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Is there a migraine epidemic among public school teachers?


I’m the sole parent of a 13-year-old who attends public school in Toronto. So, as rotating strikes by teachers continue, I’ll be worrying about my son’s unsupervised screen time as I head to work at Ontario’s largest specialist headache clinic where I treat people who suffer from severe, often chronic, debilitating migraines. 

Here is the thing – Ontario’s teachers are flocking to my clinic. Elementary teachers, kindergarten teachers, special education teachers, music teachers, gym teachers, principals, guidance counsellors and office administrators, all number among my patients these days. 

Is there a migraine epidemic among public educators?

Migraine is a neurological condition characterized by recurrent and sudden onset of severe headaches. It’s often accompanied by sensitivity to light, sound and smell, nausea, vomiting, fatigue, dysphoria, and cognitive impairment. (Elementary lunchroom supervision duty was probably invented to trigger migraines). Attacks can last for hours to days. 

With each unique patient, I try to understand how migraines are incubated and sustained. To do that, we talk in detail about the rhythms and challenges of daily life. In addition to prescribing medicines, we discuss alternative therapies and behavioural modification strategies to ensure that migraines are not triggered or exacerbated by environmental conditions.

Over the years, I’ve witnessed the impact of increasing workplace stress on teachers. Most of my teacher patients are women. Migraine is, after all, most common among women of childbearing age, medically speaking. And, most teachers are women who are also parents. But I’m not ready to blame this just on estrogen. My patients include male and transgender teachers, too. 

Scientists have hypothesized that diseases are common in populations because either the disease or traits associated with it have conferred a survival advantage at some point in human evolution. People who suffer migraines, for example, are sensitive to weather changes (they joke about their migraine barometers), noxious or unusual odours and subtle environmental shifts.

Migraine sufferers generally dislike sensory chaos, like classrooms. Maybe being a public school teacher is a migraine risk factor or a risk factor for worsening migraines. It is for head injuries.

I have treated teachers who have suffered head injuries from schoolyard exuberance – basketballs, soccer balls, book bags and snowballs – resulting in chronification of their headaches. I have treated teachers injured deliberately or accidentally by distressed students.

Emotional stress, particularly stressors related to worry, is a powerful migraine trigger. Teachers who worry about their students seem to suffer more migraines. I’ve heard teacher after teacher speak with growing anxiety and concern about how young children increasingly struggle with mental health issues, and how parental and school support systems are not equipped to help. My patients are the front line for all of this. 

To manage increasingly severe migraines I ask teachers to try to make time for self-care, exercise, proper nutrition and hydration throughout the day. And all of them tell me that time does not always allow. Mornings are for preparation, and connecting with children as they arrive. At lunchtime there are supervision duties, staff meetings and team practices. After school, teachers pour themselves into the extra-curricular programs. They put in these extra hours, often away from their own children.

My son, for example, works hard at French because his French teacher is also his basketball coach and they’ve connected on the court.

I’m worried about my patients. They are suffering under the weight of our under-resourced (and under-appreciated) public education system. Their minds and bodies are paying the price.

Suvendrini Lena is a playwright and neurologist. She works at the Centre for Addiction and Mental Health and Women’s College Hospital and is a lecturer in psychiatry and neurology at the University of Toronto.

@nowtoronto

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