Top Headache Doc: Migraine Is Not What You Think

For decades, migraine was explained to patients as a blood vessel problem: swelling, throbbing, treat it by shrinking things back down. That explanation is mostly a myth, and it may be part of why so many older treatments never worked.

Dr. Fred Cohen is medical director of Headache Intervention and an assistant professor of medicine and neurology at the Icahn School of Medicine at Mount Sinai. He's one of the few headache specialists in the country trained in both internal medicine and headache medicine, has over 40 publications in journals including The Lancet and Cephalalgia, and has lived with migraine himself since his teens.

In this conversation, you'll explore:

• Why migraine is a neuroinflammatory condition, not a vascular one, and why some medical schools still teach the outdated version
• The "broken thermostat" phenomenon of chronic sensitization, and how untreated migraine can convince your brain that constant pain is normal
• Why only about 30% of people with migraine ever experience aura, and the surprising range of ways it can actually show up
• The current treatment landscape, from triptans to CGRP therapies, Botox, neuromodulation devices, and what's coming next
• Why Dr. Cohen calls this the golden age of headache medicine, and what that means if you gave up on treatment years ago

If migraine has ever made you feel like your body was working against you, or like you'd already tried everything, this conversation will change how you see both.

You can find Fred at: Website | Instagram | Episode Transcript

Next week, we're sitting down with Marisa Renee Lee to talk about why the tidy stories we tell ourselves about grief and resilience tend to fall apart, and what it actually looks like to build a life around pain instead of waiting to get past it. Be sure to follow Good Life Project wherever you get your podcasts so you don’t miss any upcoming episodes!

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