The Mindful Migraine

Joan Didon (1934-2021) is an American writer and journalist. Her obituary in Vogue casually mentions: “She was afflicted by migraines and was frequently depressed, even wearing dark glasses through the wedding ceremony.”

I found a picture on Joan’s website, and sunglasses indoors does appear to confirm she is a person with migraine. Maybe I’m reaching, but there is something tentative in the posture and slim smile that says, “be careful Joan”, rather than “ugh – I’m unwell”, in that particular moment… a migraine was a possibility but hadn’t yet arrived:

[Image source: JOAN DIDION MARRIAGE | joandidion.org]

Although she wrote copiously, it is Joan’s short essay “In Bed” (1968), that I want to summarize and discuss here.

[I found a 5-page PDF version here: “In Bed“.]

The essay opens with: “Three, four, sometimes five times a month, I spend the day in bed with a migraine headache, insensible to the world around me.” She writes, later, that her first migraine attack aged 8, for which her doctor (unfortunately, and surely needlessly) prescribed an enema.

As I read through the short text there were many lines that jumped out:

“The physiological error called migraine is, in brief, central to the given of my life.”

“…[the] fact I spent one or two days a week almost unconscious with pain seemed a shameful secret, evidence not merely of some chemical inferiority but of all my bad attitudes, unpleasant tempers, wrongthink.”

“For I had no brain tumor, no eyestrain, no high blood pressure, nothing wrong with me at all: I simply had migraine headaches, and migraine headaches were, as everyone who did not have them knew, imaginary.”

“…perhaps nothing so tends to prolong an attack as the accusing eye of someone who has never had a headache.”

“All of us who have migraine suffer not only from the attacks themselves but from this common conviction that we are perversely refusing to cure ourselves by taking a couple of aspirin, that we are making ourselves sick, that we ‘bring it on ourselves’.”

“There certainly is what doctors call a ‘migraine personality,’ and that personality tends to be ambitious, inward, intolerant of error, rather rigidly organized, perfectionist. ‘You don’t look like a migraine personality,’ a doctor once said to me. ‘Your hair’s messy. But I suppose you’re a compulsive housekeeper.’ Actually my house is kept even more negligently than my hair, but…”

“…not all perfectionists have migraine, and not all migrainous people have migraine personalities.”

*

Why, she wonders, can’t we just say that migraine is something we live with… like diabetes? She then suggests that she herself has managed to learn to live with migraine and sees it “as more friend than lodger”.

“We have reached a certain understanding, my migraine and I,” she writes, “It never comes when I am in real trouble. Tell me that my house is burned down, [etc…] It comes instead when I am fighting […] a guerrilla war with my own life, during weeks of small household confusions, lost laundry, unhappy help, canceled appointments…”

[This too resonates – how is that I can present my PhD progress with minimum medication, but I can’t make it to my daughter’s soccer match? It is as if, on some level, the migraine knows when it’s knock-down presence will be life-altering rather than simply life-annoying.]

“And once it comes”, Ms Didion then writes, “now that I am wise in its ways, I no longer fight it. I lie down and let it happen.”

And whilst she seems in the later stages of the essay to be OK with migraines, earlier in the essay she speaks of an attack in much harsher terms: “The actual headache, when it comes, brings with it chills, sweating, nausea, a debility that seems to stretch the very limits of endurance. That no one dies of migraine seems, to someone deep into an attack, an ambiguous blessing.”

[This apparent (dis)connect is real – I feel the same. A migraine attack is a horror story… but I also no longer “fight it” – I’m no longer a “migraine warrior” as I’ve said before. There is a level of acceptance attached to my diagnosis that I didn’t always have. I’m no migraine lover, and I haven’t ‘surrendered’ to my diagnosis, however, I’m no longer a fighter.]

Ms Didion ends the essay with a sense of contentment. Her migraine over, she climbs out of bed and stops to smell the flowers. Her negative sentiments apparently evaporated, her pain is fully diffused.

[I remember those days. It was as if nothing had ever happened… but it rarely came straight after an attack. I still had to limp through several more hours of brain-fog before I could pay attention enough to notice a flower’s fragrance without wincing. There was no sudden hoppity-skip, “hooray the pain is over”, exuberance… rather a slow slide, or resurfacing, back into the land of the living…]

It’s a reminder that there is SO much that IS similar from one person’s migraine to another… AND so many ways in which the pain experience is you-nique.

That’s why I think these “stories matter” – they remind us that we are not alone – albeit lonely – and that if others can live a creative life with migraine, so can we.

Take care, taking care, Linda x