There are some spoilers.
Author Amy Long's memoir Codependence should be required reading for anyone who has chronic daily headaches (CDH) and migraines or has a loved one who grapples with this stubborn and life-altering neurological disease. The author chronicles her quest for pain relief and an improved quality of life through various compelling essays. Along the way she exposes the stigma attached to using opioids on a regular basis. Interweaved in this memoir is the author's relationship with her first love, one she recounts from start to end. She's also candid about some recreational drug use at a young age. However, Long is not an addict.
She clearly delineates the difference between addiction and dependence—a crucial demarcation often ignored in the current era of anti-opioid sentiment fueled in part by the media, CDC, medical establishment, and by an ableist culture that often cockblocks chronic pain patients who seek legitimate relief.
The author regularly undergoes what can only be described as a series of odysseys in order to have a valid prescription filled, specifically for Oxycontin—the only medication that puts a substantial dent in Long’s CDH and allows her to function.
A pain warrior myself, I have grappled with CDH since the year 2000 when episodic migraines transformed into a constant 24-hour migraine that refused to release it's vice-like grip for over two months. The amount of devastation CDH wreaks on every aspect of one's life cannot be overstated and is clearly depicted in Codependence. The author exposes additional obstacles faced by those who live with invisible illness—including the myriad ways others fail to validate or even merely acknowledge the existence of that pain.
Long tells it like it is when she speaks of stressors like counting or stretching out pills, so they will last through the next couple of workdays; this is common practice among CDH patients in today’s opiodphobic climate where some patients have been forced to taper off medications that were improving their quality of life. Even worse, others have been forced to quit cold turkey.
Over 40 migraine-related genes have been discovered to date. Genetically speaking, episodic migraineurs and CDH patients have inherited different numbers and combinations of these genes; in part this accounts for why one person may respond to a certain medication or treatment and another doesn't. Therefore, treating chronic migraine is highly challenging and cannot be approached as a one-size-fits-all endeavor.
I particularly like that Long provides a sort of running catalogue throughout Codependence which lists properties of various medications she's taken over the years. What I admire most is the author's grit while achieving academic and personal goals, and navigating the triumphs and trials of living with CDH. I admire Long's decision to be an independent woman, one who has chosen a difficult yet rewarding path. Long has decided not to settle for less in her relationships, personal or professional. However, I also admire that Long knows the value in sometimes asking for help—a necessary survival strategy and a mark of emotional maturity.
The author walks readers through the long list of doctors who have treated her and exposes a lesson I learned the hard way—how to play the game as a female patient during a medical appointment because, unfortunately, sexism is alive and well. Long knows there is a penalty for crying, raising her voice, or appearing emotional in any way. Yet, she balances these harsh truths by acknowledging physicians who have been caring and helpful.
If you are a caretaker of someone living with migraine disease—chronic or episodic—Long’s Codependence will help you understand the daily hardships your loved ones face. If you live with CDH, this memoir will not take away your pain, but it will validate and echo many of your personal experiences. How I wish a book like this existed back in my early 20s when I was a graduate student and a CDH newbie trying to obtain effective treatment. In addition to patients and familial caretakers, Amy Long's Codependence should also be read by every physician, nurse, and therapist. If we are serious about building an inclusive present and future, we can’t afford to discount the experiences and narratives of those who live with invisible illness. Codependence challenges readers to set aside assumptions and embrace empathy and education.
This summer I have faced a slew of weather-induced migraines while rereading Codependence to remind myself of Long's resilience and perseverance—and my own—while taming the migraine dragon one day at a time.