Botox is not a treatment for anxiety and depression and do not fucking tell me to meditate my migraine away

People act like I get migraines because I’m pissed off and sad and don’t exercise enough, but I actually am pissed off and sad and don’t exercise enough because I get too many fucking migraines.

The Mask by Riddhi Parikh

The Mask by Riddhi Parikh

The framing of research on migraine co-morbidities kills me. People with migraine, especially chronic migraine, tend to have a bunch of other problems, like anxiety, depression, fatigue and sleep problems. Fatigue is just a straight up symptom of migraine and perhaps you, not being a migraine researcher, would think it is too obvious to even mention that being in near constant pain that is exacerbated by things like the noise and motion of your daily commute – not to mention the sound of your own goddamn heartbeat – makes people fucking miserable and exhausted and unable to sleep well.

So you might think that a study on whether a drug that makes people’s migraines better also reduces the “common co-morbidities” of migraine would never have a chance of getting published because it’s equivalent to asking “does fixing a broken leg also help you walk?”

You would be wrong.

Most migraine articles (and the people writing them) seem to assume either that those “co-morbidities” are independently occurring problems in migraine patients or even that patients get migraines because they are anxious, depressed, fatigued, or sleep deprived. So when I saw the headline OnabotulinumtoxinA Effective in Reducing Depression and Anxiety Symptoms in Chronic Migraines, I was torn between rolling my eyes until they got stuck in the back of my head so I never had to deal with another headline that was blatantly pandering to the stock price of Allergan at the expense of my healthcare – and – writing an angry screed about the gendered stigma of migraine and the soul crushing experience of trying to get access to like, life, in the face of it. Because botox does not and cannot treat anxiety, depression, fatigue, and insomnia.

But then I made it through the whirling cesspool of my emotions and realized that despite the headline,the paper is actually pretty strong evidence that the fatigue I experience isn’t happening independently of my migraine. And the depression from being in constant pain and excluded from work and social spheres isn’t causing my migraine.

Because botox does not and cannot treat anxiety, depression, fatigue, and insomnia. If botox fixes migraine co-morbidities, that’s because migraine causes them and botox reduces migraine attacks.

So the next doctor or acquaintance who pushes anti-depressants or sedatives or yoga or meditation or cognitive behavioural therapy on me when I actually need something to soak up all that CGRP my nerves are pumping can go fuck themselves.

There are real feedbacks between migraine symptoms and effects and migraine attacks, but the best point of intervention is at the starting point – the goddamn fucking migraine, not my fucking feelings about migraine.



If voting changed anything they’d abolish it

I’m really enjoying Ha-Joon Chang’s Bad samaritans: the myth of free trade and the secret history of capitalism. In a chapter discussing some serious tension between free markets and democracy, he discusses typical neoliberal policies and how they actually undermine democracy. He’s talking about developing countries and writing from 2008, but I’d argue that neoliberalism undermines democracy in all countries – just look at the last 10 years in North America and the EU.

Neo-liberal economists worry that politics opens the door for perversion of market rationality: inefficient firms or farmers may lobby the parliamentarians to get tarrifs and subsidies, imposing costs on the rest of society that has to buy expensive domestic products; populist politicians may put pressure on the current central bank to ‘print money’ in time for ecection campaign, [etc] …

The neo-liberals solution to this problem is to ‘depoliticize’ the economy. They argue that the very scope of government activity should be reduced – through privatization and liberalization – to a minimal state. In those few areas where it is still allowed to operate, the room for policy discretion should be minimized. … Such restraints can be provided by rigid rules that constrain government choices – for example, a law requiring a balanced budget ….

This next paragraph channels my personal political economist hero, Karl Polanyi.

The first problem with this argument for de-politicization is the assumption that we can clearly know where economics should end and politics should begin. But that is not possible because markets – the domain of economics – are political constructs themselves. Markets are political constructs in so far as all property rights and other rights that underpin them have political origins. … [W]hen neo-liberals  propose de-politicizing the economy, they are presuming that the particular demarcation between economics and politics that they want to draw is the correct one. This is unwarranted.

More importantly for our concern …, in pushing for the depoliticization of the economy, the Bad Samaritans [developed countries like the US and EU members] are undermining democracy. Depoliticization of policy decisions in a democratic polity means – let’s not mince our words – weakening democracy. If all the really important decisions are taken away from democratically elected governments and put in the hands of unelected technocrats in the ‘politically independent’ agencies, what is the point of having democracy? In other words, democracy is acceptable to neo-liberals only in so far as it does not contradict the free market…”

The university hybridized with business and kept only the worst of both

On the one hand, the authors are clearly concerned about the fate of their younger colleagues. On the other hand, I could not avoid the impression that the report considers young scientists not as unique creative individuals with “brains and character, strength and health, happiness and spiritual vitality, interest and motivation, and no one knows what else”, but as colonies of laboratory mice that need to be maintained at a low cost, propagated in needed quantities, and trained for use in the laboratory.

Source: Are scientists a workforce? – Or, how Dr. Frankenstein made biomedical research sick – Lazebnik – 2015 – EMBO reports – Wiley Online Library