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Keeping Stress Consistent: Avoiding Let-Down and Stress Migraines

Keeping Stress Consistent: Avoiding Let-Down and Stress Migraines

Most of us experience a connection between stress and migraine disease, whether it is the migraine attack that comes during an intensely stressful period or the let-down attack that comes when the stressful period is over. That connection may or may not be a direct link, but almost all of us have experienced it enough times to assert it exists. So, how do we deal with that connection, especially during the holidays – a particularly stressful (and migraine-filled) time for many of us?

Perhaps by taking a different perspective on stress management than usual.

Managing stress can be a crucial migraine survival tool, for chronic migraineurs in particular, and it often leads to reduced severity or frequency of attacks. But, despite how we often talk about it, stress management is not always about simply reducing stress levels with yoga, meditation, more sleep, less work, etc. Sometimes, it is about keeping those stress levels consistent.

A migraineur’s brain is sensitive, and this sensitivity means it does not do well with change. It likes stability, be that with meal times, sleep schedules, or stress levels. Changes in these areas affect our hormones and our bodies, and they can throw our brains off track and straight into an attack – even if the change is a good one (such as a sudden reduction in cortisol, one of the major stress hormones). One way to manage stress then, is to keep our schedules as consistent as possible.

Get up and go to bed at the same time. Eat at the same times, as much as possible. If you like yoga, or another meditative practice or exercise routine, try practicing it daily. If you are like many of us, and your Mondays and Tuesdays are often stressful and filled with work emergencies while your Thursdays and Fridays are more low-key, see if you can’t spread your obligations out more evenly. Try moving regular deadlines or giving yourself 48 hours to respond to requests, whatever works for you and moves some of the pressure from the beginning of the week to the end.

Such consistency can be more difficult during holiday seasons, with all the extra obligations and celebrations. You may be able to reduce the season’s impact on your health by restricting parties and outings to no more than one or two per week, especially if you can do so by substituting another event or activity you usually attend or enjoy during the week. If you are on vacation, you may also consider tackling a personal obligation, errand, or task during the day when you would normally be handling a stressful work project. This can help keep stress levels consistent, while still enabling you to enjoy personal downtime and time spent with your loved ones.

By including consistency as one of your stress-management techniques, you may be able to avoid some of those dreaded stress-related and/or let-down migraine attacks. Like most things for us migrainuers, it is at least worth a try.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.


  • mrst53
    3 years ago

    My let down migraines hit after an argument with my hubby and they start with a stabbing pain to the base of the left side of the head. From then on, it creeps up the left side of my head and over my eyes and it becomes a full scale migraine. I take my meds, grab my ice packs and head to bed.

  • Laura
    4 years ago

    I didn’t know the name for the type of migraines that my father had while I was growing up like clockwork every Sataurday of a weekend he didn’t work and myself when I became a single mom and had a day off. I always called them “decompression” migraines.

  • Janet
    4 years ago

    Your article is well written. These past many months haven’t been good for a chronic migraine sufferer such as myself.

    Managing stress and migraine has gone out the window as my mom passed away on January 3rd. The trips to Chicago and back so many many times over the past many months has taken a huge toll on my migraine brain.

    I thought I had a handle on things having gone back on Butalbital daily, with a kick from frova or sumatriptan on the tougher days. However, all bets are off as I crashed and burned big time this past week…

    I will read your article once the idea of losing my mom isn’t so painful.

  • Sarah Hackley moderator author
    4 years ago


    I am so sorry to hear of your loss. I lost my mom four years ago, and I understand too well the pain you’re going through. I hope you may find some peace and healing in the coming year.

    Warm regards, Sarah

  • Mr. Grain
    4 years ago


    Thanks for being attuned to this trigger. For years my experience with the letdown trigger felt isolated from the migraine community, but after the Montefiore study more and more people are talking about it. It’s nice to read about strategies to manage the letdown effect by lowing our high-stress periods and raising our low-stress periods.

    I’ve had some success treating my weekly letdown migraines with Amerge on Wednesdays, and then Maxalt in 12 hour intervals. I’m finding that my migraine does start rearing it’s head on Wednesday afternoon, or at least the prodrome can start that early. Hitting it with Maxalt then helps later in the week. Does anyone have success in aborting the letdown migraine? When does it hit for you, and when do you try to abort it?

    I’m hoping to hear comments from people who have prevented the letdown migraine via your suggested methods or any others as well.

  • Sarah Hackley moderator author
    4 years ago

    Thank you for reading and commenting. I’m glad you’ve come across a regimen that seems to be working for you at least some of the time. Triptans don’t work on me, so I don’t have anything to add there, but perhaps other readers will. Warm regards, Sarah

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