Photo courtesy of Nat Lanyon/The Licensing Project

Learning to Coexist with Chronic Migraines


Psychotherapist Annie Armstrong Miyao gets migraines. She’s found many of her friends and clients suffer from them, too. They’re just not talking about it: Faced with a lack of medical understanding or accessible, effective treatments, people with migraines often shoulder the full weight of the condition in silence.

What has helped Armstrong Miyao cope is acceptance and self-nurturing. It doesn’t cure the migraine—ultimately, she has to wait it out—but it does remove some of the heaviness migraines impose on her life.

Mothering Migraine

I lie in the backyard and my four-year-old, as she tends to do, chooses to lie on top of me, her little head angled on my chest so she can suck her thumb. We breathe. My eyes close to dim the brightness of the sun, and I let the heat help relax my muscles. I practice observing the pounding in my head while I connect to a peaceful place in my body, holding space for both feelings at the same time. An effort to marry some peace with pain.

“This is my medicine,” I tell her.

“You got a migraine, Mama?” she asks.

“I do, honey.”

During this particular stint, I have been migrainous for most days of the previous five months. I am exhausted from the pain, dizziness, and nausea of it all. As a migraine begins its march of cortical electrical depression, a series of symptoms sets in. I lose my balance without warning and must find a wall to hold on to. I must look away when the kids swing. Sometimes light creates the perception of objects blurring into one another. I will feel like I am hearing the world through a tin can, sounds buzz down my ear canal. I become nauseated, and half my face will sometimes droop. My sharp mind is dull. I cannot find words. I mix up pickup times at school and burn food on the stove.

My girl goes to get some things from the pretend store that my husband built the children under the slide of the swing set. She returns with a piece of wooden cake.

“No sugar, Mama, so you don’t get a migraine,” she tells me.

“Thank you, my love. More medicine, please.”

She resumes her position lying on my chest. Small green wild parrots have settled in pockets of Los Angeles; we listen to them talk back and forth over our neighbors’ avocado trees. My daughter announces the insects that fly by, and for a moment we are still.

How do you overcome a challenge when the challenge is a storm inside your head that spreads through your body like a hideous mix of seasickness and hangover?

How do you tend to an illness that is so specific to the individual and mysterious to the medical community, and whose treatment methods are elusive and vast?

According to the American Migraine Foundation, a billion people worldwide suffer from migraine—predominantly women, which may be part of why we are so far behind in our understanding of the disease.

It is common for women to learn to live without speaking of our pain from a very young age. We learn to go to school with raging menstrual cramps. We work and raise children while pregnant. We bear children (a phenomenally beautiful, powerful, and often violent act against the body), are offered little to no postnatal support, and return to our lives with wrecked pelvic floors, clogs in our milk ducts, and hips out of alignment—without saying a word. And we are still climbing back from centuries of our mental and physical ailments being ignored or lumped into some untreatable category (look to hysteria or endometriosis). I spent years pushing through migraines, accepting generic, just-shy-of-dismissive assessments from doctors, ignoring my own suffering as I tended to others’ pain.

I went from neurologist to naturopath to new neurologist; to optometrist, chiropractor, acupuncturist; to massage therapist, ob-gyn, general practitioner, dentist; to a medium, my therapist, and yet another neurologist.

When I was in my 20s, I left a stable romantic relationship for a wildly passionate one. I was so terrified I was making the wrong decision that I decided if I was going to fuck up my love life, I was going to do something good for me, too. So I quit smoking. I’ve felt the same impulse as over the years my migraines progressed from occasional to regular to chronic. As migraine attacks wreaked havoc on my well-being, I was going to do things that may or may not cure me but were undeniably good for me.

I wedge in regular acupuncture and resume my own therapy. I carve out small moments to meditate. I cut out alcohol and sugar. I add herbs and a diet designed to balance my hormones. I put a cap on the number of patients I treat, despite financial pressure. I try different medications. I listen to the cues my body gives me and respond in the same way I tend to my two-year-old when he starts to get off-kilter: Do I need a snack? A nap? A snuggle?

I ask myself, “Why are you saying yes to this?” to make sure I pause long enough to think about what I can handle versus what I want to handle or think I should handle.

When I find myself shoving a piece of chicken in my mouth over the kitchen sink, I slow down and remind myself I am not a racehorse and this is not a race; each day is marathon that I will walk.

When a chronic condition that impacts your health, spirit, and stamina and it raises its hydra heads, everything is hard. When a migraine blossoms, it is hard for me to work with my patients, to write, to mother, to do the things that bring me joy. Even my relished bedtime routine, with little heads snuggled into armpits and fat-toed feet squishing further under my thighs for warmth—even those luscious moments can feel hard when I am in the grip of a migraine. Sometimes I call it off and pass the baton to my husband. Other times I bear down and engage in the task at hand that ultimately makes my heart full. I do not want my condition to dictate my life, to rob me of joy.

I know how to mother, how to nurture, yet I spent years not doing it for myself. I listen to the mothers in my private practice express this sentiment: We are swimming against a riptide. We have to find our way to calmer waters.

I am learning to love myself unconditionally, this includes the part of me that is migraine. For it is my chemistry that tips me into a deep, almost poetic descent into disorientation and discomfort. It is me. I must forgive my brain and body for doing this to itself and I must practice loving it as it does.

So when the fog of migraine releases me, I am gifted with an awakeness, a presence to the simple, beautiful sparkle of the moment. Wisdom and peace are often gained after struggle. Those peaceful, joyful moments when the world is still and clear—we have to hold on to them and string them together, stitch them into a quilt. I lie on the grass with my sweethearts and soak in the sun, take my daughter’s medicine, and keep treating myself with love.

Annie Armstrong Miyao is a Los Angeles–based psychotherapist, writer, and mother of three.