This book was just ok for me. Like other self-help types, I found a lot felt like filler and was repetitive. I started skimming through just to find parts that were applicable to my own migraines, as there was also a lot of info that didn’t apply to me.

I did find the book validating for my migraines, especially the fact that mine often give me headaches on my whole head, not just one side. But overall, the majority of the book was very meh for me.

I'm not sure how I feel about thinking of migraine as a disease and disability of which the headache is just a symptom, but I am open to enlightenment. Thanks @Abigail for the rec!

Good information, helped me get a hold of some things I hadn't registered as symptoms.


If you have migraines, read it. Finally, someone who doesn't trot out silly assumptions like "Just stop eating chocolate and you'll be fine."

The author is a Doctor, with a fondness for meds, and I found her a bit prone to underemphasize triptans' side effects (which they do have), but on the other hand, she's respectful of people who don't want to use them, and quite positive about alt treatments of many sorts (except herbs, but she gives pretty good, specific reasons for that).

Very nice to have a comprehensive picture by someone not promoting a panacea.
informative medium-paced

An informative and excellent book. One of the best.

Second reading. Lots of things I'd forgotten, lots of things to relearn.

Second reading. Lots of things I'd forgotten, lots of things to relearn.

This is easily the best migraine book I've ever read. It's a fantastic resource and chock full of information.

The writing is dry; it's mostly information about migraines and/or examples of cases that the writer (an MD from Harvard who is a migraineur who runs has her own headache clinic) has dealt with in her clinic. The dry writing might turn some people off, but if you're like me and have read a lot of journal articles or other non-fiction writing, it shouldn't be a problem.

There are a number of forms and worksheets to help anyone discover symptoms, patterns, and triggers for their migraines, and also assess the severity (hopefully to be able to see what treatments are working). There is a lot of information to help deal with the issue holistically, it's not just about avoiding chocolate, wine, and taking medication. She comes at the problem from several angles, and mentions alternative treatments whether or not she actually agrees with them.

The reason I didn't give this book 5 stars is because I felt some of the information wasn't quite complete. I've taken most of the medications (prophylactic and treatment mentioned), so when she says "if you can't take X, you may be able to take Y, check chapter 9" and Chapter 9 doesn't address the difference between those drugs, I find it a problem. Also, she mentions that a "doctor who immediately prescribes Z is probably not a good doctor, go see ch 9" and again doesn't address that, another problem (is it because Z is dangerous, or because Doctor isn't checking out any of those other meds? what?).

So overall, amazing. Whether or not I believe the information about the pharmaceuticals in use is complete, it's still pretty good and the rest of the book is excellent, giving plenty of tools for helping deal with migraines.

I took notes while reading this. New studies and research have led to the view of migraines as a complex neurological disease of the central nervous system. Far from just a headache, the symptoms can include vomiting, scalp tingling, visual distortions, inability to speak, cold hands and feet, and problems in cognitive processing similar to a stroke, as well as a massive headache often centered behind one eye. All of these are things I experience, yay!

What happens when a migraine occurs is that your nervous system has an out-of-control reaction, which triggers a wave of energy that flows across your cortex and causes your neurons to fire rapidly back and forth from positive to negative charge. (This would be when I see sparkly stuff in the corners of my vision.) This causes the main problem: SPREADING CORTICAL DEPRESSION. You don't want this. It involves a sudden catastrophic loss of serotonin and dopamine, leading to other badness: dilation of blood vessels and inflammation of nerves as they release neuropeptides, particularly the trigeminal nerves that run up the face and behind each eye socket. It's awful.

Triggers can be a lot of different things, and the author is careful to emphasize that they depend on the individual. She discourages the reader from blindly following rules that claim all people with migraine (or migraineurs) need to avoid certain foods or whatnot. For example, coffee can be a trigger for one person but helpful in migraine prevention for someone else. She advocates making a big list of your triggers, based on observation. IKEA is a trigger for me. Not getting enough sleep. Feeling too happy, especially following a stressful period. Bright lights (I am a freak about avoiding them lately.)

I didn't read the entire book, but the sections I checked out were informative and authoritative and easy to follow. Bernstein lays out for the reader the current medical understanding of migraines and how they happen. Other chapters offer clear advice for prevention and treatment plans - including the guidance to write down a clear plan for what steps you will take when you feel yourself getting a migraine in any situation - work, in the car, etc. Very helpful. She talks about the different medicines and their benefits, as well as other treatment plans involving yoga, meditation, and biofeedback.

After years of reading differing advice online and in magazines, this book afforded me an unexpectedly deep sense of relief. I think it mostly came from validation, from knowing that what I have is pretty common although its symptoms are freaky. It made me feel more of a sense of control than I had before - just from small ideas, like that cold hands might be a trigger as well as a warning of a migraine, and I can control that by not letting my hands get cold.
informative slow-paced