The Emotional Phases of a Migraine

When it comes to discussing migraines, it is the physical symptoms that tend to be the focus. In my 15 years of living with chronic migraine, this is the first time I have dissected the emotional journey of a migraine. Each phase has its emotional challenges from the beginning signs of prodrome to the exhaustion-laced postdrome. In this article, we will explore the emotional landscape of a migraine, offering insights and strategies for coping with the psychological toll of this complex condition.

Prodrome

The first phase of a migraine is prodrome. The American Migraine Foundation states that this phase can “begin several hours or days before the aura and headache phases of a migraine” and that some people confuse their prodromal symptoms with migraine triggers.¹ Some of the prodrome symptoms that are common for me include a stiff neck, a tight jaw, a lot of yawning, a craving for spicy foods, irritability, and sensitivity to lights, sounds, and smells.

There are a variety of emotions for me to process during the prodrome phase of a migraine. The two main emotions that I am faced with at the initial signs of an impending migraine are frustration and anxiety. To me, these emotions are wrapped together around the acceptance of a future migraine that will interrupt the schedule that is my life and the uncertainty of how long the interruption will last. There is a sense of helplessness hovering over the situation. The feeling of being overwhelmed can appear quickly due to navigating the physical symptoms of prodrome and the associated emotions while trying to handle daily responsibilities. All of this creates a lot of strain, which leads to irritability over small annoyances feeling more significant and harder to tolerate.

Aura

According to the American Migraine Foundation, an aura is “recurrent attacks of neurologic symptoms that can include visual, sensory, speech, motor or other central nervous symptoms.”² My aura normally comes as a speech disturbance, where I cannot form words or sentences for a while.

The first time I was struck with aphasia, my aura presentation, the fear is something that I cannot explain. I was talking to my mother, then all of a sudden the words would not come out. The helplessness we both felt at that moment was intense. Now that I know this will happen and eventually stop, the fear and helplessness are not emotions I continue to feel. People who do not know about my aura stage feel these emotions when I suddenly cannot speak.

When the aura phase takes hold, I experience some isolation because the only option is to ride out the aphasia. There is no magic fix for it. Additionally, I feel apprehensive because I know where this is leading, to a migraine.

Headache

The headache phase of the migraine is the most emotionally challenging phase for me. There are endless amounts of emotions that come along with the severe pain that disrupts the ability to focus on anything but the pain. Physical and emotional fatigue leads to a new level of exhaustion.

As the pain increases, I struggle with frustration and irritability. Every little thing bothers me as though it were a major issue. Sometimes even my hair touching my face or the dogs drinking water too loudly makes me want to scream. In other cases, frustration can build as the medications fail to manage the pain.

The guilt of missing life events or responsibilities can weigh heavily on individuals. There is also a heavy dose of fear. This fear ranges from wondering just how bad the pain will get to how long the migraine will last to the dreaded thought of an emergency room trip.

I spent yesterday and all last night in the headache phase of a migraine. I was frustrated because my medications were not helping and the option of going to the emergency room was even less appealing. This leads me to suffer the wrath of a migraine with what I have available to me because the reality of going to an ER is too much to deal with at the time. I was lucky enough to manage some sleep throughout the night, which was able to balance some of my emotions again.

Postdrome (hangover)

The postdrome, also known as the hangover, phase is exactly what it sounds; a phase in which your body is hungover without the night of drinking. This is a period when all the emotions crash together. There is relief that most of the pain is over but also depression from the combination of emotions and acknowledgment of what was missed.

For me, the brain fog continues, which is also frustrating. The mental drain can cause mood swings which range from being short-tempered to being whiney, like a toddler who did not have their nap.

As I write today, I am in the postdrome phase of a migraine. My brain feels like mush and I want to be held (much like a kid). Since I have a little touch of head pain mixed in with my cognitive confusion, I have some apprehension over the finality of this migraine. Part of me wants to shake off the brain fog and tackle the day, while the other part wants to curl up to recover more.

What emotions do you experience during a migraine?

Navigating the emotional phases of a migraine can be daunting. It is important to recognize and learn to manage emotions throughout the migraine journey. It took me a while to learn to realize why I was feeling certain emotions and manage my emotional reactions. This has helped prevent me from taking my emotions out on those around me.

What emotions do you experience and how do you navigate your emotional phases during a migraine?