Migraine is more than a headache – a rethink offers hope

I spent about 30 years getting migraines before I realized that wearing sunglasses helps my light sensitivity. It seems like that'd be a fairly intuitive thing to have tried, but somehow I never did.

I've tried many drugs to combat them, but there is one thing that helps me short-circuit it 99% of the time is a high amount of caffeine. It's not perfect -- I liken it to side-stepping a train; you get missed by the train itself but still get thrown off by the wind and noise, still fall hard on the ground, still get bruised but not hurt as badly -- but it works well enough, so as soon as I get the visual aura, I slam back a strong coffee and know that it'll work. Why? No idea, perhaps the pressure in the brain's blood vessels are affected?

What I don't see as often discussed is the subtle changes in consciousness that accompany migraines.

For me, in the pre phase (12 hours or less before the true onset), the first sign that I'm heading towards one is a sudden immediate bias towards pessimism with a kind of resignedness too (which is quite unlike my normal states of mind). That's often my first clue. It's like the storm clouds are gathering on the horizon and all light and colour is drained from my life.

Then, the visual aura hits. Now I know what's happening with certainty and I hit my caffeine prophylactic. The caffeine stimulation combined with the first inklings of pain and knowledge that you're about to go "into the shit" gives you quite a fight/flight feeling. You're at a bit of a loss as to what to do, since you're amped up but there's nothing to do but wait it out.

Then once the aura fades, you feel quite strange. I'll typically go lie down at this stage. If the caffeine worked (which is like 99% likely for me), I feel in a kind of haze but I'm not in deep pain - just uncomfortable and mentally quite scattered, though I'm no longer pessimistic about the future. In fact, it's like time collapses, and I'm forced to be in the moment. It makes me feel sick to try to think about the past or future - it all feels like a huge burden to try to internalize those states of time. I just try to focus on my body and how I'm feeling. It's almost like a meditative state. I can't sleep due to the caffeine but I try to rest and keep my mind clear.

At some point I'll realize that I'm mostly through it, and can get up and move around and generally kind of resume my day. But it feels like a hangover of sorts. Everything is hazy. Thinking is difficult. Very sensitive to light and noise.

Then, surprisingly, the next day I'll feel mentally GREAT like my mind was cleaned.

Which brings me to the most interesting part of all this for me - the migraine has a lot of similarities to a psychedelic trip. There's a come-up that's distressing, a plateau where one is forced to be in-the-moment, a depletion afterwards, and the next day onwards a feeling that things are cleaner and better ordered than before, like your mind and spirit has been defragged.

Perhaps both the migraine and the psychedelics are stressors or some kind of release valve on your brain.

One wonders if there's increased brain plasticity post-migraine like with psychedelics.

PFO closed, migraines basically gone.

PFO can lead to stroke too for the same reason, and that's when it's usually closed, after a stroke. Not all migraines are caused by PFO. I went on blood thinners first for a year as a test.

Here's the long story version: https://news.ycombinator.com/item?id=40895116

Some confounding variables on diet/weight loss/sleep quality. But I don't care, things are better and I'm happier for it.