I’m Sorry for What I Said When I Was in Prodrome

I used to say “I’m sorry for what I said when I was hangry,” but what with my eating protein-rich foods every three hours to keep my blood sugar even and ward of migraine, hunger is no longer the issue.

Prodrome -- the first three stages that usually play out during a migraine attack -- can be pretty elusive. It can include everything from yawning to brain farts. Usually, I know something’s up when I feel escalating, acute pain in my neck or shoulder. Other times I know an attack is on its way because my brain feels as if it has outgrown my skull by about four sizes. If I can smell someone’s perfume from across the room and it goes straight into my frontal lobe like a thousand tiny daggers, that’s also a pretty big clue. Another telltale sign is full-body fatigue and muscle burning, felt while going up or downstairs like a 95-year-old former construction worker.

I’ve tried to be hip to prodrome’s ways so that I can catch attacks early on and medicate with a triptan before things get too hairy, but the one prodrome symptom that I just can’t seem to nail down has to do with sudden, plummeting despair and/or irritability. I usually don’t notice it until other symptoms take hold, and then go “oh yeah… I took a hugely grumpy turn about half an hour ago!” I’m not sure why this symptom can trick me so easily. Is it because my sadness or irritability is usually focused on something, however small, and I assume it’s justified? Is it because living with migraine is hard, and it’s totally reasonable to become really upset about cancelling plans or sacrificing my health to carry them out, or something so simple as not being able to order anything on a trigger-ridden menu?

The weirdest thing about this prodrome symptom is that unlike pretty much every other symptom, it can make itself visible. My partner can sometimes sniff out a migraine before me if he notices that I’m not as attentive during a conversation, or I’ve started freaking out about something that’s usually not a big deal. One time we were having a nice meal at a deli, and all of a sudden I realized I hadn’t taken in his last few sentences. Despite the delicious meal, the lovely atmosphere, the nice day, I was suddenly feeling low and uncomfortable all over. I felt my face freeze with irritability. He said “you’re going down aren’t you?” and sure enough, about 20 minutes later the symptoms began piling on top of each other.

In one way, it’s comforting that my partner knows me so well he can spot an oncoming attack before me. In another way, it’s unnerving. Shouldn’t I notice when my mood dives so low, so quickly, that I can’t participate in normal conversation?

Migraine is the ultimate trickster, but I’m determined to wrangle it the best I can on any given day. Bit by bit, I am getting better at catching on to all the weird and wonderful (minus the wonderful) prodrome events, but in the meantime, I’m sorry for what I said when I was in prodrome.

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