and the fact that it's Monday -- make your head hurt? Or could it be a migraine? In honor of National Migraine Awareness Month, here's how to tell ... and what to do about it.

According to Lawrence C. Newman, M.D., Director of the The Headache Institute at St. Luke's-Roosevelt Hospital Center in NYC and attending neurologist at St. Luke's-Roosevelt Hospital Center and Beth Israel Medical Center, there are over 300 medical conditions that are associated with headaches, broken down into two main categories: primary, in which the headache itself is the problem; and secondary, in which the headache is the result of another medical condition, such as a stroke or brain tumor. Migraines, he explains, are a type of primary headache. Dr. Newman says women are three times more likely than men to have migraines -- lucky us!

"Migraines tend to be one-sided, to throb or pound, are moderate to severely painful, and in general they require you to sequester yourself, or to remove yourself from routine activity," Dr. Newman says.

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In addition to head pain, you can also expect accompanying factors, such as nausea or vomiting, and sensitivity to light, sound and/or smell. For women, migraines can sometimes get worse during your menstrual cycle (as if you need any more to deal with during that time of the month!). Dr. Newman says menstrual migraines can often be much more severe and more resistant to treatment.

In comparison, Dr. Newman explains, most of the time when people say, "I have a headache," they're referring to tension headaches, which have the opposite diagnostic qualities as migraines. "Tension headaches tend to be on both sides of the head simultaneously; it's a pressure-like sensation that's mild or moderate, and it doesn't interfere with function, and there's generally no nausea or light, sound and smell sensitivity," he says.

Both migraines and tension headaches can be caused by a variety of factors, including dehydration, irregular or not enough sleep, over-exertion, and, yes, caffeine. "Caffeine is double-edged sword," says Dr. Newman. Caffeine can be sometimes be taken at the onset of a headache to relieve it, he explains, but both too much caffeine and a lack of caffeine (withdrawals) can also cause headaches. No wonder why you need that morning cup of Joe!

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Speaking of relief, here's what Dr. Newman has to say about managing and getting rid that pain in your head:

1. Try to find out what's causing your headache -- and change or eliminate it. "The best way you can help yourself is to try to figure out what causing your headaches," says Dr. Newman. He asks his patients to keep a diary, tracking their headaches, their severity and any potential lifestyle or health factors, such as menstrual cycle, exercise patterns and consumption of certain foods like chocolate and aged cheeses, and alcohol intake.

2. Over-the-counter and prescription medications. "Some people respond well to over-the-counter medications, whether it's a caffeine-containing medication like Excedrin, or an anti-inflammatory medications like Advil or Aleve," says Dr. Newman. "If those don't work, your doctor might think a migraine medication, which will treat the accompanying symptoms, might be in order."

3. Preventative medication. "If your headaches are frequent, meaning more than once a week, you might be a candidate for preventative medication," says Dr. Newman, explaining this can include certain high blood pressure, anti-depressant and anti-seizure medications, and even Botox for very severe migraines.

4. Make life changes to decrease your headaches. Dr. Newman calls his plan "SEEDS:"

Sleep: Maintain a regular sleep pattern. "Too much or too little sleep can cause headaches," says Dr. Newman, who says sleeping in on the weekend to "catch up" from a week of sleep deprivation isn't healthy.

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Eating: Avoid foods you've identified as triggers, and remember that skipping meals is just as bad as eating the wrong thing.

Exercise: "Thirty minutes of aerobic exercise at least three times a week will decrease headache frequency, in party because it releases endorphins, which are natural painkillers," he says.

Drink: This is not only about avoiding drinks that are likely to cause your headaches, but also about drinking at least five or six 8-oz glasses of water per day to stay hydrated.

Stress reduction: "Do something for yourself every day," says Dr. Newman. "Carve out some time every day where you can relax, whether it's doing yoga or going out for a walk."

According to Dr. Newman, there are some warning signs that your headaches are more serious than a tension headache or a migraine, and are cause for you to seek professional evaluation. Red flags include:

- Headaches that comes on suddenly and very painfully, which could indicate a brain aneurysm.

- Headaches that come along with neurological symptoms, like an inability to speak, slurring of your speech or weakness or numbness on one side of your body, which could indicate a brain tumor or stroke.

- Headaches associated with high fever, extreme stiffness of your neck and confusion, which could be a sign of meningitis.

- Headaches that have changed. Even if you have a long history of migraines or regular headaches, if you suddenly get a different kind of headache, you should get it checked out.

- Any headaches that changes or begins during or at the end of pregnancy, at which time you're more prone to blood clots that can lead to stroke.

- Any regular headaches that you or your regular doctor can't cure. "If whatever you're doing isn't working, if your headaches are interfering with your life -- even it they're benign -- that's a reason to seek help," says Dr. Newman.

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