It starts, more often than not, with a shimmer. It happens between one blink and the next; one minute, I’m reading, or watching a movie, or playing a game with a friend, and the next, there’s a sparkling sort of alien blur right smack in the middle of my vision. It eats words whole and fractures my vision, kaleidoscoping the world around me in patches, sometimes obscuring more than half of my visual field.

If I’m lucky, that’s all that happens. If I’m not, my head will start pounding within minutes, throbbing with the sort of agony one imagines might be inflicted by, say, the head crusher—a medieval torture device which, you guessed it, crushes your head inch by horrific inch. Nausea often follows close behind the pain. When I was younger, I usually wound up sick to my stomach. Once, during lunch at school, I became so quickly and violently ill, I had to run and throw up behind some bushes because the bathroom was too far away. In recent years, thankfully, such severe nausea has become only a rare occurrence.

As for the visual hallucinations and the pain? They are frequent visitors, and have been for most of my life. I am a writer who suffers from migraines with aura. And I’ve found, over the years, that you can’t really write with migraines—but you can write in spite of them.

Writing with a Migraine: Or, How NOT to Write

During my college years, I became a master procrastinator. I handed in more than one research paper at the eleventh hour—often literally, thanks to the option of online submission. As an English major, I wrote more essays than I can remember writing, but there’s one I still remember vividly. It was on Edgar Allan Poe, and I was particularly excited to write it, and yet I still managed to put it off until the very last day. This proved to be a huge mistake when, halfway through writing it, I blinked and realized I couldn’t read the last sentence I’d written. I had a migraine—and only a few hours left to turn in the paper.

I had no choice. I had to write. I popped a couple of pills (Tylenol; this was back before I had prescription medication) and spent the rest of the night with a cold washcloth on my neck and a face drained of color, alternating between typing and throwing up into a nearby bucket. I submitted my paper less than a minute before the deadline; I even got an “A.” But it was also one of the worst experiences of my academic career, made all the more frustrating because the assignment meant so much to me on a personal level.

They say pain fuels better writing, but migraine pain isn’t like emotional pain—you can’t write your way through it, or out of it. For me, my number one trigger is spending too long staring at a computer screen. Unfortunately, in front of a computer screen is often where I do my best work. Writing as a migraineur is less about understanding how to use your pain than it is about figuring out how to write without making it worse.

Balancing Work, Play, and Migraines

Finding a good work-life balance is already challenge enough for most people; throw in migraines, and you’ve got a real head-scratcher on your hands. After all, you can schedule work, and you can even schedule play—but there’s no telling when the next migraine attack will be, or how long it will last. I’ve gotten rid of them in as little as less than an hour, but on the other hand, the worst episode I’ve ever had lasted four days straight.

For me, the key to balancing it all without losing my mind (much as I would like to, some days) lies in maintaining a flexible schedule. I try to hold myself accountable on the good days, and do my best not to blame myself for the not-so-good days. As it turns out, it’s surprisingly easy to blame yourself for something as blatantly not your fault as a debilitating health issue, and depression and anxiety often walk hand-in-hand with migraines. It’s taken me years to figure out that:

Just because I can’t work while I have a migraine doesn’t make me lazy.
Just because my body and my brain don’t always work the way I want them to doesn’t mean I’m broken.
Just because I don’t always write like I’m running out of time doesn’t mean I’m not a real writer.
Migraines may be a permanent fixture in my life, but they do not define it.

I still get migraines frequently, and I still get frustrated and discouraged when they interrupt the flow of my day-to-day existence. But I’ve picked up a few tricks along the way, too, which at least minimize the impact of my migraines, even if they can’t cure me of them completely:

I keep my prescription migraine medication handy at all times (or at least I try to). The minute I spot a sparkle, or feel that tell-tale pressure begin building in my brain, I immediately take one.
I work from home on a part-time schedule. I realize not everyone has this option, and I am incredibly grateful that I do. I am doubly blessed in that my part-time day job allows for a flexible schedule. And, of course, when it comes to my work and writing outside of that job, I am my own master. If I need a day off or a long break to wait out a migraine, I can always take it and make up the time later. I wouldn’t trade that for even the highest-paying office job—after all, fluorescent lights are another one of my triggers.
I keep cold packs in the freezer and an electric heating pad in the closet. Placing something cold on your neck or forehead tends to alleviate migraine symptoms. Alternatively, some days my migraines are triggered mostly by stress—in this case, a heating pad or a nice, long bath is the perfect way to loosen up tense muscles and relieve pain.
I wear tinted PC glasses and hydrate my eyes during long workdays. It’s thought that the blue light emitted by most electronic screens can be damaging to your vision, not to mention trigger migraines. I wear tinted PC glasses that block some of that blue light, and use Visine every few hours I’m on the computer to help keep my eyes from getting strained (which can also trigger a migraine).
I take frequent micro-breaks, and longer ones when I need them. I get up between work tasks to stretch my legs and step away from the computer, if only for a moment or two. I spend my lunch break away from my desk—dinner, too, if I’m working late. I try to minimize non-work-related computer time during the week, and I make sure to take a breath between my day job and working on my craft. I read physical books more often than I use my e-reader, and during really bad attacks, I go lie down in a dark room with a cool washcloth over my eyes and take a nap.

And of course, I keep the obvious in mind: eat well, exercise regularly, get plenty of sleep and drink plenty of water. None of this keeps me from ever getting a migraine, but it helps. Every little bit counts.

A Portrait of the Migraineur as a Writer

I don’t write as much as I’d like to. I spend more hours of my life curled into a fetal position and clutching my head than I care to count. I lose time, and sometimes, I lose my patience. But in spite of my migraines, I’m still here, still writing. Even when it hurts. Even when I can’t even read my own words on the page. Because even though my computer screen may be a migraine trigger, it’s also an open window to the part of my brain that I actually like, the part that can build an entire world out of an idea the size of a grain of sand, the part that makes me who I am—a writer, a creator, not just a migraineur.

Scribo, ergo sum.