Rule Six: Migraine is About a Mismatch Between Inputs and Outputs.

Here is what I mean by this: migraine is what happens for some people when our bodies cannot constructively process certain types of sensory and biochemical stimulation, that is, inputs. Migraineurs talk a lot about our "triggers," which are the inputs our bodies aren't dealing with well. We talk about triggers because migraine attacks leave us desperate for answers, and identifying triggers is a part of finding them.

Getting Hijacked

Some kinds of answers are delightfully easy to find. Sleep cycle thrown wildly off? Unlike most bodies, mine does not just produce some fatigue and foggy-headedness for a day or three, and then be done with it. My body has a temper tantrum instead. The three days that a typical brain spends adjusting to the new reality, my brain spends in Dire Emergency Mode (whose unwieldy symptoms I have described elsewhere). Why? I've shaken my fist at that impenetrable question for years, and all I can offer, really, is that probably my circadian rhythm, and all the intricate biological processes it sustains, were briefly mismatched. Typical brains get over the bump in the road. Migraine brains have a wipe out.

How delightful, then, when there is a simple cause and effect relationship, as there is, sometimes. How delightful when all you really need to do is try to keep your sleep and wake times consistent. Right? How hard could that be?

As it turns out, it can be very hard, but at least it is doable. We want things doable. Achievable. Put-it-behind-us-and-move-onable. And if sleep cycle disruption were the only trigger in play, then I would have no cause to write these words to you. Maybe it wouldn't even be called migraine, anymore. It would be called GoToBedAlreadyYouFool. I like the sound of that. I could dig it.

All too often, or at least in my case, it isn't so simple at all. It turns out there are endless possibilities and combinations when it comes to triggers. You can find lists of common triggers many places online. When I read them, they mostly just strike fear into my heart, because they are often very long, and each item on each list represents another discipline I wonder whether I must impose on myself. (For example: somebody somewhere gets triggered by avocados, so now I'm supposed to avoid avocados? But they are tasty and good for me! But wait, if I do eat avocado, and then I get a migraine, is it somehow my fault? Should I feel guilty for eating avocados, given the risk?) I've figured out that most of the triggers on those lists don't apply to me, so I avoid the lists now. I don't want to give my migraine brain any ideas. I already navigate too long a trigger list.

For the Sake of the Herd

There is another reason to pay attention to the inputs that provoke migraine: What if migraine is nature's way of seeding the herd with extra sensitivity — sensitivity that can guide it away from danger? This isn't an original idea. I may have first read it in Dr. Robert Cowan's book The Keeler Migraine Method. He writes about an unnamed neurologist who

"argues that migraineurs are further along the evolutionary path than nonmigraineurs. Because of our heightened sensitivity to hostile elements in the environment, we are better equipped to act as the sentinels of civilization."

It is one of humankind's oldest diseases, and some go so far as to assert it has spared no human population, anywhere, ever. It has not been selected out, in spite of its disabling qualities and in spite of many thousands of years for the last lion to kill the last migraineur.

It makes a kind of sense, then, that migraine would benefit human societies wherever it occurs. It is probably no coincidence that a similar benefit is postulated by Dr. Elaine Aron in her writing on highly sensitive people.

Both arguments go something like this: Let's say you are alive tens of thousands of years ago, and nomadic, and life is simpler. You are traveling with a clan, and one member of your clan is a migraineur. It's a hassle for everybody when this person gets an attack, because then the rest of you have to help carry the person and his/her stuff. Maybe that's not even possible. Maybe when the migraineur gets an attack, the whole clan has to sit around on the ground and wait for the attack to pass, grumbling and playing idle games with pebbles and sticks. The sick person is just too sick to move, is also too important to the clan to leave brutally behind. So it's a hassle for everyone, but then the sick person gets better and they can move on.

But what if our prehistoric comrade has one or more of the common environmental triggers, like sensitivity to barometric changes, or strong odors? Most people might not notice, or might dismiss these environmental attributes as unimportant, but the migraineur can't. The migraineur's body goes into Dire Emergency Mode, and that is the thing the clan notices. The clan has to stay put when the barometric pressure swings wildly, or has to keep away from noxious fumes.

Can you think of any reasons why these inconveniences might actually help keep the clan alive? I can. Barometric swings signal weather changes, and bad weather is a good time to play it safe and shelter in place. Strong odors could be associated with toxic gases or even simple rot — both things it's best to stay away from anyway. We know these things now, but how did we learn?

Maybe migraineurs helped teach us. Maybe, just maybe, we still can. Maybe our sensitivity is useful, and has the potential to be helpful to our modern-day tribe in the aggregate, if horribly inconvenient in the individual, day-to-day experience.

Rule Seven: Migraine Sucks Up a Lot of Happy Juice.

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During an attack, the body goes into Dire Emergency Mode. All the migraine symptoms that bring you to your knees are appropriate for true emergencies, when sheltering as far away from danger as possible makes a lot of sense. A beam of daylight coming through your bedroom window isn't a true emergency, so the response of disabling, all-consuming pain isn't very helpful in the moment, but that's beside the point here. What is worth remembering is that your body is experiencing it like it is an emergency. And it is generating real pain for reasons of its own.

Bombs and Monsters

If bombs are raining on your neighborhood, is happiness going to be your dominant emotion? No. That's because you know rationally that bombs are bad for people like you and me, but also because your body knows biologically that life-ending moments and happiness do not naturally coexist. Again, this is a useful adaptive trait. Our forebears who felt really happy while bears or monsters or mean people were slaughtering their families did not, it is safe to say, fare well in the romance department or leave a lot of kids as their legacy. That is to say, the “YAY! APOCALYPSE!” reaction got selected out of most of the human population. Hurrah for that.

For the rest of us, migraine is a simulated emergency, like bombs and monsters, which means the body is screaming at the top of its lungs "BAD BAD BAD VERY VERY BAD NO NO NOT THIS NO NOT THIS STOP IT STOP IT STOP IT" and so on throughout the attack. All of that correlates to powerful chemical signals in the brain. And all of that correlates to feelings of extreme distress. And it's hard to bounce straight back from extreme distress into happy land. You need other chemicals in your brain — my technical term for these is "happy juice" — to find your way back from extreme distress. And when, a single attack can last for days, as mine can, or occur back-to-back for a succession of weeks, you better have a deep well of happy juice to draw from. Otherwise, you won't be happy even while you are recovering, even though the monster has finally left you alone, and you're alive, and your family is too, and you know rationally there were no bombs. After being stranded so long on Migraine Island, it will take extra time for your body to build up its happy juice reserves again.

Super-Size That Happy Juice

All of this means you've got to try to keep a lot of happy juice in your brain, as much as possible, between attacks. Really. In my opinion, one of our most important jobs as migraineurs is to take such amazing care of ourselves that we have this huge reserve of happy juice to draw from. That way, when the baseline of happy juice is really high, that particularly nasty attack doesn't knock us down as badly and we can be more resilient. The setback isn't so bad. You can be up and running faster, and also, not incidentally, you will be more pleasant to be around.

This was one of the harder rules for me to accept. Migraine can seem so self-indulgent. I mean, laying in bed all day? Really? Who does that? (Sick people, that's who.) And now I'm saying I'm entitled to be happy the rest of the time, too?

Not exactly. It's not that you can't have other moods. It's that keeping your baseline very, very strong can make a huge difference to your migraines, your quality of life, your relationships, and every thing you touch. One of my hard-learned mantras is: Taking care of my body first is how I get things done.

The bottom line is, chronic pain generally, and migraine in particular, take a toll on mood. If you have to be energetic, at the top of your game, or pain-free to be happy, then you may never get a chance. You need to buttress yourself. You need a new approach. Find routes to happiness that are other than the ones that aren't working for you anymore. It can be done. It can even be a worthwhile journey. And you're not alone in it.

Next up...
Life in the Shadows Ever wonder how living under siege *really* feels for someone else?


More Migraine Island!