My New Year's Resolution: Making Peace With Migraine

I've lived with migraines for fourteen years and after trying every remedy under the sun I finally found something that helped ease the pain: words. They were written by Joan Didion in 1964.
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I saw the movie Atonement last night, and while my companions were discussing the merits of the book versus the movie - a discussion I would have liked to jump into with enthusiasm -- all I could think about was that poor mother in bed with her migraine. There are broken hearts and broken promises and broken bodies all over that devastating story, but the mother with the migraine did me in long before any of those miseries showed up.

I've been that mother, more times than I could possibly count - the person who has to leave the party and go lay alone in her room, with no light, no sound and no motion, because any further disturbance will push the whole system over the edge. I've lived with migraines for fourteen years - fourteen years of days lost to exhaustion and nights spent in pain, of hunger and thirst and vomit and hours spent lying on cold floors of bathrooms and hospital emergency rooms that were too busy to see a patient who was, after all, still breathing. And after fourteen years of desperately trying every remedy under the sun - every drug, every herb, every abstinence, every kind of healer from traditions all over the world, I finally found something, last year, that helped ease the pain: words.

They were written by Joan Didion in 1964 in an essay from The White Album entitled, "To Bed." They'd been there all my life, these words, had I just gone to the library or to a really good bookstore, and plucked The White Album from the shelves. But I happened upon them by chance, while trolling the internet for yet a new magic cure. I started to read, and then I started to devour and when I got to the end of the piece, I thought, "That's it. That's exactly it."

The words about migraine were these:

I have learned now to live with it, learned when to expect it, how to outwit it, even how to regard it, when it does come, as more friend than lodger. We have reached a certain understanding, my migraine and I... And now that I am wise in its ways, I no longer fight it. I lie down and let it happen...[and] when the pain recedes...I count my blessings.

Didion's essay, though powerful beyond measure, is only a few hundred words. It's not a guidebook for making peace with migraine. I had to figure out that path for myself - but here's the amazing thing: I did. The process took the entire year, but here I am, on the brink of a new year, and I can chant Didion's words like a mantra because they are now mine, too. I still have migraines, but I have significantly fewer and they are far less dramatic or disruptive. It's a beautiful thing.

So on New Year's Eve, I resolve the exact same thing I did last year. I resolve to continue living in détente with my headaches. I resolve to keep the peace. And for anyone who saw Atonement and felt as much empathy for the two-second shot of the mom with the migraine as you did for the devastated lovers, here's a truncated version of how you might make peace with your migraines, as well:

1. Learn when to expect it. Keep a journal and don't cheat. Every single time you get a migraine, list the time of day, the quality of the weather, how you slept the night before and the night before that, what you ate, whether or not you drove on a road with glare. It's not enough to say "red wine gives me a headache," because the truth of the matter is that red wine might only give you a headache on days when it has rained, or on days when you have slept less than six hours or on days when you also ate a bit of cheese. Know exactly what triggers a migraine. See if you can learn so much about your migraine that you can predict it.

2. Learn how to outwit it. Keep using that journal and add information about what works once a migraine has come. Does ice help? Does ice only help in the first 30 minutes or does ice help throughout the entire migraine episode? Does ice on your neck do anything? What about on your feet? Think this comprehensively about all your behaviors and all your remedies - your sleep patterns, your exercise habits, when you take your meals, and every over-the-counter pain killer, strange-sounding Chinese herb, vitamin, tea, and narcotic. You can't be smarter than your migraine if you're not smart about what helps.

3. Become wise in its ways. Record where, exactly, the pain starts and what the quality of the pain is like. For many years when doctors would ask me to rate my pain on that 1-10 scale, I would tearfully say, "Ten," and think that I had conveyed something important. Not so. All I had conveyed was how much it hurt. I hadn't said where the pain had started, how it had spread, where it had concentrated its power. Once I started to pay attention, I found that sometimes the pain starts high on the right side of my neck and other times it starts low. Sometimes the sensation builds from my jaw line, other times from my temples or my sinuses or higher in my forehead. By pinpointing the way my migraine was actually working, it became less sinister.

4. Learn how to regard it as more friend than lodger. I don't think Didion was suggesting that you adore your migraine and invite it to afternoon tea. I think she was suggesting that there is room to consider it in a slightly different light. Anything that has become less sinister and mysterious has moved down the continuum from alien to friend, and any movement in that direction should be welcome indeed.

5. No longer fight it. This sounds similar to the ridiculously simple "Just say no" directive -and dangerously close to the rage-inducing suggestions people without migraines often make to those of us who have them: maybe you should try yoga, you'd be better if you weren't so stressed, what about Excedrin? But the fact is that sometimes ridiculously simple is brilliantly wise. Constantly fighting against your own body is exhausting, unproductive, counterintuitive, and a good way to cause depression and despair. You could just....stop. You could embrace the fact that you are a person with migraine. When a migraine hits, you could just say to yourself, "Here's a migraine," and let it happen. Accept that your day or your night is shot. Accept that you may have to take a bunch of medicine and that the next day may pass in a drug-induced haze. It's not about giving in; it's about giving up the desperation.

6. Know that the pain will recede. Because it always does.

7. Count your blessings. If you don't have a migraine on a day when you have a big presentation, count that as a blessing. If you have a migraine on a day when your child is starring in the school play, but your drugs work and you get to go, even though you're shaky and a little nauseous and tight, count that as a blessing, too. It seems cheesy, but it works to shift your perception away from the negative and toward the positive, which is a straight path to peace.