4.0

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.