Fasting with a migraine on 9th of Av Rabbanit Debbie Zimmerman
Av 5782Topic : Three Weeks , Fast Days , Shayla ,
Thank you for your previous answer. I prepared for the fast like you suggested and also woke up before the fast to have some coffee and eat something, and I was able to get through the fast. I am worried about Tisha B’Av since the fast starts the night before. I know it is more serious, but are there any leniencies? How badly do I have to feel before I can break my fast?
In general with my migraines – I start feeling badly and have a window where I can eat and drink, take something, relax a bit, and it will pass. If I ignore the signs and the window and the migraine comes on all I can do is lie down in a dark room until it passes. Even then sometimes I will get violently ill.
I am glad to hear you were able to fast without feeling ill, and I understand your concern about Tisha B’Av. While you are correct that Tisha B’Av has a stronger obligation than the other rabbinically mandated fasts, most poskim agree that the rabbinic obligation is not as absolute as the biblical obligation of Yom Kippur when only the dangerously ill are exempt from fasting. So to understand how best to approach the fast we will continue our previous discussion of the source of the obligation and who is exempt and who is obligated to eat.
The source of the obligation
As we mentioned, the prophet Zecharya relates that the Jewish people fasted in Av after the destruction of the First Temple. Based on a Mishna the Gemara in Rosh Hashanah – which states that Tisha B’Av has a stricter status than the fasts in Tevet, Tammuz, and Av because five great tragedies, including the destruction of both Temples, happened on that day – the fast is obligatory until it becomes a festival in a time of peace.[i]
The exact nature of the obligation is debated. Tur states that the prohibition against eating and drinking on Tisha B’Av is midivrei kabbala and therefore just as strict as that of Yom Kippur, except that the consequence of eating on Yom Kippur is karet and for Tisha B’Av it is makot mardut – lashes for rebelling against halakhic authority.[ii] (OC 554) Nevertheless, most rabbinic authorities do not apply all the stringencies of Yom Kippur to Tisha B’Av. As we saw in the previous response, Shulchan Aruch rules according to Ramban that Tisha B’Av in our time has the status of a rabbinic prohibition and “the rabbis did not include the sick in their decree.” (OC 554:6)
Is it possible to avoid getting sick?
Previously we discussed properly preparing your body for the fast – drinking extra water in the three days prior and eating filling well-balanced meals before the fast. Additionally, I should mention that many regular coffee drinkers experience headaches on fast days, and caffeine withdrawal can lead to migraines. Obviously, a migraine is significantly more severe than a headache, and while one may not break their fast to alleviate a headache (although one may take medication), one may do so to stop a migraine. Nevertheless, it may be worthwhile to check if caffeine plays a role in your migraines – especially since you mentioned that you drank coffee before the previous fast and did not experience one. To this end you may want to try gradually decreasing your caffeine intake in the week or two before the fast day, as that may alleviate the problem.
Additionally, some people take a caffeine pill or preemptive medication against migraines and find that that is enough to prevent illness. I advise you to discuss this with your doctor and see if it is an option. If you can’t swallow the pill without water you should try to drink less than a cheek full of water when taking the pill, but you may drink more if needed.[iii]
Exemption for the sick
Preparation may not help. Or it may help sometimes and not others. As we have discussed, the exemption for the sick applies to all rabbinic fast days, including Tisha B’Av. Nevertheless, we also saw that most authorities limited exemptions for pregnant and nursing women on Tisha B’Av, indicating that the criteria for exemption based on health issues is more stringent than on other rabbinic fast days. We went through the definition of “choleh” in the previous teshuva and summarized that it does not mean dangerously ill. As such a person is obviously exempt, but is generally understood as someone who can’t function because of illness, and may also apply to someone if fasting will lead to such a state.[iv] Therefore, someone suffering from a severe, debilitating migraine or for whom migraines are triggered by fasting is exempt from fasting on Tisha B’Av.[v] The question is – if one is physically healthy in general but fasting makes them sick (and not just uncomfortable) do they have to wait until they get severely ill to break their fast?
In this case we can differentiate between the chronically ill and someone who is generally in good health. A person who has diabetes and must eat to avoid getting seriously ill is exempt from the fast and may eat normally. People who get migraines from fasting are not necessarily considered chronically ill. Rav Moshe Shternbuch writes about someone who is “weak” in a way that fasting will hurt them. He brings a person with angina as an example, but migraines are a similar issue – severe and often debilitating pain if one does not eat/drink enough. He says that such a person is allowed to eat on Tisha B’Av but should eat in a way that reflects mourning – similar to the seudat mafseket, the meal before Tisha B’Av, a person should only have one simple cooked dish at a meal (in addition to bread). One may still drink and eat fruit and the like without limits as these are not “cooked”.[vi]
Should I try to eat or drink in shiurim?
Aruch HaShulchan states that there is no reason to eat and drink in shiurim on Tisha B’Av as it is a rabbinic fast and shiurim is only applicable to biblical commandments.[vii] Nevertheless, if you are able to prevent your migraine and still maintain an element of the fast this is preferable. This can involve fasting until the morning, in which case you have observed half the fast, or even until midday. Similarly, if it is enough for you to drink and not eat that is also preferable. In this case drinking can be anything – such as smoothies or sports drinks.[viii]
If preparing yourself before the fast can prevent the onset of a migraine, then you should do so and fast as normal. If you start feeling the onset of a migraine, then you should immediately break your fast. If at any point you are not sure you should err on the side of eating, as the custom is to be stringent on your health in these cases. If drinking alone is sufficient then refrain from eating. If not you may also eat, but you should try to have simple meals that only have one cooked item.
Remember that if you are sick or getting sick you are exempt from fasting. You are still obligated in the other aspects of the day and should observe all the elements of mourning. Some authorities point out that one should not eat in front of others on a fast. Rav Shternbuch explains that idea is to preserve the integrity of the halakhot of the fast. Therefore, if one is sick and can easily explain to people why they are eating on a fast day they should do so. One should only refrain from eating in the presence of others if those people will not take the illness seriously and will think they are just making excuses, as this degrades both the person and the fast.[ix] When you eat and drink you should not feel shame, but joy that you are serving your creator by safeguarding your health and keeping halakha.
An added note for this year – Tisha B’Av Nidcheh
When the 9th of Av falls out on Shabbat the fast is pushed to the 10th. If one is going to eat on Tisha B’Av they must make havdala before they eat, preferably on “chamra demedina” – the preferred local drink (soda, coffee, juice – not water). If one does not have to eat at night then it’s better to wait until they have to break their fast to make havdala.[x] This is especially true in your case when you may not have to break your fast.
If you make havdalah at night start with the blessing on your drink and then the blessing on the fire and “hamavdil.” Omit the blessing on “besamim.” If you make Havdalah during the day you omit the fire as well.[xi]
Additionally, when the fast is pushed off many poskim maintain that the laws are more lenient. And so this year in particular, if you’re worried that you may not be able to prevent a migraine, or if something like extreme heat exacerbates the issue you may eat before you start feeling sick.[xii]