Navigating Chronic vs Episodic Migraine

Over the years, I’ve dealt with many different types of migraine attacks: the Ice Pick, the Squeezy Brain, the Head on Fire, and the combo, Nauseated Brain on a Barbecue. While these are my own terms for my migraine variations, there are two more commonly recognized categories I can discuss in detail—since I’ve dealt with both: chronic and episodic.

Both bring distinct challenges and pros and cons, but here’s a breakdown of my lived experiences, along with a quick tip for navigating each.

Defining episodic migraine

The official definition of episodic migraine (EM) describes patterns where a person who experiences 0 to 14 headache days per month.¹ So, if this is your lucky number, it’s likely your attacks come and go throughout the month.

You could have two in a week, none in another, and then reset your migraine record by having four in a row (always a favorite). This brings up one of the biggest struggles those diagnosed with episodic migraines can face, and that’s the sheer unpredictability.

The unpredictability of episodic attacks

Right now, my migraine pattern follows the definition of episodic. After dealing with chronic attacks for many years, I never thought I’d be pain-free for even one full day.

However, working with my neurologist and finding the right balance of medications has made all the difference. Dealing with fewer painful days has helped me show up more for my family, work, and myself—and I’ll take it.

However, not knowing the day or hour an attack will appear definitely creates a low-key level of fear in my day-to-day. Whereas once I’d have to schedule my events around migraine pain levels, now I’m remaining active while creating a life that supports my overall well-being.

My top tip for managing episodic patterns

Keeping a migraine diary to log possible triggers like lack of sleep, weather, and too much caffeine helped me know when an attack is more likely to strike. Of course, there are still days my migraine feels random, and I can’t track it back to any likely culprit.

This is why I keep all my medications and tricks with me, either in my purse, backpack, or car. My relief medication of choice, Ubrelvy, is never unreachable, and I always have sunglasses.

If I’m going to be outside in the heat (my tween loves a good theme park), I also have reusable cooling towels or an ice pack. Being prepared helps take the edge off the anxiety of unpredictability.

Defining chronic migraine

Chronic migraine is a disabling neurological disorder defined as experiencing headaches on at least 15 days per month.² This could mean one relentless attack could last for days or weeks, or presents as a recurring cycle favoring one side or flipping from side to side.

Any way it presents, a break from a migraine day is hard to come by. For those experiencing chronic attacks, your level of predictability is technically more dependable, but pain levels constantly influence your life choices.

How severe pain levels impact daily choices

When I was dealing with chronic migraine, my days revolved around lowering pain levels, avoiding triggers, and planning around the next attack. There was no question—at some point, a migraine was in my future.

So, it came down to how tolerable my pain was and how much downtime I needed to have functional time. In many cases, I had to cancel plans, and it was hard to move through the guilt and frustration chronic migraine brought to the surface. I did my best to remember that taking care of myself ultimately meant more quality time spent with my family.

My top tip for navigating chronic attacks

Being over-prepared and prioritizing self-care went a long way toward eliminating some of the anxiety. My migraine bag of tricks was stocked with things like relief medications, anti-nausea treatments, Tiger Balm, eye masks, Advil, and earplugs.

These all helped reduce stimulation due to bright lights and noises, which ultimately reduced the head pain. This lived in my nightstand, and I took it with us wherever we went—along with a cozy blanket I kept in my car for an emergency nap.

While living with migraine is no picnic—knowing your migraine pattern can help you take care of yourself and come to the Migraine Picnic feeling a little more prepared.