I started getting Migraine headaches in the late spring at age 17 and continued to get them in the spring/fall weekly for about two decades[0]. I remember the age and the season because, up to that point, I had headaches. What happened that day resulted in a trip to the emergency room, on my insistence; I thought my brain was bleeding[1]. After 4 hours, I was sent home with a note to take two extra strength Tylenol. And for the 20 years that followed, that was about the quality of treatment I received.

Everything, for me, is solved with a medication that is very rarely prescribed for Migraine. My issue is that I cannot take the usual medications (imitrex, etc). They are effective, but I lack a gene that is required to flush them from my system correctly. So 30 minutes after taking the pill I'd be the happiest I've ever been in my entire life, and about 1.5 hours later, I'd be miserable. It was comical-if-they-weren't-happening-to-you mood swings, which almost killed me[2].

I've seen several doctors for this. After a mess of semi-unrelated circumstances around that event which almost killed me, I ended up on a prescription for Depokote. It's a very old medication, originally prescribed for seizures and I now commonly used off-label for bipolar. It was prescribed to me with the endorsement of "a few of my patients responded well to this, none of them had side effects, and this is where we're at on the list of choices" ... basically, the guy had no confidence it would work, so I didn't either. It was prescribed mid-summer, and I noticed after about a week that I felt like I was carrying around zero anxiety[3], and a number of other fantastic side-effects[4]. By the end of the following spring, I was convinced it worked -- completely. It was the first year I had gone any season without a single Migraine headache. Interestingly, I'd get the "aura", on occasion, but it would never melt into horrifying pain.

The whole time, regardless of specialist, there wasn't anyone who could give me a really good idea of just what the hell was really going on in my skull. I'll admit, after reading this, I'm wondering if I really have Migraine or if I don't have some other thing (cluster was ruled out). My triggers are seasonal; and I have bad days when there has been a large shift from high->low or low-> high. Interestingly, though, if I get a migraine, I am pretty much insulated from getting another one for about a week, which implies some sort of biological process that is serving some function, since multiple repeats of that trigger, or even much stronger ones, will not cause a second migraine for several days after one already landed.

[0] Varying lengths but until I learned to cope with the symptoms, it at least destroyed the entire rest of the remaining day once it hit. Often remained a day after, as well.

[1] I really, really, hated hospitals as a kid. My parents took me on my insistence because they knew I would only demand to go if I seriously thought I was dying ... even though it was a headache.

[2] A combination of medications related to Migraine which I took during an attack (as prescribed) resulted in my serotonin levels sending me to the hospital. It. Was. Bad.

[3] I never thought of myself as anxious, and it's never been an issue in my life -- that I know of -- that has held me back. But, holy cow, the difference was stark.

[4] For medications with "brain affecting" side-effects, I do not read the label. My wife takes that responsibility. My thinking is: (1) placebo/nocebo effect is really strong when the thing it effects is emotional/personality. (2) I can't trust my brain to evaluate what is happening to itself -- it's compromised by the medication.