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Sunday 20 May 2012

On Migraines: they are all in the head


They start with a spinning black penny, retch-inducing smells, impaired thought and speech. But migraines bring odd pleasures with their pain
migraine woman
Dark days: when it hits, a migraine is like a film melting in your projector. Photograph: Murdo Macleod for the Guardian
 
The first time it happened I was in bed with a book, aged maybe 10. And I remember going over the same line again and again, with rising levels of panic, as I realised I had forgotten how to read. I didn't think it was something you could just forget. Something that, having picked up, you could then one day drop again. I see now it was my first migraine.

Today migraines are in the news and they're in my head, tightening around my crown like an alice band. The NHS is considering offering Botox to patients with chronic migraines. They don't know quite how it helps, but they've decided it does. The blocking of muscle contraction, which is what the botulinum toxin does to those stunning their wrinkles, hasn't been proved to relieve headaches, but two clinical trials did conclude that it led to a 10% reduction in the number of patients' headachey days. In addition, I imagine, to a laboratory paved with clingfilmed foreheads.

I'm writing now through day four of this month's headache, one that began (as do many) with a flickering blind spot in the centre of my vision. It starts small, a spinning black penny in the middle of a page. I slump in my seat as it spreads darkly over my sight like jam, and I can't see, or think, or entirely understand speech. It's the film melting in my projector – it's a bit like falling. Smells slay me. Noise, fine, but smells – Angel perfume in a lift, for instance, or that dirty spitting rain you get in cities, the kind that smells of apocalypse – will make me retch. And minutes later the headache comes.

The author Siri Hustvedt wrote about a migraine aura phenomenon called Alice in Wonderland syndrome – the migraineur feels parts of their body ballooning or shrinking. For me it's often my hand. I'll lie in bed and under my cheek it'll swell to the size of a football, or a room, or shrink until it's dust. These episodes when my reality wobbles are not entirely unpleasant.

I half-enjoy the days preceding a migraine when everything feels like déjà vu. When walking home, a series of sights – a smoking schoolgirl, a chained-up bike – are overwhelming in their impact. Everything I see reminds me of something else, but something just out of reach. It reminds me that it's reminding me, but not what it's reminding me of. In its un-graspableness, this feeling is similar to one of the factors that brings these migraines on – the reflections from the Regent's Canal that play on the ceiling above my desk. Ripples of light lead to ripples in my reality, this warm tightness behind my eyes, a grim ache in my jaw.

The pain is sometimes awful, but more often it's medicated and so simply… saddening. I take these lovely painkillers, so it's rare I'll feel the blinding sharpness. Rather than being slammed into a wall, it feels as if my head is stuck in a closing door. It's the dull agony of a deadline looming, of a nagging phobia, of going up in a lift as your vertigo builds. But I miss stuff. Parties, dinners, often meanings – I'll be interviewing somebody in a brightly lit room and will find myself two thoughts behind, my eyes scrunched in concentration, praising Olympus for the reliability of its dictaphones.

I realise, though, that it's these vibrations on the drum skin of my life that make me me. I see the world through a smoky, migrainous filter. And like somebody teetering on the edge of a depressive episode, not yet fallen, I'm able to stand outside it and look around, curiously. Medicating with Botox seems like an apt metaphor – in ironing out the migraineur's wrinkles, the doctor smooths their reality. No more hands the size of houses. No more fainting as an effect of sunlight spearing through dark trees. So I've learned to embrace this gentle madness. In succumbing to a migraine, I get to test what's real.

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