By Jorie –
As the soon-to-be wife of a United States Marine Corps veteran who toured in Iraq during Operation Enduring Freedom, as well as the daughter of an Air Force veteran, and granddaughter of three more service-people, I know a little about the military. Okay, maybe a lot. I grew up influenced strongly by the military and it has now seeped into my love life too. I also know a bit about how PTSD works, because my fiancé, Trey, lives with it as well as episodic headaches.
During Headache on the Hill, I had the pleasure of attending an event especially focused on the link between military veterans, PTSD, migraines, and chronic headaches. This event was sponsored by The Headache and Migraine Policy Forum, a non-profit organization striving to “advance public policies and practices that promote accelerated innovation and improved treatments for headache and migraine sufferers.”
This specific policy forum included an excellent panel of neurologists and experts in the field, and was led by Kansas Congressman Roger Marshall. Rep. Marshall is, firstly, very aware and knowledgeable of migraine and headache disorders as he himself is a military veteran, but he also comes from a medical background as an OBGYN. He is also a member of the Congressional Veterans Caucus.
The panel of experts for this forum included Dr. David Charles as the moderator, Dr. Donald Higgins, Dr. James R. Couch, and Dr. Alan Finkel — combined, these men specialize in neurology and neurosciences, brain injury, migraine and headache disorders, and PTSD. Christopher Meek, co-founder and chairman of SoldierStrong, also sat on the panel.
The goal of this policy forum was to discuss better access to healthcare for veterans with migraine and headache disorders as well as to answer WHY veterans are among the highest group of people to contract migraine and headache disorders. Is it due to PTSD? Why is PTSD so heavily linked to migraine and headache disorders in general? Is it due to the crippling number of blasts, explosions, machine gun fire, mortars, and other loud mechanisms that became routine for them?
The answers to these questions aren’t easy, as mental health and neurology are both very complex areas of study. However, these doctors all agreed that veterans are exposed to a lifestyle that would commonly and sensibly induce migraine or headache. The interesting part is that many veterans who do end up with migraine and headache disorders combined with PTSD are not diagnosed nor do some of them display symptoms for a number of months or even years after returning home from active duty.
Christopher Meeks mentioned that the “warrior effect” often prevents veterans from seeking medical treatment or even accepting their health issues. Having migraine or headache disorders “makes them feel like a failure. It takes them to a dark place,” he said.
The statistics showing the correlation between migraine and headache disorders among veterans is shocking. According to The Headache and Migraine Policy Forum’s informational provided at the event…
– 36% of service members deployed to Iraq for a year or more experience migraine.
– Veterans with traumatic brain injury are more likely to have chronic migraine,
– There was a 27% increase in migraine diagnoses occurred across the Armed Forces between 2001 and 2007.
– Migraine may be accompanied by depression or post-traumatic stress disorder.
– Those who do contract migraine are typically age 25 – 55, in the prime of their lives.
Dr. James R. Couch, whom I mentioned earlier, has dedicated many of his studies to veterans’ health, specifically PTSD and headache disorders. There was a statement he made that really stuck with me: “If you’ve seen one patient, you’ve seen one patient. Don’t try to mash them all together and say ‘this should work for everybody.” How many of us migraine patients wish we had a doctor say that?
Dr. Couch studied those who served in Iraq and Afghanistan and found that, of those veterans who had received a TBI (traumatic brain injury),
– 6% had severe or disabling headaches.
– Headache days averaged 10 to 14 days per month.
– 9% had chronic daily headaches, which is defined as 15 headache days per month.
Now back to my fiancé, Trey. He served in Iraq during 2008 – 2009 in Operation Enduring Freedom, an initiative from the United States, directed by then-President Barack Obama. OEF was the official name used by the U.S. government for the Global War on Terrorism between 2001 and 2014.
Trey came back seemingly okay, but something had definitely changed. I can’t say exactly what that was other than to take his word for it, because I didn’t know him back then. We met in 2012 and, I would like to say it was love at first sight, but I’m not that cliche. So it was more like “I really like you” at first sight, and we started dating 18 days later and never looked back.
The things that changed for Trey included his mental health to a varying degree, but he also experiences episodic headaches to this day. He describes his headaches as “painful and debilitating, occurring suddenly” in the occipital region of his head, at any random time.
Whether Trey’s headaches are due to combat-related lifestyle or combat-related PTSD, we really don’t know. We just know that it’s enough to stop him dead in his tracks and have him rummaging through my migraine kit for some relief.
Migraine and headache disorders in general are not well understood, as most of us can agree, but they are becoming more recognized as research and awareness progresses. “We used to get no lectures on headache in medical school,” Dr. Couch added. “Now we get two to three or more. Gradually, we’re improving. This should continue.”
We have found impressive ways to improve the lives of our service people through the invention of body armor such as Kevlar. These types of protection are bringing our soldiers home more and more frequently injury-free. Even Dr. Higgins noted, “I am amazed on a daily basis at the breadth of the services that are available and can be made available to our veterans.”
But what we ultimately want for our veterans is to give them the gift of not only coming home unscathed on the outside, but to help them overcome those scars on the inside—the invisible wounds.
Migraine, headache disorders, and PTSD are not seen by the naked eye. These are struggles that are faced inwardly by our military members. As Dr. Finkel stated, “these soldiers were changed while they were protecting us and our freedoms.”
This is a job for all of us. We need to make sure our veterans understand—and that America’s public understands—that we are here to help, here to give them a better life, and strive to overcome not just the trauma on the outside, but on the inside as well.