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How do you know when postdrome is over and your brain is back and ready for work?

When you consider yourself a smart, capable person who is good at taking initiative and getting things done, it can be hard to put on the brakes.  I can definitely use business-speak to describe myself:  I’ve always been a “self-starter,” you see, so much so that I eventually realized that one way for me to be really happy and empowered in a career would be to start my own business.

I’ve blogged before about what it’s like to be an entrepreneur who has to juggle work life, home life, personal relationships (friends, family, and partner) and more with the reality of what it’s like to live with migraine disease.  I am extremely grateful to my employees (whom I tend to think more of as coworkers much of the time) for not only picking up the slack when I’m struck with a migraine but also watching out for me so I can help prevent a migraine from setting in or getting worse.  My partner, Jim, is a fellow migraineur so is in the unique position of being able to be truly empathetic when I’m down for the count. My immediate family, all of whom now live within a couple miles of me (this is a good thing) are wonderful, and my friends are just fabulous. All in all, I count my blessings pretty often and know how lucky I am.

Turns out the person that expects the most out of me is myself.  Turns out the person who puts the most pressure on me, who has the highest (and sometimes unrealistic) expectations, who pushes me to work when a friend would tell me to rest, is ME.

Over the years, I have gotten much better at pausing projects when I feel a migraine coming on and keeping my work load to a more realistic level.  I’m not great at it, but I do find that I am learning to not take on quite as much and to be a little more gentle with myself when I can’t tackle all the projects I want to work on.

One area I really need to improve on is my post-migraine behavior.  In my early days of taking triptans, I bounced back almost immediately when I took my medication. I vividly recall being out to dinner with friends, feeling a migraine kick in, and popping my Imitrex without any worries about the evening being a bust. I was back to myself within an hour or so without needing to think about how to get home immediately.  My drugs don’t work as quickly now, and between the drug’s side effects and the postdrome that accompanies the end of the pain phase of my migraine, I don’t bounce back to my “regular” self quite as fast as I used to.

Herein lies the problem:  I’ve noticed in the last couple of years that I try to act like I’m at 100% as soon as the medication starts working.  The most notable examples happen when I have had a migraine much of the day and finally start to feel better in the evening. My mind is still hazy and my sassy self might not be as quick with comebacks, but my head pain is gone and I feel SO much better than I did earlier. So I do what I want to do: I try to do some work tasks.

Inevitably, I screw up something that is pretty straightforward to a person whose brain is functioning normally.  I’ll try to process an order for a long-distance bookshop customer and end up having to do it over three times before I get it right (don’t worry—it always ends up working out!).  I try to use QuickBooks to pay some publisher bills and end up totally confused about the invoice numbers.  It’s only once I’m mid-task that I realize that my brain is not quite ready for more nuanced, complicated jobs quite yet.

How do you know when the postdrome is over? How do you know when your brain is again capable of the tasks that your healthy self can do without incident?  I have had trouble knowing when I’m good to start work again and when I need to just put my feet up and relax for a few more hours.  Does anyone out there sympathize with this problem?  For those of you who have figured out how to handle this: any tips would be great.

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.


  • 7shqah
    4 years ago

    My main problem on postdrome days is a huge lack of motivation. My muscles feel tighter and I’m more physically tired than usual, but still otherwise functional. It’s the choosing to do something that is a problem!

    I have a few strategies now.

    1 – If I don’t have anything really pressing to do, or on a deadline, I simply swap the week day for a weekend day. That way I can just read or watch movies or surf the internet or whatever fiddly thing I feel like doing, and just be good to myself knowing I’m not “loosing” anything time-wise. Then on saturday I’m more than happy to get back to work because I’ve had a “day off” during the week, rather than just a lost day of suffering.

    2 – If I do have something that I can’t postpone, I boil it down to it’s absolute minimum, write up the steps I need to do in order, and then shut off all distractions other than that paper list and just focus and push on one thing at a time till I’m done. I find that if I can get myself moving I am ok, but the start is hard. Having a next simple thing to do without thinking about the big picture makes it easier for me. Then I also know when I’m truly done and can stop for the day.

    3 – I used to really lay back and try to physically protect myself and not do much. But lately I’ve realized that getting up and going to a vigorous Power Vinyassa yoga class makes me feel great again! It loosens me up and clears my head. I’ll still be tired afterwards, and I won’t have the same strength, balance or flexibility I normally would, but none of those things really matter.

  • bluebird
    5 years ago

    Yes There are (rare) times when I am well. feel like my best self.
    And then the rest is some stage of Migraine.
    Some level of unreliable functioning.
    Some sliding in or out of brain fog, confusion,vulnerability.
    Grateful for the many kindnesses of others.

    Thank you for letting me know I am not alone with these many challenges. d

  • Julia
    5 years ago

    Well, since I can’t work anymore it’s not an issue. But my mom used to say that I wasn’t back to “normal” until I stopped stuttering or could complete a sentence without any “uh”s. Usually takes me 2 days to recover. My life has to work around my migraines instead of the other way around. I hope someday I will get back to migraines being rare again, but I’m not holding my breath.

  • Clairie
    5 years ago

    SO relate to what everyone else has said. Sometimes I can get into work and not realize just how bad the postdrome still is until I’m forced to concentrate, make decisions, etc. I do accounting work as well, and it is nervewracking to think I’m screwing something up I would not have otherwise. And I HATE sitting slackjawed in front of the (too bright) computer screen, reading the same thing over and over because it cant sink in, or a coworker asking me for an opinion and I just can’t form a proper sentence let alone an idea. BUT for me, I can notice a huge change as soon as the foggy, confusion, brain slowness is finally gone. Never can predict exactly how long it’ll take, but I just feel totally different, and then I know I’m good to go as far as work! Too bad it’s not more clear-cut than that.

  • labwhisperer
    5 years ago

    Thank you for writing this. Yesterday was one of those post drome days where I could not find the right words, was driving and couldn’t remember if I was on the north or southbound lane, even though I had been driving for 30 minutes.
    Friends often ask if I am having pain, but I too, find days like these more troublesome.

  • Angie
    5 years ago

    Wow, I wish I had the answer to this issue.

    Prior to this year, when I was still employed, I would stick to the routine work that I had done for years when I was in doubt. Even the idea of building a new database or working out complicated formulas in Excel was overwhelming so I knew to avoid those tasks if at all possible.

    My migraines went chronic/intractable at the first of the year. I always have some level of migraine with head pain and other sensory issues. Some in my life have “suggested” that I do freelance work from home. The issue is that my brain rarely seems to function as it once did and I never know when those rare moments will be. It took me three tries just to correctly enter my username and password for this site so I could write this response. The last thing I want to do is tell someone I can have something done by “x” date and then not be able to get it done.

    Sometimes it seems there are no good answers. Well, there are no good answers that will meet my expectations of myself and the expectations others have of me.

  • Maggiecook
    5 years ago

    I do not know when the postdrome is over. Since I have so many migraines there are days where my brain is in la la land. Co workers can tell right away, and are very supportive of me.
    Sometimes I do some strange things on some of the paper work I need to get done, then I hear it from higher ups. I just tell them I was in la la land from a migraine, and straighten out the mess the best I can.

  • jo17151
    5 years ago

    My postdrome is more debilitating than migraine pain.

    I too don’t realize it’s a problem till I’m in the middle of something . . .such as ordering coffee and suddenly don’t remember how to say “medium dark roast” and don’t know what to do when the clerk says “that’s $1.70”.

    Similar to what Maureen had mentioned, years ago a counselor had me make up a list of 3 things at work that are a bit complicated, but I do well and without difficulty plus 3 “life” activities. Over the years I’ve changed my list – and go through spells when I just decide I’m good to go and don’t need a list. I did this recently till something bit me in the butt and I’m back to lists.

    Examples: 1. create a new spreadsheet and enter formulas 2.explain ABC to a client 3.compose an email to my boss requesting approval for XYZ. All things I can do on a fairly regular basis without hesitation.

    Life activities – 1.order coffee and engage in pleasantries with the clerk (or others in line)2. do my mom’s banking 3. plan balanced dinners for next week.

    Big confession: I will cheat when “testing” myself. There. I said it.

    To keep myself honest, I’ll make myself do the above out loud (rather than just reading the list). I talk to my cat or even to the mirror and then it’s really obvious when I’m stopping mid sentence/ drift to another topic / fumble for words. With the menu planning, I’ll sit down and usually draw a blank. As far as doing banking – I’ve made enough mess of my own accounts by transposing figures or making a transfer backwards. I would feel horrible if I did that to my mom’s accounts.

    Good topic!

  • Maureen
    5 years ago

    “If at first you don’t succeed, try, try again.” While this may be a cliche, I think it is probably a good rule to follow. If on the third try, you are still having difficulty, you probably ought to set it aside for later. Maybe you can order bills by due dates, or write a list of things to do when you are more fully functioning, but, probably, right now you should rest. You gave it the old college try, so give yourself a bit more time. This is probably a better time to indulge the self-care items you usually put off… hot bath, face mask, teeth whitening – or other less brain intense activities like light manual labor… dishes, laundry, sweeping.
    Right now I am in the twilight of definite one-sided, but manageable pain, (4-5)so no hard labor or hard brain work. Counting a stack of money was almost the end of me! How much is 18 five dollar bills??? Definitely one of the great mysteries of a migraneur’s world:)

  • Kelly (Miss Migraine)
    5 years ago

    This describes me to a T. I hate not being able to work because of a migraine, and I always jump back in as soon as I feel even a little bit better. But this winds up causing ANOTHER migraine because I didn’t give myself enough time to recover. I’m usually also mid-task before I realize my brain is still not working properly. Maybe I should try taking a cognitive function test before I get back to doing important things…

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