I always have an 8 week cycle and for one week after the 8 weeks were up, I felt fine, I was able to have a few drinks even. That is the test for me. Then last Sunday afternoon I had a really bad regular migrane and for 5 days now I have been getting hit with clusters at 1:30am and 4:30am and, if I go back to sleep as soon as I wake. I am 10 weeks now. I know it's only 2 weeks past,but I am in a panic. Could they still go away? The shadows don't seem as bad as they were during the 8 weeks. I have a vacation planned in 3 weeks, I have done nothing all summer waiting for the 8 weeks to pass. I know it has to be a year before they are chronic, but are there warning signs that, that is happening?

Please, please! Take a deep breath (or six!)

You have discovered the formula for endless anxiety and distress.

The struggle to predict the future is hopeless. If you have read much here you know we constantly talk about how unpredictable Cluster is, how it changes time, form, location, and so on.

You don't have much time before your trip to start to learn how to control your rumination and anxiety--but give it a look. This is a process which works if you apply yourself to learning and practicing it.

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Pain vs. Suffering--research support
(Posted, 1/7/07) 

SSRIs used to treat depression have gained a good track record but docs have been long aware of relapses when the med is stopped. Research has lead to a recommendation that the med be continued for up to 18-months after the depression has lifted because this reduces the rate of relapse. Parallel research revealed that this longer use of the meds allows our brain to "rewire" itself leading to better long term outcomes.

The article (available on the OUCH site) "Pain vs. Suffering" is based on cognitive therapy. These forms of counseling/psychotherapy have been strongly supported by good research. Now some evidence is appearing that these therapies act like the SSRIs to stimulate our brains to "rewire", affording protection against strong anxiety conditions. Bottom line: looks like it may be possible to alter brain functioning to build in a permanent reduction of the anxiety which besets many folks with CH. While the gods may not have made a final pronouncement yet, experience with cognitive therapy, so far, really supports its use to treat anxiety & depression. While using "pain vs. suffering" takes time, commitment, and practice, it beats endless use of benzos, etc.

"“My brain is generating another obsessive thought. Don’t I know it is just some garbage thrown up by a faulty circuit?” After 10 weeks of mindfulness- based therapy, 12 out of 18 patients improved significantly. Before-and-after brain scans showed that activity in the orbital frontal cortex, the core of the OCD circuit, had fallen dramatically and in exactly the way that drugs effective against OCD affect the brain. Schwartz called it “self-directed neuroplasticity’ concluding that “the mind can change the brain?’ (TIME, 1/29/07. Major article on the human brain.) (OCD is classified as an anxiety disorder.)

It's where a lot of pre-planning can help. On cycle I have portable oxygen tanks and imitrex injectables with me everywhere I go. Even off cycle, I keep imitrex kits in the glove box and with my luggage. Relish your pain free times, ALWAYS be ready to do battle with the beast.

Joe