Creating a life beyond migraines

Migraines are still largely a mystery, both to the medical profession and certainly to the millions of migraineurs, whose lives are slowly and silently eaten away from suffering this debilitating disease. A truly comprehensive medical book on migraines titled "The Migraine Brain" by neurologist Carolyn Bernstein only appeared as recently as 2008!

I first felt strange twinges in my brain when I was about 16, climbing up the stairs in my high school in India towards the 5th floor science labs. With every step I climbed it felt as if something liquid, usually lurking behind one eye, bobbed around and thumped hard in my head. But it seemed to stablize once I arrived at the labs. As a young girl, I was convinced I had a brain tumor, and didn't say anything lest I caused my family more anxiety than it already chronically experienced. When I was about 20, an emotionally traumatizing incident was followed by a blinding, brain-wracking pain episode like I had never experienced before. For 3 days, I could not lift my head from my pillow, the jelly in my head growing full-size and bursting through the veins in my temples, and the nausea so extreme that the slightest movement of my eyes caused retching. My cousin's husband, a cardiologist, was summoned home in an urgent bid to help me recover. He asked me just a few questions and pronounced his diagnosis with confidence: She has migraines! With this, my mysterious affliction received a respectable name.

In my early twenties I began getting migraines frequently but carried on zealously with my erratic schedule in architecture school. By my late twenties, living and working in America, I began getting migraines 2-3 times a week, which for the most part meant perennial migraine. Sometimes I had continuous 14- or 17-day spells with no respite in between. I tried everything my doctors suggested (well almost) - thyroid supplementation, anti-depressants, beta-blockers, triptans. I also tried supplements (magnesium/B-vitamins and feverfew), accupuncture, yoga, thai massage, and potent chinese herbs (with dead scorpions in the mix!). All these remedies provided temporary relief, but nothing made a lasting, fundamental shift. I found myself angry, distraught, depressed, and sometimes even hopeless about life.

It was in my thirties, in a "rebirth" following the collapse of a 9-year marriage, that I finally slowed down my life enough to pay attention, become present, truly occupy my body, feel and listen. I began taking full personal responsibility. I had observed the rapidly increasing inefficacy of medications in my system; I now chose to wean myself off all drugs and undertake only natural therapies for my healing. I experienced many severe migraine spells before I began to gradually see benefits.

If I were to sum up all that I am doing in a single, overarching, "how-to" guideline, it would be this:

Remove all toxicity from your life and allow yourself to heal from within.

This must happen in 3 dimensions:
PHYSICAL
MENTAL / EMOTIONAL
SPIRITUAL

In this lens, I elaborate on guidelines under each dimension - physical, mental/emotional and spiritual.

Following the overarching guideline -remove all toxicity from your life and allow yourself to heal from within- even in any one dimension provides immense benefits. Gradually learning to practice it concurrently in all 3 dimensions has magnified the impact significantly, and has propelled me to a life beyond migraines. I still get them, but with less severity, frequency and most importantly, with a diminishing significance and meaning in my life.

To meet the overarching goal for removing all toxicity and allowing yourself to heal from within, the following are some guidelines in the physical dimension.

1. START WITH YOUR GUT!
There is a reason why we say "I had a gut feeling"! Even though we experience migraines in the neurological system, the digestive system is the best place to investigate one's overall health.This is because the digestive system is where we convert food into energy, blood, new cells - everything we need to create for a happy, healthy life. Inflammation inside the body is the principal cause for the degeneration of our bodies, and consequently, many, many diseases.

A GI (gastro-intestinal) test is the easiest way to examine how your digestive system is doing, the level of your body's immunity, toxicity, levels of inflammation etc. The Schwarzbein institute(http://www.schwarzbeinprinciple.com/pgs/dr_schw/institute1.html) is a good resource for this, as are many naturopathic centers.

A GI test can also reveal food allergies - most typical ones causing internal inflammation are gluten (wheat, rye, barley and many other grains) and casein (dairy). Often following a gluten-free/casein-free (GFCF) diet resolves several health issues for a large part of the population. (Personally, I was found to be allergic to gluten, casein and soy protein!)

2. CHECK YOUR METABOLIC / HORMONAL (IM)BALANCE
Related to inflammation and GI tract functioning are all our hormones. The biggest learning I've had is that our hormones are not isolated agents (thyroid, adrenal, sex, pituitary etc) but work in close concert with each other at a systems-level, to maintain an optimized balance in our body so it can perform all its functions. An imbalance in one likely indicates an imbalance in another, and an isolated test for one hormone seldom reveals what the total system is doing. So if someone tests your thyroid and recommends thyroid supplementation, an underlying problem may be your adrenals, which are pumping out too much cortisol due to stress, affecting other hormones. Or if insulin is too high, a related problem could be a malfunctioning thyroid. In the case of migraines, serotonin plays a huge role, and is connected with hormonal balance. Many women suffer migraines that are linked to their menstrual cycle, also making the hormonal system an important player.

To understand your full system hormonally and metabolically, a specialist in endocrinology who has a natural, systemic approach would be your best bet. Getting your hormones in balance through diet and nutrition is the best course of action, and hormone replacement therapy, if needed, should be the last and carefully considered recourse.

3. EAT RIGHT - THE RIGHT FOODS, THE RIGHT WAY
I have found that eating the right foods in the right way correlates to almost 60% of the results!

For the right foods, there are two aspects:
- The first is to identify any allergic foods and trigger foods, and avoid those. Food allergies are different from "trigger foods" for migraines, because they contribute to the overall inflammation in the body, and hence system level issues. Trigger foods are those which when add up to a level beyond your body's specific tolerance level, can trigger migraines. Some common trigger foods are aged cheese, MSG, nitrites/nitrates, red wine, chocolate etc.
- The second is to simply eat healthy, fresh, natural, unprocessed foods. I once read a simple guideline that startled me: "If it didn't grow out of the ground or didn't have a mother, don't eat it!" (I have forgotten the title of the book - I will try to locate it.) Eating this way automatically eliminates many things we take for granted in our diets - packaged and preserved foods, fruit juices, processed cereals, condiments etc. Educating oneself in nature's most nutrient-rich foods and eating these goes a long way in health.

For the right way, there are 3 aspects:
- The first is understanding how to put together a balanced meal. A balanced meal is one in which essential proteins, carbs and fats are present in the right proportions. The proportion is as important as the quantities of each. Dr. Diana Schwarzbein's work is the best guide I have found for this information.
- The second aspect is to establish how often you eat. Eating smaller portions more often in the day keeps blood sugar balanced, energy levels constant, and is less taxing on all your system components. It also prevents binge eating.
- The final aspect is how you actually eat - i.e, what your mental/emotional disposition is. If you eat when you are stressed, upset, on the move, etc, the quality of your disposition causes your body to focus attention elsewhere, rather than on digestion. Perhaps this is why eating has been a ceremony in so many world traditions - and sitting at a table with your family and saying Grace is prescribed. Being thankful for your food, tasting every morsel, and chewing until your food is liquid not only helps you enjoy your food to the fullest, but also prepares your body for proper digestion and absorption of nutrition.

4. ELIMINATE TOXINS
This is a really important step, and while it is the easy to outline, it is hard to implement, because our bodies become addicted to the very toxins that are harmful to us, and I don't mean just tobacco and alcohol, but also allergic foods.

If you have identified your allergic foods, eliminating them will give immense benefits after the initial period of withdrawal, during which many symptoms may actually become exaggerated. For trigger foods, initially eliminating them entirely, and then managing the total content of triggers in your system helps to calibrate your level of tolerance.

For toxins that are bad for us all, here is some difficult news: caffeine, alcohol, tobacco, aspartame (or any artificial sweeteners that are chemically derived), and sugar (other than what is consumed through fruit) are all rather damaging to our bodies. When I first began eliminating these from my diet, I did feel terribly deprived. But eventually, I found that eating naturally opened so many delicious options that I felt lucky instead of compromised!

5. GET ALL TYPES OF EXERCISE IN BALANCE
Just like eating in a balanced manner, exercising in a balanced way is really important and rather easy to implement.

The three types of exercise one should get are:
- Cardio-vascular exercise: while some people enjoy running and extreme cardio, the best thing for migraneurs (and most of the population) is to get moderate cardiovascular exercise, in which the heart works hard without over-extending itself. For most people, a daily 30-minute brisk walk is sufficient! As Dr. Diana Schwarzbein points out (to my considerable surprise), cardiovascular exercise in extreme forms can be yet another addiction; more on this can be found in her books.
- Resistance training exercise: Moderate weight training, pilates and yoga all provide resistance training, which helps us build muscle and bone. I have found this to have considerable benefits to migraine, because unlike cardio, it can be done without jarring the body, and over time, one builds one's tolerance for trigger foods along with muscle and bone!
- Calming / relaxing exercise: this is the most neglected type of exercise, but very beneficial. Stretching, lighter forms of yoga, a leisurely swim, a stroll in a park, simple breathing exercises (pranayama) are all ways of getting calming exercise. Doing these exercises even during a migraine attack can help relieve the migraine, and at other times, they ready our bodies for harder exercise, prevent injury and release stress.

6. GET TIMELY AND QUALITY REST
Sleep and relaxation are big factors in healing your body naturally and changing migraine patterns. Three factors matter: the timeliness, duration and quality of sleep.

- Timeliness is getting sleep regularly and in a consistent pattern in concert with your circadian rhythm - i.e. going to bed and waking up the same time every day regardless of it being a weekday, weekend or vacation. While this may seem too rigid, it makes an unbelievably significant difference.
- Duration is the length of nightly sleep. While 8 hours is recommended, for some migraneurs the ideal time may be 7 hours and others 9. Listen to your body's needs and fulfill them. (I have found, for instance, that if I go to bed by 10pm, I need fewer hours than if I go to bed at midnight, and wake up more refreshed! This is probably because the former is more aligned with my body's circadian rhythm.)
- Quality of sleep is determined by whether you are able to get deep, dream-free sleep. The type of mattress and pillows, temperature, darkness in the bedroom, sleep posture etc all make a difference in sleep quality, as do caffeine or sugar intake especially after 7pm, and nighttime TV or other latenight sensory stimulation (and I don't mean sex :-)). Relaxing activities such as taking a hot bath, aromatherapy or reading a pleasant book go a long way towards improving sleep quality.

Apart from nighttime sleep, migraneurs may need and benefit from mid-day rest. I personally find that a 20-30 minute rest (even if I don't actually nap) goes a long way in managing stress, while falling into a deeper sleep in the middle of the day may actually disrupt my circadian rhythm and cause a migraine onset!

7. TRY MASSAGE THERAPY, CHIROPRACTIC CARE AND ACCUPUNCTURE
Massage is incredibly healing, not just as at the physical level, but also the emotional and spiritual levels. The gift of healing touch has the power to change everything. I have had the fortune to work with several wonderful massage practioners, including a Reiki master, whose energy work has gradually re-wired my body. Chiropractic care promotes natural healing by opening up spinal junctions. Accupuncture does a tremendous job of unblocking stuck energy thereby also promoting natural healing.

To meet the overarching goal for removing all toxicity and allowing yourself to heal from within, the following are some guidelines in the mental/emotional dimension.

1. ELIMINATE (OR CHANGE) TOXIC / CO-DEPENDENT RELATIONSHIPS AND CIRCUMSTANCES
This, of course, is easier said than done. I cannot, however, emphasize the importance of this enough. When we are in unhappy relationships and circumstances (work, home, social, educational...) we are doing the equivalent of consuming toxic chemicals.

Co-dependence occurs when we become addicted to the very toxic relationships that are destroying us (just like we do with allergic foods)! In a co-dependent relationship, we become so used to the dynamics, that we unconsciously become party to their propagation. Several wonderful books by Melody Beattie shed incredible light on co-dependence and the path to recovery.

At first it may be difficult to identify which relationships are co-dependent or toxic for us - but it is more common to have them than not. An easy indicator of co-dependence is when one puts compulsive energy into changing the other person rather than focusing on taking the necessary steps for one's own needs and betterment. Also, any relationship or circumstance in which you are feeling low self-esteem, riding highs and lows, feeling overly responsible for all the ongoings, or feeling exhausted and depleted is probably toxic for you. While the toxicity often lies in our reaction to people and relationships rather than the people themselves, the first step may be to eliminate the people and relationships, to create space for examining our reactivity. By doing this, existing relationships can be changed, and one can "break up with the negativity" without breaking up with the person!

2. DEVELOP AND MAINTAIN AN EMOTIONAL SUPPORT SYSTEM THROUGH HEALTHY RELATIONSHIPS
The opposite of harboring toxic and co-dependent relationships is to generate a network of healthy relationships that create a nurturing support system. (Beware - what seems like a nurturing, supportive relationship could easily be co-dependence in disguise!) Remember that a nurturing relationship is one in which two equals can exercise their independence (including in beliefs and attitudes) but choose to come together for mutually fulfilling interactions. Healthy boundaries are maintained, and identities are not fused. No one indulges in caretaking, but all parties are able to offer caregiving and support. Truly nurturing relationships have an incredibly healing impact.

3. CONSIDER COUNSELING
It is impossible to observe and assess something from all sides - in all its dimensions - if it is not first placed outside us, and given some perspective. This is the main benefit of counseling - a neutral party becomes an interactive tool to help externalize what is happening in our conscious or unconscious mind.

Many people still consider "getting help" a sign of weakness, citing the objection, "But why can I not do this on my own?" My answer is - you ARE doing this on your own. All your actions for change will only come from your own insights. But it is impossible to have insight when one is still fused with one's problems inside one's mind. To gain insight, one must use other people and situations in life to externalize what is lodged within. The advantage of a therapist is not only in his or her specialized training, but also in the fact that s/he has no personal stake in your life and decisions (unlike all your friends or relatives).

Counseling can benefit migraines by helping to get at underlying mental/emotional factors, or to process the debilitating impact of migraines on your life. Many migraneurs become severely depressed from the fallout of migraine without being aware of it. Counseling helps to alleviate further complications with depression and isolation as a result of migraines.

4. CONSIDER INTRODUCING AN ANIMAL'S COMPANY AND LOVE INTO YOUR LIFE
Animals (and nature in general) have a tremendously healing impact. They remind us of nature's rhythm. Their unconditional love, playfulness and living in the present are great teachers as well as stress-reducers. If you cannot have a pet yourself, consider spending time with friends' pets or volunteering in an animal shelter.

5. CONSIDER (VIPASSANA) MEDITATION
Meditation done on a regular basis can produce immense health benefits. There are several kinds of meditation taught by many masters. My experience is with Vipassana (in S.N Goenka's Vipassana centers), thought to be taught originally by The Buddha several thousand years ago. The practice of Vipassana - observation of the way things are - is powerful, and assists in implementing all the spiritual guidelines suggested in the following section.

6. CEASE TO ASSOCIATE SELF-WORTH WITH MATERIAL POSSESSIONS, ACCOMPLISHMENTS OR RELATIONSHIPS
All of us have a desire for things, accomplishments and people. Desire is healthy, but when we begin to identify ourselves with, or measure our self-worth through these elements, we cause toxic build-up. This is because things, accomplishments and people are transient in nature - something is bound to change in all these areas of our lives and disappoint us. real, natural self-worth comes from within, and is as independent of external circumstances as possible. Deriving self-worth from external circumstances is a formula for unhappiness.

Many migraineurs were either over-achievers to begin with, or become so as a way to counter their debilitating condition (I think I was both!). This causes an unhealthy attachment, especially to accomplishments. And when the constant effort for perfection or achievement is thwarted by a migraine attack, a downward spiral of lowering self-esteem is activated. Instead, detaching from material possessions, accomplishments and relationships creates inner peace and joy, and activates natural healing.

7. DO EVERYTHING POSSIBLE TO NURTURE AND EXERCISE YOUR INNATE CREATIVITY
Every single one of us was born with creative power. (Creativity is not to be confused with with artistic ability.) I have found that accessing, nurturing and exercising one's creativity constantly is the key to personal evolution. Being creative in one's work, play, relationships, life situations allows access to an innate joy and peace consistently. Few things feel like a struggle. Being creative is regenerative, and therefore, a strong antidote to illness and an expediter of natural healing.

8. IDENTIFY, AND ACT ON YOUR LIFE PURPOSE
Finally, get in touch with yourself and what holds most meaning to you. What purpose overlaps with your innate gifts and skills? Identifying this and acting on this will enable your creative energy to be constantly engaged. Work will not seem like a chore - it will simply be a part of your complete life's natural trajectory. When you are acting on your life purpose, you are in harmony with your true nature as well as the needs of the universe. This easy, natural flow prevents toxic build-up and powerfully activates healing and regeneration. (Reference the work of Dave Pollard in the book list below.)

To meet the overarching goal for removing all toxicity and allowing yourself to heal from within, the following are some guidelines in the spiritual dimension.

1. PRACTICE ACCEPTANCE / FORGIVENESS
The first step in healing my migraines spiritually has been to practice acceptance and forgiveness. You might wonder, what do these things have to do with an excruciating illness? The answer is that resistance and unforgiveness are the spiritual toxins that build up in our bodies, leading to disease and preventing healing.

Acceptance is the alignment with whatever is. It is the cessation of resistance. When
I first started to get off all medication related to my migraines, I observed the huge rush of fear and struggle in me whenever a migraine attack began. My mind and body braced for the worst, preparing for what felt like an eternal, unbearable pain-episode. Then one day, I realized that there was a choice to do just the opposite. Instead of resisting and rejecting the pain as something "bad," I could accept it, even welcome it! As I began doing this, the pain was allowed to course through my body rather than be lodged within it! Imagine that something fluid in nature is wanting to flow through you, and you resist it with an internal force, causing a dam-like structure to be erected. What is going to happen to the energy of the fluid against the dam? It is going to surge, swell and lash against the resistance. But if you remove the resistance, it is going to flow through you. And what came into you from the universe, must flow back into the universe. I began noticing that every time I was able to accept the pain and visualize it as a strong river flowing through me, its course was expedited and I received relief sooner and sooner over time. (Even if you are still taking medications, you could practice this).

Why forgiveness? Well, forgiveness is a state of being rather than a concrete action we take towards a person or situation. This state is the corollary to acceptance. When we are in a state of forgiveness, we are in harmony with the way things are, and harbor no ill feelings or wishes that things were different than they are. Holding thoughts of forgiveness towards people and situations has healing properties. This is especially relevant for chronic conditions such as migraines because it becomes easy to hold grudges and even extreme anger or resentment against our afflictions. "Why me? Why do I have to have this excruciating illness? What - a migraine again?" We also feel guilty for not being social/familial participants, for possibly neglecting our jobs, partners, children, or for not keeping up with the activities of all the "normal" people ... and this lack of forgiveness for ourselves can cause us to neglect our needs, and thus perpetuate the cycle of chronic migraines.

2. PRACTICE PRESENCE
Much has been written about the power of being present. (The Power of Now by Eckhart Tolle is a personal favorite.) Besides tremendous benefits in general, the benefits specifically to migraineurs can be significant.

Presence is the ability to gently observe what is here and now without judgment and reactivity. The reason this is powerful is because the present moment is our only access, our only portal to life. When we access that portal, infinite possibilities open up to us, including the possibility of being entirely migraine free. The moment we take our focus off the present and into the past (in which migraines occupy a prominent role), we become energetically closed off to the possibility, and place our past in the future!

In practical terms, presence and mindfulness are huge stress relievers. Eating with presence benefits digestion, going to bed with presence enables quality sleep, relating with others with presence enables better emotional connection, working with presence produces inspired work ... the list goes on. Therefore, practicing presence along with the physical and mental/emotional guidelines can exponentially multiply benefits.

3. PRACTICE DETACHMENT
The third step in the spiritual process is practicing detachment along with acceptance and presence. Detachment is not apathy. It is, in fact, the ability to feel everything with presence and acceptance, without attaching any meaning or significance to it. Non-significance is the hallmark of detachment, which can be seen as having two aspects: "it is impermanent" and "it is impersonal."

How do we attach significance? We do so by creating a narrative, a label, a story, and then convincing ourselves that that story is a permanent description of who we are. Detaching from these narratives, labels and stories is not the same as denial: we continue to be fully aware, we recognize what is happening in the present moment, and we observe it. All we do differently is that we don't label it.

Why does detachment help migraines? Well, because often our story about our migraine history becomes less of a tool to understand our affliction, and more of a way to identify our SELF. Over time, we become unable to separate the story from our self - they become fused as one and the same thing. Once we become personally attached to story in this way, we have an unconscious stake in preserving and perpetuating it. This is because, if the story becomes untrue, our identity with which we have become familiar, with which others have become familiar, and within which we feel comfortable and safe, is challenged. "I am a migraneur" is part of our identity, and we don't want to give it up!

You may be thinking - are you crazy? Why would I want to live with such a debilitating disease? It is not you (i.e. your true nature) that wants this, but your ego** does, because your ego is attached to the identity you have created thus far. It is frightened to let go because it fears change, which it sees as loss, erosion, and disintegration of itself. Your ego loves to hold on, to preserve, to propagate itself!
(** I use the word ego to describe self-concept, from which aspects like pride, identity, reputation, hurt, offense, shame, embarassment etc all spring.)

The earliest step I began to take towards detachment (relative to my migraines) is that I stopped saying "I am a migraineur." I began to say instead (when necessary), "I experience migraines." Next, I gradually reduced making references to migraines in interactions with newer acquaintances in my life (I mentioned it only if I was actually experiencing an attack.) I also stopped getting excited about comparing notes or commiserating with every person I met who shared my affliction. Over time, these steps have helped me loosen the stronghold of my story, enabling the possibility of being migraine-free to gain more and more momentum.

4. BELIEVE THAT YOU ARE ALREADY HEALED
This is the most recent step in my spiritual journey relative to migraines. Instead of working towards some future time when I will be fully healed of migraines, I have begun feeling a sense of peace in the deep knowing that the potential for my healing isn't at some point in my future, but it is right here, right now. The acorn that will be the oak tree has all of the oak tree inside it - right now. So, by deeply feeling my own healing power right here, right now, I am able to see that I am already healed. This is not some theoretical statement to cheer up myself, but a sincere, energetic re-connecting with the creative, regenerative force of nature, with the divine spirit, which always has our highest and best under consideration. Such faith is the automatic generator of gratitude, which simultaneously heals and replaces self-defeating thoughts and behaviors. One is then naturally and gently guided to the thoughts and behaviors that align oneself with an "already healed" state! Each one of us can access this power by awakening to consciousness and presence!

1. GINGER
Ginger is a natural anti-emetic (helps control nausea) and aids digestion. My favorite is to consume it in large quantities in Indian food, tea, and in a freshly made apple+carrot juice. Ginger tea during a migraine attack can help.
2. TURMERIC
This is an anti-septic and controls inflammation in the body. Again, I consume this in Indian food, but high quality turmeric extract (powder in capsules) can be found in many health food stores, such as Super Supplements.
3. APPLE CIDER VINEGAR
This age-old remedy works wonders in controlling acid in the body. My habit is to drink 2 tablespoons of organic, raw, undistilled apple cider vinegar (with the "mother of the vinegar" in it) in a glass of warm water before meals. I sometimes mix in a teaspoon of honey to take the edge off the vinegar.
4. FISH OIL
This supplement (if you don't get 2 servings of salmon every week) does wonders for overall health.
5. BERRIES
Berries are the best fruits to consume without fear of increasing your body's acidity or sugar levels. They also pack in healthy anti-oxidants; a staple for my diet.
6. FIBER
Fiber cleanses the body of toxins, and plays a huge role in preventing migraines. The best ways to get fiber are to add freshly ground flaxeed or apple pectin to (berry) shakes.
7. WATER
No amount of stress on drinking water can be too much.
8. CHAMOMILE TEA
Chamomile is a natural relaxant, and can relieve stress and pain when consumed in significant quantities.
9. STEVIA
This is a natural sweetener derived from a plant. Not only does it have no calories, it causes no sugar highs or lows and is even indicated as a natural supplement for diabetics! If you must eat sugar, try Stevia. If you don't like its taste, try Agave syrup instead. This does have calories, but doesn't cause blood-sugar imbalances like ordinary sugars.
10. ICE PACKS
Ice packs on the head during a migraine attack can work wonders.
11. HOT PACKS
Hot packs during a stressful period or an aura (not when a migraine attack is fully underway) can relax constricted muscles in the neck and shoulders, and prevent the over-dilation phase which causes full-blown migraine pain.