The Migraine Hangover
After the Headache phase of a migraine attack, do you ever feel overly tired, lethargic, emotional, depressed or euphoric, and unable to concentrate? If so, you may be experiencing the Migraine Hangover!
Migraine Awareness Week 2022
This year for Migraine Awareness Week we are focussing on the Phases of Migraine. Individual migraine attacks come in several phases; they have fancy official names.
- Prodrome
- Aura
- Headache
- Recovery
- Postdrome
Most migraineurs will experience at least one of these with their migraine, but probably not all and they may vary during different attacks. It’s much easier to look at these phases if the person has episodic migraine and not chronic, as then they can all blend into one.
Postdrome
The phase we’re going to talk about here is the postdrome, or Hangover phase. It’s the final phase and it can last for a few days after the headache and recovery phases.
Many of the symptoms of this phase can appear during both the prodrome and/or the headache phase as well. They usually include:
- Feeling like you have a hangover.
- Sore muscles.
- Food intolerance.
- Alteration in mood.
- Impaired concentration.
- Decreased energy requiring a period of rest.
A small proportion of migraineurs feel energised or euphoric immediately after an attack and can return to normal activities at once. However, this phase can also be cause for concern or dismissal by some people.
Invisible and dismissed
The postdrome is also the one most friends, family and employers are most sceptical about. This plays havoc with work and school too as you end up taking time off or go in and rick being teased by staff and colleagues alike for being hungover. Afterall, the headache is gone so you should be okay.
So those non-headache symptoms that people just don’t understand can be the worst part of migraine. The brain fog, dizziness, clumsiness, fatigue, etc, can turn your life upside down, but most people wonder what these symptoms have to do with headache?
If you’d like to see what they had to do with headache, watch this wonderful talk by Dr. Nick Silver, Consultant Neurologist with the Walton Centre in Liverpool. https://www.youtube.com/watch?v=LhAckxlPe2U&t=1403s
Study
In 2016 a study on the postdrome was conducted using an electronic diary to record symptoms. https://n.neurology.org/content/87/3/309.short. It concluded that “81% reported at least one non-headache symptom in the postdrome. Postdrome symptoms, in order of frequency, included feeling tired/weary and having difficulty concentrating and stiff neck. Many patients also reported a mild residual head discomfort. In most attacks (93%), there was return to normal within 24 hours after spontaneous pain resolved. There was no relationship between medication taken for the headache and the duration of the postdrome. The severity of the migraine was not associated with the duration of the postdrome. Overall state of health scores remained low during the postdrome.”
Why does it happen?
No one really knows why these phases happen, but they do know that the profound changes in blood flow, electrical activity and pain during the earlier phases can carry on to this phase and make us feel washed out and completely useless after the headache phases has passed.
It’s so unfair!! You get all the pain, exhaustion, and flack of a hangover without the initial pleasure of the alcohol.
Not everyone will experience the Postdrome, in fact not all attacks will end with postdrome, but it has been identified as a significant phase and is often overlooked as many people put the symptoms down as side-effects of the medication taken in earlier phases.
So what can be done to help during this phase?
First of all, medication is out as you’ve already taken what you can earlier on, so back to the old familiars, hydration, and rest. Some people may find other things beneficial to them, such as Yoga, as stretching after being all tense and scrunched up for so long can be a relief, others can recover by taking a glass of fruit juice or something else relatively healthy.
The best way is with regular ‘migraine hygiene’, in other words learn your individual triggers, get to know your own migraine, get into a good sleeping and eating routine and try to avoid anything that you know will make things worse, despite the cravings (remember the cravings are part of the migraine) and of course keep a migraine diary – beit digital or paper. And most importantly during this phase, try to relax and rest, don’t push yourself through it if you can help it. Your brain and body need time to recover!
The American Migraine Foundation says “Caffeine during the prodrome phase can have a positive effect for some people, but others find it makes their symptoms worse. Many find comfort food, ice packs, heating pads, massages and additional rest helps to soothe their migraine hangover. Ignoring or pushing through the effects of the postdrome phase doesn’t give the body necessary time to recover, and can increase the risk of having another attack. Take it easy and rest during this time.”
The information contained in this article is for information only and not intended to replace medical advice or diagnosis.
