When the migraines came for me, there were signs of adulthood creeping into all corners of my life: a recent marriage, a real estate purchase, and occasionally being addressed as "ma'am" at the bodega. At 30, I had also just landed a job with above-average perks.
I worked as a copywriter at a clothing brand run by handsome older women who dinged chimes to "center" themselves at meetings, talked about holistic wellness, and occasionally took their shoes off in the office. I enjoyed a new-age corporate environment where pants with elastic waistbands were socially acceptable and employees received free massages from Stephan, the ambiguously European office masseuse.
Life was going well—almost too well. And then the headaches began. On Saturday mornings, I'd wake up feeling as if my pillow and headboard had conspired against me to simultaneously stick an icepick through the back of my eye and an axe into my forehead. At first, I thought I was on the receiving end of a new type of mega hangover: Into my late twenties, I drank wine with dinner, wine after dinner, and sometimes even had an after-wine-after-dinner drink. So the resulting pounders weren't a huge surprise. I'd have to lie in bed all day trying to sleep off the pain, which was usually relieved only by .5 mg of Xanax, 800 mg of Ibuprofen, and six hours of sleep. When darkness fell once again, I'd just be rising.
But within a few years, I started getting headaches even when I didn't drink. And when it began happening also during the week, I decided to see a neurologist.
"Congratulations," she said. "You have migraines."
The doctor prescribed me triptans, a class of drug known to narrow the blood cells around the brain. I found this validating—there had definitely been times when I thought my head might explode. The pills helped if I took them as soon as I felt the headache coming on, but if I awoke already trapped in its viselike grip, I'd have to wait out the throbbing in bed, shades drawn.
When I have a migraine, I can't do anything. This nothingness is almost as infuriating as the unrelenting pain. I can't read or watch TV or mindlessly scroll through Twitter, haphazardly endorsing things. As a generally anxious person, I like to fill all of my free mental space with distraction, to avoid facing my own thoughts.
Looking back, I wonder if my body was trying to tell me something.
My new job had afforded me the salary necessary to qualify for an apartment purchase with my equally new husband. It was a tiny, albeit charming place with hardwood floors and an original 1960s Danish-style shelving unit in the living room, a pint-sized bathroom and a small-but-operable-by-New-York-City-standards kitchen.
"Wait until you see the roof deck," the real estate broker said.
Besides the fact that it needed a little fixing up, we couldn't figure out what was wrong with the place. The asking price was surprisingly low.
"Why are they selling?" I asked.
"It's a couple," she told us. "They're getting a divorce."
Living a place where people had fallen out of love didn't sit well. My husband and I had been married less than a year, but we argued a lot. And then there was sex—we'd only had it a handful of times since our wedding night. Since we weren't the kind of people who got married to have kids, we bought the place and threw our newlywed energy into decorating our quaint little fixer-upper, which I thought would be the perfect distraction from our lack of marital bliss. It turned out to be just another stressor.
"What do you think of blue tile for the bathroom floor?" I'd ask my husband, instead of expressing my increasing discomfort with the pileup of renovation costs. Most of our bickering, which had become an almost daily occurrence, stemmed from one of three issues: money, sex or booze.
Having recently lowered my own alcohol intake to avoid getting migraines, drinking had become less attractive as a spectator sport. I'd noticed he'd been spending his evenings after work on our new roof deck with a couple of Brooklyn Lager tallboys, while I read or watched TV in hiding, from on a tiny glowing iPhone screen in the bedroom.
"Do you really need to drink every night?" I'd ask.
"You're always holed up in the bedroom anyway," he'd counter.
Even in our new 500-square-foot apartment, we found ways to successfully evade one another. But for me, avoidance was taking a physical toll.
"The headaches can be aggravated by stress," my neurologist told me on a follow-up visit after counting the number I'd had that month. "Are you stressing about anything in particular?"
I could almost feel the vein in my head pulsing.
"No," I lied.
She put me on a preventative anticonvulsant that I took every day in order to limit the migraine frequency. The headaches did decrease, however slightly, and I was able to keep them mostly confined to the weekends. Among other infuriating facts about migraines: they can be triggered by an end-of-week reduction in stress—as well as an annoyingly specific list of other weekend consumables I refused to completely cut out of my life, such as chocolate, cheese, and wine.
On Saturdays, I'd shut myself into our shoebox bedroom, head pounding, face covered with a pillow, feeling guilty for not spending more time with my husband who would stick his head in and check on me every few hours.
"Should I even bother making dinner?" he'd ask, sounding disappointed as if he already knew the answer.
Luckily for me, in addition to my office's wellness perks (like the 5:20 pm foam-rolling class), my employer offered excellent insurance and flexible scheduling. I cannot think of a better time in my adult life for my migraines to suddenly become much worse. One Sunday, I realized I'd been suffering from an acute attack since the previous Thursday—more severe than any other I'd experienced. Status Migrainosus, I learned, is a debilitating migraine lasting 72 hours or more. After lying in bed for four days writhing, my brain overheating with agony, I gave up and called my doctor's answering service.
"On a scale of one to ten, how bad is your pain?" she asked when she called me back.
She sighed. "All you can do is go to the ER."
I could barely muster the strength to get into a taxi, a black plastic bodega barf-bag strapped to my right hand. Because I couldn't read my iPhone screen, I let my husband direct the driver to the Bellevue ER by mistake, instead of my doctor's affiliated hospital, NYU, a few blocks away. Several of the other patients were handcuffed to their beds.
I managed to go to sleep over the sound of a man screaming for his methadone as I received an IV drip loaded with a potent cocktail of steroids and painkillers and awoke a few hours later, headache only dulled. I went home exhausted to sleep off what felt, by comparison, like a lullaby of sledgehammers pounding softly inside of my skull.
Not long after, I had another whopper that lasted seven days, and according to my daily headache diary, crested at a nine on the pain scale over the first weekend—and then hovered around a four or five during the week. The second weekend, it became severe again, so I called my neurologist's answering service again, and a different doctor responded. When I gave him the rundown, he offered advice I wasn't expecting.
"I can give you steroids, but first I want you to try something."
"Stay home, do nothing, and relax. See if the headache goes away on its own."
What? It had been an entire week already. I wanted him to prescribe stronger medication, an aggressive treatment of electronic pulses, lopping off the top third of my head—anything but nothing. Defeated, I lay on my couch staring at the ceiling listening to myself breathe and tried for the first time ever to simply exist in the presence of my physical pain. I gave in to the migraine, figuring if it swallowed me whole, I'd just concede to dying already. When I woke up the next day, my headache was gone.
I have never been the type of person that could sit still long enough to meditate. But at the recommendation of my doctor, I enrolled in mindfulness-based cognitive therapy for migraine sufferers. Through it, I learned that the best way to relax is to simply stop trying to change your current physical or mental state. After much skepticism and many failures, I succeeded in reducing my stress by practicing breathing exercises and meditation. When I felt anxious, I was supposed to acknowledge my thoughts and feelings with curiosity, instead of burying them in a blitz of Xanax.
At first, acknowledgement was more difficult than avoidance, but it eventually led my husband and me to couples therapy, where a nice woman mirrored back to us what we had failed to communicate to each other on our own. It took a few months, but she helped us figure out that we couldn't just sit on our asses in different rooms waiting for sparks to fly. We had to actively pursue spending time together—doing things we both enjoyed.
"Is this what middle age is like?" I asked one Friday night as we laid on our leather couch for hours listening to jazz records.
The migraines didn't go away, but they became more manageable. I began to see them less like hostile invaders and more like annoying relatives—the kind who eat all of your food and break some stuff but eventually go away. At work, I actually looked forward to becoming the kind of handsome older woman who dings chimes, talks about holistic wellness, and takes her shoes off at meetings. It's worth noting that my stance on desk-side massages remains unchanged.