Navigating Let-Down Migraine
Last updated: August 2022
When flying on a plane, have you ever come in for a rough landing? Like hard enough that the plane bounced on the runway? Perhaps even bad enough that the safety materials dislodged from the ceiling? I have, and it’s not a fun way to land.
That image comes to my mind every time I get a let-down migraine. It’s the same feeling. After maneuvering through a particularly intense period of life, down we come, back into the world of migraine — with a hard landing.
Crashing after a stressful time
People who’ve never had a migraine think I’m joking when I tell them there’s actually a condition known as “let-down migraine.” I suppose it does sound a bit ridiculous. In reality, all migraines are a letdown in that they are a disappointing turn of events. The condition really should be called a “come-down migraine.” It doesn’t happen to all migraineurs, but for many of us, after we’ve been through a particularly stressful time, we crash. And when we crash, we crash hard. Others can understand it more easily when you ask if they’ve ever had a cold or gotten sick on a vacation. Many people have had that experience, and it’s the same idea.Why do let down migraines happen? Researchers are still trying to figure out exactly what let-down migraines are all about, but they estimate that it has something to do with hormonal levels increasing during periods of stress and then decreasing afterward. When they decrease, the bottom falls out, and we pay the price. Even though migraineurs often feel like our heads are working against us, in this case, it seems our brains are attempting to protect us in times of stress.When do let down attacks occur?Whatever the cause, let-down migraines arrive like clockwork for many of us. They follow any period of stress, whether a particularly demanding time at work, a visit with family, or an unexpected emergency. Directly following the resolution of that stress, a migraine arrives, and for many of us, it’s an especially severe and stubborn one. An upside to these attacksProbably the only upside of a let-down migraine is its reliability. If you’re someone who gets let-downs regularly, you might consider planning ahead and doing your best to make some space and time in your schedule to respond to a potentially tough attack. So many times, we get surprised by migraine attacks. We scramble to cancel plans, to align care for children, to mobilize others to fill in where we can’t. PredictabilityLet-down migraine is one instance for which we might be able to reliably predict an attack in advance. In response, we might clear our schedules. The ability to plan ahead may reduce stress and may even decrease the likelihood of it occurring in the first place. If you surprise yourself and end up migraine-free, bask in the pleasure of resuming normal responsibilities or add in a fun unscheduled event. Avoiding the hard landingThough not discussed very often, let-down migraines are a very legitimate part of the migraine cycle for many of us. Migraine effectively steals so much time and so many experiences from us that it can be helpful to familiarize ourselves with all the ways it arises. Creating a good response strategy is yet another important way to be as well-prepared as possible. And maybe sometimes, we can avoid the hard landing altogether!
Are the family and friends you will be seeing this holiday season understanding about migraine?