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What are the first feelings you experience when the headache from your migraine has lifted—whether after hours, days, weeks, or even months of living with it in some form?
Do you deal with the infamous “hangover” that can be almost as bad as the headache attack, just in different ways, and often lasts for up to 48 hours?
The postdrome is often referred to a “hangover” effect from migraine, a suitable term since some of the symptoms are much like the morning after having had too much to drink—a heavy head, sometimes nausea, neck pain, sensory sensitivity, irritability, cognitive difficulty, fogginess, and depression. While many of these symptoms are predictable, there are some suggestions for minimizing the effect of this “hangover”:
- Hydration: Some migraine patients find it difficult to drink water during the most intense period of their headaches. This dehydration caused by migraine may be one of the main causes of the postdrome stage.
- Rest: The human body burns a lot of energy trying to fight headaches. Whenever possible, migraine patients should shake off their postdrome feeling of weakness with plenty of rest.
- Over-the-counter (OTC) relief: Some physicians recommend taking aspirin or ibuprofen in measured quantities during the postdrome stage. In some cases, however, the hangover may have been caused in part by excessive doses of these medications; for this reason, migraine patients should check with their doctors prior to self-medicating.
- Vitamins and minerals: Some migraine patients report feeling much better after they get over their headaches when they take supplements such as magnesium and riboflavin (Migraine Relief Center).
As you recover, however, do fears begin to seep in, like: “How long will I have before the next attack?”
Dr. Ira Shapira, explains in his essay, "MIGRAINE: Managing the Postdrome Phase or Migraine Hangover with SASPGB":
“Unfortunately, pain is an emotional response and hence the memory of both pain and the fear related to pain are inexorably linked. So are all the other Emotional Memories that can act as triggers. Sight, Smell, Taste, Vision inputs as well can all be involved turning on the "Fight or Flight" reflex. Suffering during Migraine and Migraine Postdrome may be related to a combination of emotional memories as well as neurovascular issues” (Shapira).
Has it really gone, or is it just lying latent, waiting to strike again with the slightest trigger or twinge? A study in The Journal of Headache and Pain examined the relationship between (cephalalgiaphobia: the fear of having a headache attack during a pain-free period) and migraine, leading to the determination that the fear may well lead patients to use analgesics in the absence of pain to prevent headaches and to improve their well-being: “It’s like taking an ibuprofen before your headache pain or migraine aura even occurs because you are so frightened of developing one” (Doherty).
Nonetheless, the fears and questions we have between migraine attacks are real.
- How much can I accomplish not knowing how long I’ll have?
- Should I push myself, plan anything, go anywhere?
- Can I finally make plans with friends for next weekend, having had to reschedule two nights ago?
- What if I have to cancel again?
- How long before they just give up on me and think they can’t count on me?
- How much can I do without triggering another attack?
According to the American Migraine Foundation, “Everyone experiences the postdrome phase differently: it does not necessarily occur in everyone with migraine, nor does it happen after every attack. These inconsistencies can be confusing, and often cause “migraine hangover” to be mistaken for a different medical condition” ("There's a Very Distinct Migraine Phase...").
For some, the migraine completely lifts from your body, leaving you with exhilaration, an overall sense of well-being, of normalcy. You wake up and appreciate even the small things so much more. The poet, a migraineur, says, "This is the day of the rainbow/the bird with a twig in its beak./At last, when least expected,/this is the great escape./Uncontainable..." (Crossley-Holland lines 14-18). Still, though, the same fears soon settle in.
I’m going to surmise that you or your loved one has experienced many of these complex feelings and reactions, sometimes almost simultaneously; this is the postdrome phase of migraine, combined with cephalalgiaphobia. This part of living with migraines is largely misunderstood and, again, invisible to most others.
As we know, living with migraines is a burden that dramatically affects our quality of life—sometimes even in between attacks. While sounding simplistic, staying mindful and present in the moments, days, or, for some, weeks between migraines can help us live more fully and gratefully during the respite.
References
Crossley-Holland, Kevin. 'Deliverance." So Much More than a Headache: Understanding Migraine through Literature." Edited by Kathleen J. O'Shea. Kent State University Press: 2020.
Doherty, Colleen. “The Phobia of Having Headaches,” Verywellhealth.com. Oct. 2020. Accessed 31 January, 2021.
"How to Deal with the Postdrome Phase of a Migraine." The Migraine Relief Center. March 14,2014. Accessed 30 January, 2021.
Shapiro, Ira. "MIGRAINE: Managing the Postdrome Phase or Migraine Hangover with SASPGB." January 2021. Ihateheadaches.org. https://www.ihateheadaches.org/blog/migraine-managing-the-postdrome-pha…. Accessed 1 February, 2021.
“There’s a Distinct Migraine Phase with its Own Symptoms that Begins When Your Head Pain Ends.” The American Migraine Foundation. February 2018 . https://americanmigrainefoundation.org/resource-library/migraine-hangov…. Accessed 31 January,2021.
