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Mindfulness for Managing Non-Pain Symptoms

This is the fifth post in a series exploring the topics covered in the book You Are Not Your Pain [Amazon affiliate link]. See You Are Not Your Pain: An Introduction to learn more.

You Are Not Your Pain is, unsurprisingly, focused on pain. But the concepts in the book, which are those of mindfulness-based stress reduction, can apply to all sorts of physical symptoms (and to life well beyond illness). In the book, Vidyamala Burch mentioned that she uses mindfulness to reduce fatigue. While I employ mindfulness for managing pain—and in all other aspects of my life—I had never tried to experience fatigue mindfully. I was so intrigued that I asked Vidyamala to explain. 

Kerrie Smyres: I saw in an interview that you used to have severe fatigue. Did your fatigue decrease as part of your mindfulness practice?

Vidyamala Burch: Yes my fatigue has massively decreased over the years in which I have practised mindfulness and compassion. Really to a remarkable degree. I now have a lot of energy, in fact more than a lot of my able bodied friends! This is partly because of what I have learned about myself through meditation and awareness. There is so much less inner conflict. Also, I have learned to manage my energy in daily life much better through pacing myself. I used to go at things hammer and tongs and then have a big flare up, but I am now more balanced in my approach. I use the slogan “take a break BEFORE you need it” rather than keeping going at an activity until I am completely shattered. That’s made a big difference.

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Migraine Mood Changes: Depression-Like Symptoms

migraine-mood-changesI was standing in the bedroom alone with my eyes closed, taking deep breaths. I didn’t know Hart had entered the room until he asked, “What’s up?” “I’m nervous about you leaving,” I said, and the tears I’d been keeping at bay burst forth.

Even though I don’t have an anxiety disorder, I have subclinical levels of anxiety in two situations: sleeping when I’m home alone all night and when Hart travels long distances. The Fourth of July brought both of those. During a migraine attack. It led to one of a handful of full-blown panic attacks I’ve ever experienced. It was horrible, but made a lot of sense in retrospect. For the few weeks prior to that night, migraine attacks were going straight for my mood.

I first noticed it during a migraine attack on Father’s Day. I had to stop looking at Facebook posts because they made me miss my dad too much. This isn’t abnormal in the realm of grief, but I also cried when I realized that the attack would keep Hart and me from enjoying our day’s plans. Even that’s an understandable reaction to the situation. Becoming racked with guilt when the precarious stack I’d built in the freezer caused Hart to drop a container is not normal. Instability in the freezer is a common occurrence in our household and it’s usually my fault. The container didn’t break and Hart wasn’t upset, but I felt like an utter failure. These are all indications of depression, but my mood returned to normal with that particularly intense migraine attack cleared.

Migraine attacks bring major mood changes for me maybe a dozen times a year. The experience is unpleasant and unpredictable, but never enduring. Until this summer. During many, but not all, of my migraine attacks over a three-week period, I cried at song lyrics that wouldn’t normally make me cry and was quick to anger in low-stakes situations, like not being able to find the pen I wanted to use. These are telltale symptoms of clinical depression for me. So much so that my doctor wanted me to start another antidepressant.

I held off on the meds for a week because it just didn’t feel right. It didn’t follow the pattern for depression. Then again, it didn’t follow the pattern for migraine mood changes, either. Still, I watched and waited. By the time that week was up, mood disturbances were no longer regularly part of my migraine attacks.

Migraine symptoms are so weird. (I swear I say that at least once a month.) They’re both predictable and unpredictable. I expect to have associated mood changes occasionally, but this is the first time I can recall three weeks during which many attacks were accompanied by depression-like symptoms. I’m wondering if the uptick was caused by a short-term change in my brain similar to what my doctor described when I suddenly became sensitive to Wellbutrin’s side effects:

The brain you have after a migraine attacks is not the same brain as you had before it. Any medication that acts on the central nervous system, like antidepressants, could interact with this new brain in a different way than before, causing an increase in side effects. My dose hadn’t changed, my brain had.

The changes to your brain after an attack are not permanent, so please don’t let this scare you. It’s more like a storm with high winds came through and there’s still dirt and debris in the street. The street sweeper will get to it eventually, but it may take some time.

This explanation makes intuitive sense. The Father’s Day migraine attack that kicked all this off was particularly intense and odd. My thinking was way off. Despite being drug-free, I was thinking as if I’d smoked marijuana. That’s never happened in quite this same way before. Perhaps the celery that triggered the attack was genetically modified to have a psychedelic effect.

Whatever the explanation, the problem seems to have subsided for now. My mood has been stable for about a month. I’m grateful for the increased empathy that came from my tiny glimpse of insight into what panic attacks can be like. And I will be grateful if I never have to experience one again.

 

(In case you’re curious, the grief I’ve been wrestling with this summer has been entirely independent of migraine attacks and migraine mood changes.)

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Migraine and Blurred Vision

The migraine attack I’m in the middle of is mild. The pain is a 3, I’m only moderately fatigued, and my cognition is not impaired. Since those three symptoms are usually the most disabling for me, I should be able to do the work I woke up eager for. Except blurred vision has decided to make an appearance during this attack.

Blurred vision is a common part of the visual aura that precedes the pain phase of a migraine attack. A year ago I learned that it can also occur any time during the attack. This became intimate knowledge after blurred vision suddenly added itself to the constellation of migraine symptoms I might experience. It doesn’t happen to me a lot, but is quite pronounced when it does.

It’s one of those symptoms that cannot be relieved and there are few workarounds. Driving is out, so is looking at my phone. The computer is nearly impossible to read. When I magnify the text enough that I can read it clearly, it throws off the formatting, thus making it hard to read for a different reason. Fortunately, my e-reader on the largest print setting (which is about five words a page) lets me lose myself in books. Since the migraine attack is otherwise not too bad today, I’m going to try to put a coat of stain on drawers I’m refinishing.

I had migraine for many years before I realized that I was experiencing more than a headache. Now the other symptoms are so prominent that I can barely see past them. Yes, they literally blur my vision, but they also interfere with my life more than the one symptom that everyone associates with migraine does. Even with all my migraine experience, the depth and breadth of non-pain symptoms continue to astonish me.

(I almost included a picture with this post, but it seems cruel to make other people with migraine look at a blurry image.)

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Crowdsourcing: Migraine Aura While Asleep

Hart dreamed he had a visual migraine aura and woke up with a migraine. My guess is it wasn’t just a dream, but he was seeing the aura while asleep. Since an aura originates in the brain, not in the eyes, this seems logical to me, but I can only find one article about it. Based on two case studies, the authors say that geometric patterns from visual auras can be incorporated into dreams. I assume that dreaming you have an aura is a literal, direct incorporation into the dream, rather than the more abstract idea the article mentioned.

I’m really curious about this and can’t test it out on myself (since I have, fortunately, not had an aura outside of that terrible weekend). I have vivid dreams and nightmares during migraine attacks, but don’t think they usually precede attacks, and I don’t have a visual aura at all. So I’m crowdsourcing. Do you have auras in your sleep, either like the typical visual auras you get when awake or bad dreams?

 

 

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A Malfunction in the Brain’s Software

software_malfunction“I often say that the software system of the brain now is impaired. And all of the functions that software runs — like your thinking and your behavior, your emotions and your sleep — can potentially be impaired as well.” Although neuropsychologist Gerard Gioia was talking about the brain’s recovery following a concussion, it’s an excellent metaphor for migraine.

I’ve often said that my brain function is at 30% (or some other percentage) during a migraine attack. I’m not confusing mind and brain here (though my mind malfunctions, too). Every bodily function that the brain directs works less effectively than usual during a migraine. You become clumsier, maybe dropping things or walking into walls. Thinking is impaired, so it can be difficult to find words, make sense of written language, or understand what someone else is saying. You may experience vision changes, like blind spots, seeing flashing lights, or blurred or double vision. Your mood swings can be so substantial that you’ll wonder where all this emotion is coming from. Sleep may be impossible or unavoidable. You might even perceive objects—including your own your limbs—to be larger or smaller than usual (Alice in Wonderland syndrome).

These (and many other) symptoms are familiar to people with migraine, but it’s hard to explain it to people who don’t have migraine. Perhaps the software metaphor will make this weird illness called migraine easier to describe.

I’m curious to hear from those of you who have cluster headache, NDPH, tension-type headache, or another headache disorder—do you also feel like your brain is malfunctioning?