Migraine advice centers around prevention, treatment and pain management but doesn’t talk much about that strange and frustrating fourth phase: postdrome, also known as the migraine hangover. Not everyone gets it, just as not everyone gets an aura before their migraine, but those who do know how lousy the final stage feels. The pain has gone and left in its place dizziness, brain fog, sluggishness, and low energy.
Usually “hangover” means dealing with the after effects of alcohol, but not here. With a migraine “hangover”, the migraine is still in effect, and because of that, it is crucial that you not rush back into your day-to-day life. The migraine has not passed, and evidence shows an increased sensitivity after each successive attack. This can lead some individuals to have chronic daily migraines.
We know that you do not want more migraines or worse pain. Here are the three things you can do to help yourself recovery fully, and not risk exacerbating your migraine pain.
Take Care of Yourself
If you haven’t already, stop thinking of migraines as headaches and instead think of them as a chronic illness to be managed. A diabetic has to take insulin and eat carefully. You take medication, do your best to avoid triggers, and take care of yourself no matter what. Those aren’t nice words. That is a prescription for managing this chronic condition.
Many rush back into life as soon as the pain is over. Many women, especially, feel guilty for having to retreat, for taking time off work or from family duties, for not crossing items off the to-do list. As soon as the pain is gone, they’re back on their feet pushing through the fog and lethargy of postdrome without realizing the damage they’re inflicting.
Look, whether or not you suffer from migraine hangover, you owe it to yourself and the people around you to treat yourself well. If that means spending a few more hours lying down, or if that means soaking in a bath. And when it means saying not to some of the obligations you’ve lined up for yourself: do it. It is not waste time, and it is not weakness. It is how you manage your life with migraines.
Ease Back Into Doing
So what does it look like to take care of yourself? It’s a little different for everyone, so you should come up with your own plan and routine for exactly what it will be for you. However, the essential components for recovering from migraines (and migraine hangover) should always include:
–Rest! Lying in the dark enduring the searing pain of a migraine—that doesn’t count. Get some quality sleep, or read a book, or just sit and stare at the wall. But you just endured a long and painful thing. Your body needs a few hours to recuperate. Give it that time.
–Take it slow. It’s tempting to rush back into your obligations and your daily routine. Don’t. Push things back, cancel appointments, delegate work—take at least a full day to not feel rushed. You have a chronic illness, remember, and the stress of rushing can trigger you.
–Do half. That is, your to-do list is a mile long. There are things to plan and do and catch up on and all are important! But what’s more important is preventing another migraine. So, take that list and chop it in half. Then, half it again. Postpone, cancel, and delegate everything you can. Now begin.
When You Avoiding Triggers, Offer Thanks not Apologies
Most migraineurs have a good idea of at least some of their triggers, and still many of them struggle to stand up for their needs for fear of being rude or (worse?) needy. They don’t want to offend anyone else, and they don’t want to inconvenience anyone with what they need.
Start here: people want to help other people. It makes us feel good. If you say you’re sorry all the time, it gives the impression that you have something to be sorry for and that they have some reason to forgive you (or not). Saying thank you makes the other person feel appreciated. Even if you’re turning down an invitation, people will feel like they helped you. And a weird psychological truth is that they’ll probably want to help you more.
Practice ways to say “thank you” instead of “I’m sorry.”
Try, “Thank you so much for thinking of me. I wish I could be there,” instead of, “I’m so sorry I can’t go!”
Try, “Thank you for turning down the lights. I work much better this way,” instead of, “I’m so sorry for being such a bother.”
There will be triggers you can’t avoid and situations that demand apologies, but being choosing to feel grateful over feeling helpless goes a long way in curing a migraine hangover. How do your family members, friends, and co-workers respond differently to you now?
One of the most difficult realizes of chronic pain is receiving help. You feel helpless and you know you need help, but asking for it makes you feel worse—like a big helpless burden on everyone around you. But you’re only a helpless burden if you actually are a helpless burden. The choice is yours.
In some ways, you are a little helpless because in some ways, we’re all a little helpless. (No doubt you can think of ways everyone you know proves this statement.) Your job is to focus on how you can be helpable—or, how you can help even when you’re helpless. Give the best of yourself when you’re feeling well. Spend quality time with the people you love. Serve them. Help them. Laugh with them. And importantly: get enough sleep, eat well, and don’t over schedule yourself—especially in the migraine hangover phase. Taking good care of yourself is the first step in being helpable.
Your pain is real and so are the feelings that go with it. And, they’re just one part of your life. Maybe a big, unavoidable, awful part of your life, and still just a part. Help others help you by giving to them when you’re well, and receiving their help when you’re not. Family, friends coworkers, online or in person—there is always someone. Give help. Receive help. Say thank you.
You’re Almost There
If you’ve made it to postdrome, you know you’re almost in the clear. You’ve endured the worst part. It’s like you’re in the Amazon and you’ve escaped the anaconda—but now you’ve got to cross the piranha river. Are you just going to rush right across it? No! You’re going to rest up, get your energy back, drink your water, and then cross very carefully. Nobody wants a migraine hangover, but take heart. You’re almost there.