Since returning home from holidays and being back at work, I’ve really being seeing things much more clearly and where my achilles heel lies with this dizziness garbage. It’s interesting that while in the thick of it all, it becomes very difficult to sort through what’s really going on in terms of triggers and what the root cause is exacerbating things. The main thing I’ve noticed is this:
I’m back on a computer for 6-8 hours a day and with that my symptoms have changed since the holiday for the worse, and it’s happening fast. In other words, things are heading back to how they were before I left and reestablishing themselves as they were. The main thing that has been fired up again is visual vertigo, that is vertigo triggered by visual stimulation, namely focusing on a Macbook screen all day long. The consequence of this for me is that, over time, it starts to affect my feeling of well being. It seems to slowly but surely turn the screws and by the end of the day I feel more and more flat and even anxious. By contrast, in Thailand I was on my Mac no more than about 10 minutes a day. By the end of 12 days my mood was absolutely great, my confidence was high, and I felt like my usual happy self despite having some nasty rough patches post massage and motorcycle riding. So visual vertigo of the sort created by typing (eyes flicking around the keypad because I cannot type without looking down) and looking at a computer screen is a direct trigger of migraine-related depression and anxiety and feeling unwell.
An SSRI (Cipramil) then did two things for me: 1) it lowered the ability for visual vertigo to be kicked off (raised threshold) and thus stopped the serotonin-happy chemical drain, and 2) kept serotonin topped up even if there was a small draining process going on throughout the day via visual stimulation. I wonder how many of you might also relate to any of this? Of course, if I rev up migraine activity, it means that I am even more likely to have visual vertigo occur which in turn means feeling worse (depression and anxiety) which further fuels migraine. Maybe this is why Effexor is supposedly such a good med for some people because it really kills the ability for visual vertigo to occur. George, I think you mentioned this.
This visual vertigo is something that has plagued me since day one, the day I got hit with VN. So I wonder if this is a bigger issue for me having had vestibular damage versus someone with pure MAV only or does it matter at all? Probably doesn’t matter because if someone’s migraine is hitting the vestibular system hard, then clearly visual vertigo is/ can be a serious problem. I know many of you get set off by walking through the supermarket or by looking at tiles on the ground while walking or just lights flickering.
Anyhow, I’m just thinking out loud about the mechanisms at play. It doesn’t change anything … I can’t not work on a computer so it means getting a drug down the hatch that either stops this visual stuff or at least drops it to much lower levels and prevents it from draining away happy chemicals.
Reading through the literature suggests that those with visual vertigo have a working diagnosis of a poorly compensated peripheral vestibular disorder, a psychiatric component that could be responsible for either producing or worsening the symptoms, and my guess, that migraine activity keeps fuelling it and never allows the brain to compensate. The latter is Steve Rauch’s point of view: kill the migraine and then compensation can occur.