A 26 yo California-born New Englander. Currently slinging groceries in western Mass while pursuing my master's degree in library and information science.

ABSTRACT

Most people will experience at least one migraine in their lifetime. For chronic sufferers, migraine is a complex and confusing disease that afflicts and disables. Various treatments for migraines exist and ranges from home remedies to prescription medication. These treatments may or may not work, leaving the patient to try various medications throughout their lifetime and creating a stressful experience. Migraines have strong associations with psychiatric disorders, cardiovascular diseases, and other illnesses. This strong association has not been discussed in depth, but it is here that a larger question arises: what if migraines are a sort of alarm for the body, alerting us to our own illnesses, like depression and anxiety?

KEY WORDS AND ABBREVIATIONS 

aura: some migraine sufferers experience visual or sensory symptoms before the pain of a migraine sets in. It can also be experienced on its own, without the pain afterwards. Auras can act as a warning to the sufferer of an incoming migraine.

chronic migraineurs: sufferers with more than 15 headache days per month.

episodic migraineurs: sufferers with less than 15 headache days per month.

MA: migraines with aura.

MO: migraines without aura.


INTRODUCTION

Migraines are a debilitating illness, recognized as a disability under the Americans with Disabilities Act. A migraine and its symptoms disrupts life, daily function, and even the ability to communicate and take care of oneself by affecting neurological functions. Migraines are often left untreated by patients who either do not know that they are suffering from migraines and that treatment is available, or by patients or have tried multiple forms of treatment to no avail. Only by looking at the epidemiology, pathophysiology, symptoms, and treatments for migraines can we begin to understand migraines from an evolutionary medicine perspective.

SYMPTOMS AND TRIGGERS

Migraines are common in the human population, but what exactly happens when getting a migraine? Migraines are characterized as a severe and intense headache usually unilateral in location, with pulsating pain, autonomic nervous system dysfunction, and occasionally the sufferer will have an aura (visual disturbances: flashes, zig zags, colored lights surrounding a blind spot) before the pain. (Goadsby et al 2002, Sole-Smith 2012). Other well-known symptoms include: sensory sensitivity (light, sound, smell, movement), nausea, and vomiting.  These debilitating incidents can be chronic in some patients, leading to a lower quality of life and for the illness to be recognized under the ADA.

Scientists and their research often look at the lifestyles of those afflicted with chronic migraines to find potential triggers. It is important to note that not all sufferers have triggers for their migraines. Triggers can be anything from fluorescent lights, a specific scent (vanilla is a common trigger), or even certain foods (caffeine, alcohol, chocolate, aged cheeses, and avocados have been suggested). Stress is a prevalent trigger for all migraineurs, regardless of gender. For women specifically, who are more prone to migraines than men, stress – including anxiety related stress and depression related stress – is a more powerful trigger for migraines than the withdrawal of estrogen during menstruation. (Parashar et al., 2014) This may mean that women are under more stress than men, or at the very least were under more stress as migraines developed in the human species.

A study on chronic and episodic migraines concluded that “52% [of chronic sufferers are] more likely to be female, 41% more likely to be white… 34% more likely to be obese, 205% more likely to have depression, and 140% more likely to have anxiety than episodic migraineurs.” (Adams et al., 2015) This study and others suggest strong ties between mental health illnesses and migraines, as well as significant ties to neurological diseases. 

MECHANISMS

Initially thought of as a solely neurovascular disease, new research suggests that while blood vessels in the brain are associated with migraines and play a role in it, they are not the sole originator of a migraine. Rather, blood flow increases to the brain immediately before the migraine pain (upwards of 300 percent), and is normal or reduced during migraine pain. Scientists now believe that the root of migraines comes from the brain stem1 as a malfunction or abnormality. (Dodick & Gargus, 2008) Brain stem activation in specific areas has been found during spontaneous and induced migraine attacks, and it should be noted that activation extends into and outside of the headache phase of the migraine attacks. (Rothrock, 2008) Consensus suggests that migraines are a neurobiological illness, that originate from both the brain stem and with neurovascular changes. It has also been theorized that there are multiple different causes in the brain for migraines, and these causes could exist in multiples for genetically predisposed patients. (Rothrock, 2008) Migraineurs with “genetic predisposition have a reduced threshold for the activation of the brain’s ‘pain centers’ and become hypersensitive to stimuli that cause pain.” (Sole-Smith, 2012) 

There is a wave of nerve activity that passes through the brain and correlates with the pain of a migraine, and this wave can be set off by various triggers as mentioned above. This wave, a “brainstorm” of sorts, is known as cortical spreading depression. Cortical spreading depression is an intense wave of neuron activity through a large portion of the cortex. It is this wave of activity and the subsequent “neurotransmitter release that activates blood vessel inflammation, feeding pain structures deep in the brain.” (Sole-Smith, 2012) After the wave of intense neuron activity, the neurons are, in a sense, exhausted and experience a prolonged state of neural inhibition. It is in this inhibitory phase that neurons cannot be excited or stimulated. (Dodick & Gargus, 2008)

Migraines are a heterogeneous disorder. (Buzzi et al, 2005) This implies an association between other neurological, psychiatric, and cardiovascular diseases such as epilepsy, cerebrovascular disorders, anxiety, depression, arterial hypertension, mitral valve prolapses, and patent foramen ovale. This may be due to a common genetic substrate and various mutations in the same gene. (Buzzi et al, 2005; Nappi et al., 2000) There is a high risk of familial recurrence and risk of up to 1.9 times for MO and 1.4 time for MA. (Montagna, 2008) Migraine is likely a polygenetic disease, but it is unknown exactly how many genes it stems from. Some rejected theories suggest Migraine as transmitted via “autosomal dominant with female preponderance and possibly sex determined, autosomal recessive with 70% penetrance… maternal and X-linked.” (Montagna, 2008) Migraine without aura (MO) is likely to first occur during puberty, triggered by declining oestrogens. Migraine with aura (MA), on the other hand, is likely to begin “with sustained high sex hormone levels, during pregnancy, or with oestrogen replacement.” (Buzzi et al., 2005)

Familial hemiplegic migraines (FHM), a subtype of MA, is autosomal dominant in its hereditary transmission. This is also called a mendelian migraine (following a mendelian type of genetic transmission). This is the only subtype whose transmission is known, and for our purposes is not the focus of this paper. 

TREATMENTS

Migraineurs utilize a myriad of treatments, ranging from in-home remedies to doctor prescribed medications. Some treatments simply lessen the pain to a tolerable level, others work to completely eradicate the migraine upon onset, and still others work as a preventative measure to hopefully end a migraineurs disease or turn attacks into a rare event.

Home remedies often work to lessen the severity of an attack. The most basic treatment is prevalent in migraineurs: an ice pack. Some sufferers will opt for a freezable face mask, but the results are the same. Ice is anti-inflammatory – the cold relieves the pulsating feeling that can become overwhelming during attacks and lessens it for a time. Relaxation techniques are also fairly popular, such as massages for the neck and shoulder and hatha and restorative yoga. (Sole-Smith, 2012) Herbal medicine is also a popular avenue, especially for migraineurs who have tried prescription medication but to no avail. Butterbur has been confirmed by the American Academy of Neurology to prevent migraines (studies suggest this may be because it supports healthy blood flow to the brain). Feverfew is also a well known remedy, but clinical evidence is still inconclusive. (Sole-Smith, 2012)

Vitamin supplements are touted by both sufferers and some doctors and the cure-all for migraineurs (usually not chronic migraineurs). Fixing vitamin D and melanin deficiencies have been known to drastically reduce occurrence of migraines, but this does not work for every patient. More recent studies have shown that participants who took 400 mg of riboflavin (vitamin B2) daily had drastically reduced migraines. (Sole-Smith 2012)

For some migraineurs, relief only comes from seeing a neurologist. Most prescription medications used for migraines were not originally formulated for that purpose. Botox is a newly approved treatment for chronic migraines, consisting of 31 shots given every 12 weeks, and have been clinically proven to be preventative with minimal side effects. (Sole-Smith, 2012) Beta-blockers and anti-hypertensives were originally intended to treat high blood pressure, angina, and rapid heart rate. Used because they are believed to affect relevant blood vessels, these medications have few side effects but can result in dangerous heart-rate drops. (Sole-Smith, 2012) Anti-seizure medication like topiramate act as a preventative drug, and when taken every day can reduce or even eliminate migraines all together by inhibiting some neurotransmitters. These do have adverse side effects, though, including irritability, confusion, drowsiness, and depression. (Sole-Smith, 2012) Anti-depressants have been used by balancing abnormal levels of serotonin, but are not advised for migraineurs who do not have or are not in need of treatment for depression.

Triptans are the most prevalent prescription medication for migraineurs. Consisting of medications such as Imitrex, Maxolt, Axert, and Relpax, these medications are formulated specifically to stop migraines. (Sole-Smith, 2012) Triptans are not a preventative treatment, though, and are used at the onset of a migraine (either onset of aura or pain). Triptans work by affecting several different migraine-causing mechanisms in the brain and as a result can cause mild to severe side effects (ranging from a tingling sensation all over the body to a change in the perception of taste) and will occasionally cause rebound headaches or migraines.

PHYLOGENY

The phylogenetic origins of migraines is somewhat of a mystery. Migraines cannot be seen or biologically tested for (such as a blood test), but instead symptoms are often described to medical professionals for diagnosis. Fulfilling a certain number of these symptoms will result in a diagnosis – i.e., nausea, light sensitivity, and severe pain in the temples. Currently, there is no animal model for migraines. Primates and other animals cannot speak to the pain, so diagnosing migraines is very difficult, if not impossible. In testing treatments for migraines scientists have induced migraine symptoms in rodents, cats, macaques, and other mammals. To induce the symptoms scientists have used medication, surgery, and electricity to activate various areas of the brain.

A case study on a 5 year old female Cocker Spaniel takes steps towards discovering if animals outside of humans can be afflicted by migraines. She is described as presenting with “paroxysmal episodes of vocalization and apparent fear since [she] was 6 months old.” (Plessas et al., 2013) The dog would vocalize as if in pain, have low head carriage, remain conscious and responsive, but also would refuse to eat or drink. Occasionally the dog would show signs suggestive of nausea, such as hypersalivation, frequent swallowing, lip smacking, and vomiting.  (Plessas et al., 2013) There is no known disease or condition with similar expression in veterinary literature; the case study suggests the dog is experiencing migraines as a result. To further this theory, the dog was prescribed several different types of treatments including opioids like morphine and methadone, diazepam, non steroidal anti-inflammatory drugs, phenobarbital, and a combination of acetaminophen and codeine. All treatments did not reduce the severity of the episodes. After these trials they dog was prescribed topiramate, a seizure medication that is known and used to treat migraines. The topiramate was successful: “[she] continued to experience these episodes, but the duration would last only 1–3 hours and the intensity was dramatically reduced to the point that the dog would only seem quiet, no longer vocalize, and be keen to go for walks, eat, and drink as normal. The dog no longer appeared to be photophobic and phonophobic. Interestingly, the owners reported that if they failed to give topiramate quickly enough and they administered it when she had already started vocalizing, it took longer to recover (6–7 hours); however, the intensity improved within 30 minutes of administration, she would appear more quiet, stop vocalizing and hyperventilating, and would eventually go to sleep.” (Plessas et al., 2013). Upon applying the dogs symptoms to diagnostic criteria for migraines in humans, the dog fulfilled all of them.

“THE ALARM SYSTEM” – MIGRAINES AS ADAPTATION

Migraine tends to disappear after traumatic  and severe brain injury, but recur after a degree of cognitive functioning has been regained. This suggests a degree of high level pain processing is needed in order to perceive migrainous pain and the potential aura. (Buzzi et al., 2005) Neurodegenerative diseases with focal brain damage in dopaminergic areas, like Parkinson’s, may shorten migraines’ clinical life span. This may suggest that the migraines are a potential “alarm system” for the brain; this alarm system may be an effort to protect the brain from inner injury.

Migraines have been found to be comorbid with mood and anxiety disorders. (Hung et al., 2013; Adams et al., 2015) Studies following the comorbidity with depression find a poorer quality of life, and increase in suicide risk, and predicts a poorer outcome for these patients with both. Another study found that psychiatric patients with migraine experienced a significantly greater severity of depression, anxiety, somatic symptoms, and a poorer health-related quality of life. (Hung et al., 2013) This also suggests an imbalance of neurotransmitters (like serotonin, noradrenalin, and dopamine) could partly be a cause for both the depression and the migraine. (Hung et al., 2013) The study also found that pain intensity in the migraine was significantly correlated to the severity of depression, anxiety, somatic symptoms, and health-related quality of life. As a result, the migraine severity could be used to predict the mental health illnesses and possibly their severity. Hung’s study did not include patients with manic episodes of psychotic features, and thus no patients had bipolar I disorder. Bipolar II was included, but had a small sample size (and also the highest percentage of migraine). This strengthens the suggestion of a specific relationship between migraines and depression and anxiety. 

In another study focusing on the migraine-obesity relationship, higher migraine frequency and migraine-related disability are strongest in migraineurs with both depression and anxiety. It also found that frequency and disability were increasing with and increasing BMI. (Tietjen et al., 2008) There is evidence suggesting common genetic substrates, notably monoamines and peptides in the brain (serotonin, dopamine, norepinephrine, neuropeptide Y, and corticotrophin releasing hormone) that influence depression, anxiety, migraine, and body weight regulation. This could be a neurobiological link between these illnesses. (Tietjen et al., 2008)

CONCLUSIONS

More research needs to be done on migraines and the exact origins in the brain. The exact neurobiological processes that lead to a migrainous attack need to be understood to make concrete connections between MA and MO and other diseases.

That being said, current research strongly correlates migraines with a variety of illnesses, the strongest being depression and anxiety and other psychiatric disorders. The link between severity of migraines and severity of depression and anxiety can serve as the base for further research. If other organs have ways of warning us to disease, or some illnesses serve as precursors for others, then it’s not a far stretch to suggest that migraines act as the brain’s alarm system. Migraines could very well be a way for the brain to tell us that our own mental health is unstable, that something has gone wrong in our hearts, or that our nervous systems are failing. 


FOOTNOTES

1 More research needs to be done on this theory – some current papers are published under the assumption of a neurovascular origin and others are using the brain stem theory as the origin. Dodick and Gargus acknowledge this in their paper.


REFERENCES

Adams, A. M., Serrano, D., Buse, D. C., Reed, M. L., Marske, V., Fanning, K. M., & Lipton, R. B. (May 13, 2015). The impact of chronic migraine: The Chronic Migraine Epidemiology and Outcomes (CaMEO) Study methods and baseline results. Cephalalgia, 35, 7, 563-578.

Buzzi, M. G., Cologno, D., & Formisano, R. (September 01, 2005). Migraine disease: evolution and progression. The Journal of Headache and Pain : Official Journal of the Italian Society for the Study of Headaches, 6, 4, 304-306.

Dodick, D. W., & Gargus, J. J. (August 01, 2008). Why Migraines Strike. Scientific American, 299, 2, 56.

Gil-Gouveia, R., Oliveira, A. G., & Martins, I. P. (June 09, 2015). Cognitive dysfunction during migraine attacks: A study on migraine without aura. Cephalalgia, 35, 8, 662-674.

Goadsby, P. J., Lipton, R. B., & Ferrari, M. D. (January 01, 2002). Migraine–current understanding and treatment. The New England Journal of Medicine, 346, 4, 257-70.

Hung, C.-I., Liu, C.-Y., & Wang, S.-J. (December 01, 2013). Migraine predicts physical and pain symptoms among psychiatric outpatients. The Journal of Headache and Pain : Official Journal of the “european Headache Federation” and of “lifting the Burden – the Global Campaign against Headache”, 14, 1, 1-8.

Montagna, P. (January 01, 2008). The primary headaches: genetics, epigenetics and a behavioural genetic model. The Journal of Headache and Pain, 9, 2, 57-69.

Nappi, G., Costa, A., Fortini, D., Damiano, M. G., Casali, C., Pierelli, F., & Santorelli, F. M. (December 01, 2000). Migraine comorbidity: from genotype to phenotype. The Journal of Headache and Pain : Official Journal of the Italian Society for the Study of Headaches, 1, 2.)

Parashar, R., Bhalla, P., Rai, N. K., Pakhare, A., & Babbar, R. (January 01, 2014). Migraine: is it related to hormonal disturbances or stress?. International Journal of Women’s Health, 6, 921-5.

Plessas, I.N., Volk, H.A., Kenny, P.J. (2013) Migraine-like episodic pain behavior in a dog: can dogs suffer from migraines?. J Vet Intern Med., 27:1034–1040.

Rothrock, J. F. (October 03, 2008), “Outside-In” vs “Inside-Out”: Revisiting Migraine’s Vascular Hypothesis. Headache: The Journal of Head and Face Pain, 48: 1409–1410. 

Rothrock J. (2009) Migraine aura. Headache.;49:1123–1124.

Sole-Smith, V. (2012). Migraines. Prevention, 64(12), 51-55.

Tietjen, G. E., Peterlin, B. L., Brandes, J. L., Hafeez, F., Hutchinson, S., Martin, V. T., Dafer, R. M., … Khuder, S. A. (June 01, 2007). Depression and Anxiety: Effect on the Migraine–Obesity Relationship. Headache: the Journal of Head & Face Pain, 47, 6.)

To no one’s surprise, maintaining a blog and writing portfolio is hard. In the time I’ve started this website, I have made several moves around the country, changed jobs a few times, and I just finished my first year of graduate school amidst this global pandemic. It often falls to the wayside for me, understandably.

With this rebranding, I can’t promise regular updates and blog posts. However, I can promise an aesthetically pleasing website with an updated list of my work as it is published. I haven’t submitted much in the last year or so—life got in the way—but I would like to submit more this summer. Along those lines, I’m also searching for a home for a chapbook I’ve been working on for several years.

2020 has been extremely weird and stressful, but here’s to some creative endeavors in the upcoming months, I guess.

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We’ve had some trash weather lately (see image for my MIA patio) but, that just means that I have more of a reason to stay at home and wear comfy clothes!

I’ve never thought I could be a work-from-home kind of person–I prefer to keep my personal life separate from work. While not a usual occurrence, there have been a couple days this winter where I’ve worked from home due to snow. Oddly, I find myself to be even more productive, both with my workload and my personal to dos, on these days.

I’ve been trying to figure out how to keep the productivity going throughout the week when these days come up. While it’s still a work in progress, here’s some of the things that I’ve found to help:

  • Read a book something
    Okay, this makes it sound like I read an entire book just to keep the rest of the week productive. I don’t! I read tidbits of my favorite novels, short stories, poems, and articles. I have at least six different “To Read” piles, and I just pick up what seems interesting at the time. Last week, it was online literary magazines I enjoy. Check them out, or find your own pile to read!

  • Self care
    Or rather, some semblance of self care. Last week that was painting my nails. This week, maybe it’ll be brownies, a face mask, or some crafting. Maybe I’ll finish the scarf I’ve been knitting for the last five years. I’ll probably end up partaking in Law and Order: SVU marathons (but with my laptop open, so I do stuff… hopefully).
  • Tidbits (instead of mouthfuls)
    What I really mean by this is pretty much just: baby steps. Breaking a large task up into smaller chunks. Do I want to deep clean my bathroom? Not particularly. Can I clean one thing each time I go to the bathroom? Sure. How about the laundry pile that’s taller than me? I think it’ll be better if I slowly separate the clothes into colors, whites, and delicates on my bedroom floor first.

Hopefully, 2019 leads me on the right path to discovering just what exactly I need to be my best self. Here’s to a year of learning, growth, and productive personal time.

It seems I’ve been in a rut the last few months while trying to wrap up the year. 2018 hasn’t quite gone as planned, and while it’s been an adventure, trying to keep track of everything I managed to get done and things I’ll have to push to the new year has taken its toll.

2018 has brought a lot for me personally. Both in experiences and personal accomplishments! I drove all over the country in my little civic, from Wisco to Mass to Jersey all for some weddings, and then to do it all over again and drive from Wisco through Iowa, Nebraska, and Colorado just to see Phish at Dick’s for Labor Day weekend. I’ve worked on journaling a little bit more than I have historically–and by that I mean maybe once a month I remember to write something in a notebook and call it a journal. We also adopted a kitten, Wilson, to entertain Sal… that’s still a work in progress but it’s been a blast so far.

This year, I submitted work professionally and received acceptances! In college I tried to pigeon hole myself into writing fiction exclusively, but thankfully I came to my senses and have allowed myself to explore. I had submitted some stories to a couple of magazines and either was rejected or didn’t hear back. I’ve found that I struggle to let go of and see my short stories as “ready”, even after years of revision. On the flip side, most of the work I had published this year was poetry! Somehow, it’s been a faster process for me to see a poem as finished and ready for the world. If you had told me 4 years ago that this would be the case, I wouldn’t have believed it. I had work published in Rabid Oak, Furtive Dalliance, Rose Quartz Magazine, and I have a piece accepted for the January issue of Mojave He[art] Review.

New Year’s resolutions aren’t really my style. Why do you need an arbitrary date to start bettering yourself, or changing in general? Life is always moving and changing. We should, too. Every year people ask me about my resolutions and I usually stumble through some form of “Oh shit, wait, that’s right, New Year’s is right after Christmas. That’s in a week.” And then I find my moment to disappear into the background and remove myself from the conversation, for fear of someone realizing that I have absolutely zero resolutions, and that I’m a failure for doing so.

But, I recently discovered the idea of a word or theme instead of specific resolutions, and I’m going to give it a try. As a big picture person, this seems more productive and (ironically) actionable than a declaration of “2019 is the year I start going to the gym!”

2019 is “focused, but open”.

I’m going to be taking the LSAT. I plan on continuing to write and submit to journals in the new year. Hopefully we’ll be moving out of Wisconsin and back to the east coast. There’s more weddings for dear friends to go to in 2019, so more road trips are likely in our future. I want to put myself first and get stuff done, but I also want to be more open to new people and opportunities. I want to try new things and stop myself from saying “no” preemptively.

So, here goes nothing trying to wrap up a messy year in anticipation for fulfilling productivity.

I’ve been thinking a lot about self-expression.

It’s something that I feel is very important and essential to the human experience. It is also something I struggle with the most. I don’t feel like I adequately express my thoughts in any situation. I think all day, about anything and everything. But later, when I have the ability to verbalize those thoughts? Nothing. It’s like I’ve never spoken before.

Part of my struggle with self-expression is from internalized censorship. I get extremely uncomfortable writing down my thoughts and feelings, for fear of repercussions. You don’t want to hurt anyone’s feelings, you know. While words can be used to inflict pain, the fact that an individual’s own thoughts and words are valid remains. Just because someone doesn’t like what you have to say, doesn’t mean you shouldn’t say it. The obvious caveat here is to not be a douche to others. There is a difference between self-expression and malice.

Words are important and powerful, but this power goes both ways. Words can be freeing and powerful. They can also be hateful and constricting. Either way, words have meaning. Getting your thoughts out is integral to good mental health. So what does one do when the words are stuck?

To be honest, I’m still not sure.

I journal sporadically–and by sporadically I mean maaaaaybe once or twice every few months. Sometimes I have the energy to express myself creatively and can work on a piece. Usually, I just sit and think in my head for hours and never actually express any of it. If it’s not expressed, it’s not real. Rinse and repeat.

This leads to me being stressed out and tense, and often looking for but never executing any forms of release. I mindlessly read a lot of AskReddit threads. An SVU marathon? Great. How else can I distract myself from the never-ending whirlwind of thoughts that I need to get out, but can’t? Or rather, won’t let myself get out?

Every day, I give myself a pep talk. Everything I want to express, I prepare myself to say out loud. Verbalize it. Make it real. Let it be known. Every day, I try and fail to verbalize this.

Is it possible to know who you are if you can’t express yourself? What happens if you lose the ability to express yourself–do you cease to exist? Do you stay stagnant, forever your last age that allowed self-expression? How long can you wait for this ability to return? Will it?

The kicker is that I am the one holding myself back. All I can do is keep trying. Keep trying to remember to practice self care. Keep trying to write when I can get through the discomfort. Keep trying to work through my shit. Maybe one day, self-expression will make it’s way back to me.

A morning without coffee either means that I am sick or that I overslept. Either way, a morning without coffee means a bad day. The delicious aroma wakes me up in the morning (assuming I am prepared enough to set up the coffee maker the night before) and at this point, I’m sure my blood has been replaced by my beloved brown ambrosia. Unfortunately, loving coffee has implications if you care about the environment. As the second-most-traded commodity after oil, the gas needed to get the coffee into my cup alone is enough for concern. What doesn’t come to mind, though, are the impacts of coffee’s agriculture.

Traditionally, coffee grows in tropical and subtropical environments at high elevations in mountainous areas under the shade of a tree canopy. The mere presence of the tree canopy allows for great levels of biodiversity of plants and animals, as well as eliminates the need for soil fertilizer. With increased demand, though, “full-sun” farms have turned coffee into a monoculture plant, much like corn and soy. Similar to the devastation bees face from monocultivation, rainforest animals and plants suffer from the lack of biodiversity and must adapt, relocate, or else face extinction. On the other hand, shade-grown plantations are second to undisturbed rainforests, according to the American Bird Association, as the best habitat for birds and other fauna in South America.

Brazil and Vietnam are the two biggest producers of coffee in the world. With three-quarters of their coffee farms containing no tree cover, the impacts of the coffee economy are apparent. In producing a higher yield of beans, sun cultivated coffee requires deforestation of jungle habitats, creates a need for soil fertilizer and other chemicals, and makes permanent changes to the local ecosystem. Most full-sun coffee farms grow bitter-tasting robusta coffee plants, typically used in instant coffee and pre-ground cans like Folger’s or Maxwell House. High-end options, like Starbucks, often use arabica coffee beans, a different species of the plant. Arabica plants are more likely to be grown in the shade, but even so, a shocking 41% of coffee farmland had no shade trees in 2010. With the industrialization of coffee farming, processing plants have contaminated waterways from its reliance on fertilizers and other chemical additives. Topsoil erosion has been increasing due to the widespread use of monoculture farms in Brazil, whose crops eerily resemble corn fields in the Midwest.

So what is the environmentally conscious coffee consumer to do?

The answer is simple: we make the effort to consume shade-grown coffee.

Purchasing robusta bean coffee, like a can of Folger’s or the like, support full-sun farms and the destruction of biodiversity. Although cheaper, these items leave a higher carbon footprint and more devastating trail in their wake. Thankfully, the Rainforest Alliance and Smithsonian Migratory Bird Center both certify coffee beans that have been grown sustainably. Organic and fair-trade certified coffee beans don’t necessarily guarantee shade-grown coffee but aren’t a terrible alternative. While both of these options are often more expensive, nothing beats the quiet enjoyment of a morally right and environmentally friendly cup of coffee.

“Where’s your engagement ring?! Where are my grandbabies?!”

“Oh, don’t hold the baby, you’ll catch the fever!”

“It’s like I’m preparing you for when you’re a mom!”

Quotes from women older than me, directed towards me, about future me. My response usually includes some light laughter and a quiet,  “Not yet.”

I haven’t thought much about having children outside of lectures about childbirth and human development. I know that midwifery is an evolved necessity due to our bipedalism changing the shape our hips and the birth canal. I know that human babies are born underdeveloped, with GI tracts and immune systems that need more time before functioning, all to accommodate our larger brains. Jaundice might be an evolutionary adaptation and scheduled feedings several hours apart are not beneficial for breastfeeding mothers or children. From an evolutionary perspective, our most primitive and basic goal is to reproduce to pass on our good genes to the next generation.

With the development of culture, agriculture, and industrialism, humans have surpassed these primitive goals. Now, we have so many individuals in our species that there are, surely, tons of “good genes” being passed on. An estimate from August 2016 of the human population suggests 7.4 billion people are currently alive all over the earth. Estimates from the United Nations suggest that this will increase to 11.2 billion individuals by 2100. Overpopulation is a real issue in many places globally; the most well-known solution to this came from China, with the one-child family planning policy. We do not have the room or the resources for more people. And yet, we keep reproducing, because that is what we do. But, another factor that is often ignored comes into play for modern populations when considering reproduction: environmental repercussions.

These repercussions have been documented in a number of ecosystems all over the earth—anthropogenic impacts have increased the rate of extinction by 1,000 times the pre-human rate globally, caused climate change, and permanently changed the landscape of the planet. Humans have drastically reduced the habitats of many forms of life. We are killing the coral reef; we fragment forests and leave orangutans stranded (an issue because they live solitary lives and only interact with the opposite sex to copulate); we are killing the bees; we leave massive carbon footprints simply by existing in this modern age. Americans consume the most out of any other country. The average American emits almost 20 tons of carbon, compared to 4.6 tons from the average Chinese citizen. As an American, it’s ignorant to not consider the environment when deciding whether to have children.

A 2009 study completed at Oregon State University analyzed the carbon legacy of individuals when choosing to have children. It found that by choosing to reproduce, women add 9,441 metric tons of carbon emissions into the atmosphere for each child. To put this in perspective: the most environmentally conscientious, Prius-driving, recycling woman would only reduce her emissions by 486 metric tons of CO2 in her lifetime. Having two children adds over 18,000 metric tons of carbon. Now, this isn’t to say that environmentally-driven lifestyle changes are futile—quite the contrary, actually, as these lifestyle changes work to lower emissions in the present time and to offset the drastic changes soon to come. But, this does provide food for thought. Is it worth it to have a child in 2016? How do you reconcile these conflicting interests as an environmentalist?

When engaging with the public on environmental issues, the children and grandchildren are always brought into the picture: “We need to create a better world for our grandchildren!” or “What world are we leaving for our grandchildren?” Really, just something along those lines, to add gravity to the reality of climate change. And yet, we are getting pregnant and raising our offspring in a world that will be drastically different if we don’t change our ways. How can we talk about the consequences of our lack of action for our grandchildren without considering whether or not there should be grandchildren?

Many millennials are opting to not have children. Some denounce the innate selfishness of reproduction; why create a mini-me just because I was told that this is the next logical step of life? Others cite overpopulation and choose to adopt instead. Still, others consider the environmental impacts and, again, decide to refrain. But, is it morally acceptable for me to have children, knowing full well the major climate change expected to occur in the coming years? I don’t think so. How can I be a loving and supportive mother if I know that the world my children will live in may not be habitable? Can I be a loving and supportive mother if I marry a green lifestyle with my own parenting skills?

While having a child isn’t obviously eco-friendly, it could be. What if that child grows up in a green household and develops a passion for protecting the earth? Teaching children more sustainable skills, like composting, gardening, and thoughtful consumerism can ensure the continuance of the environmental movement. Is it more effective to raise a new generation of eco-friendly fighters, or to take it upon myself to stop my descendants from polluting the planet?

This issue is complex and deserves to be mulled over thoughtfully. It is my own decision whether or not I personally would like to have children, but do I have the right to deny my spouse children if they choose to want them? How do male environmental activists consider this issue and where do we draw the line? Reproduction is not just a woman’s issue, but a global one.

I am still undecided on whether or not I would like to have children, and that’s okay. I have many years to live before that decision becomes relevant; I can ride out the next couple of years and see how the environmental movement progresses. Yet the food for thought remains: as environmentalists, how do we tackle reproduction when humans are the enemy?

When I was younger and a frequent participant in sleepovers (after the prank phone calls and truths about our crushes and dares about ding-dong-ditching the neighbors had grown tiresome) ghost stories were my favorite. I listened with the hardened demeanor only a 10-year-old could have—nothing was ever scary enough. That is, until I heard the story that would lead me to jump onto my bed in the dark as an adult (or else lose my feet).

The story has its variations. Essentially, the protagonist is lying in bed late at night, awoken by the sound of something dripping in the house. Too scared to look, she reaches off the side of the bed to find comfort in her dog. The dog licks the hand, and with newfound courage, she searches for the source of the sound during a number of trips. After each trip, the dog licks her hand for comfort. It is only on the last trip that the protagonist discovers that the plinking sound that woke her is from her dog, who is hanging dead in the shower. Then it clicks. A stranger—whoever did this to her dog—was licking her hand from underneath her bed all along.

Creepy, right? It probably didn’t help that I slept on the top of a bunkbed at the time, with no soul occupying the lower bunk. To personalize this fear (and possibly to justify my irrational hatred of this body part), I became terrified of my feet being bare when in bed. I always envisioned some depraved individual consisting of mostly skin and bones, a-la-Gollum from Lord of the Rings, reaching up and dragging me into an abyss or hacking off my feet with a rusty hatchet.

For some reason, the fear of what may happen to extremities that dare leave the sanctity of your duvet is shared by many. A quick google search of “uncovered feet while sleeping”  or “fear of feet uncovered” brings almost twenty million links—many asking if anyone else shares this fear. Consensus suggests that this trend stems from a lack of consequence from childhood irrational fears. With no consequence, why work to overcome our fears?

Sleep is essential for life. Without it, activities associated with digestion, cell repair, and growth are at risk; these occur most often during periods of sleep. Body temperature is now being seen as an important factor in the process of sleeping, with cooler temperatures being thought to cause sleepiness. Optimal sleep temperature is thought to be between 60 and 67 degrees Fahrenheit, which is colder than my apartment (conveniently set at a nice, toasty 72 degrees when the thermostat is turned on). The bottoms of our feet contain vascular structures to help regulate heat loss, just like the face and ears. Thus, sleep scientists consider sleeping with a foot exposed to be a sleep hack, as it cools the body faster and sends you on the express train to SnoozeTown.

As a self-proclaimed sleep lover who can sleep whenever I want as long as I can get into a comfortable position, this goes against every fiber of my being. An exposed foot gives the stranger under the bed the perfect opportunity to attack. On the other hand, an exposed foot has the possibility to bring me to the Nirvana of sleeps. Refusing the prospect of good sleep surely seems like a consequence; it’s also a needed push to overcome my irrational fear of feet-stealing bed strangers. If more people knew that the benefits outweigh the costs—that feeling refreshed in the morning is a great trade for risking loss of appendages because of a boogeyman—would this fear eradicate itself?