My friend comes uninvited
It comes instead when I am fighting not an open but a guerrilla war with my own life, during weeks of small household confusions, lost laundry, unhappy help, canceled appointments, on days when the telephone rings too much and I get no work done and the wind is coming up. On days like that my friend comes uninvited. (Joan Didion, 1979)
It's hard for me to remember a time before migraine. My first one was when I was thirteen, after a day of what I later came to recognise as prodrome and aura followed by disembodied but all-consuming pain.
Everyone's migraine is different, but that doesn't stop people from recommending treatments based on their own experiences. My migraine is known as “classic migraine” or migraine with aura. I see see points of colour, become sensitive to light, get confused, and start speaking gibberish. This is known as “word salad”, which doesn't really do justice to the sensation of one's mind being unable to select the right word, of being decoupled from the ability to use language.
Migraine is the second most common cause of disability, after back pain (Steiner et al., 2020). Its causes remain elusive, though it seems likely that it's a collection of neurological and neurovascular disorders. I think (hope?) it will always be somewhat unknowable. For a while my brain doesn't work and I'm incapacitated, and then it passes. It feels like something that can't be fully known.
I've become better at managing my migraine over the years, which is simply to say that I've become better at recognising the early signs. I've tried drugs, but the trade-offs stack up quickly. Weighing up side effects and the risk of migraine changes when it's been months or, once, years since my last migraine.
I had a bad one yesterday, my worst in quite a while. I'm still fuzzy and depleted.
People who experience tinnitus are often advised to undertake cognitive restructuring, to think of tinnitus as a friend who's always with them (Fuller et al., 2020). I don't think I'll ever be able to think of migraine as anything other than a tormentor.
If there is a good aspect of migraine it's in its passing. Nausea intensifies, and for me, suddenly, relief. The weight is removed. Light becomes less harsh. Colours change. Language returns.
Sources
Didion, J. (1979). The White Album. Simon & Schuster.
Fuller, T., Cima, R., Langguth, B., Mazurek, B., Vlaeyen, J. W., & Hoare, D. J. (2020). Cognitive behavioural therapy for tinnitus. Cochrane Database of Systematic Reviews, 2020(1). https://doi.org/10.1002/14651858.CD012614.pub2
Steiner, T. J., Stovner, L. J., Jensen, R., Uluduz, D., Katsarava, Z., on behalf of Lifting The Burden: the Global Campaign against Headache. (2020). Migraine remains second among the world’s causes of disability, and first among young women: findings from GBD2019. The Journal of Headache and Pain, 21(1), 137. https://doi.org/10.1186/s10194-020-01208-0
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