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Navigating Let-Down Migraine

Navigating Let-Down Migraine

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.

When we crash, we crash hard

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.


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 afterwards. 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.

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.

Clear the decks

Probably the only upside of 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. Let-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.

Though 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!

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

  • katetyndall
    2 months ago

    Exactly so, Holly. Once I relaxed into freelance, and found that I could make a living at it, the let-down headaches that came swinging in after every deadline was met went away. Unfortunately, all their little nephews, cousins, and distant relatives kept showing up to bedevil me! Such is life with migraine.

  • katetyndall
    2 months ago

    I am no stranger to this phenomenon.

    While I no longer experience the let-down migraine, it was a huge feature of my migraine history when I was in my early to mid-30s. I was working for UPI, a new hire, when the company, which had never operated in the black, implemented a round staff reductions to reduce its debt load, and as one of the last hired group, I was let go.

    It was a shock. I started freelancing to make money while beating the bushes for a job. It was a very stressful period. Migraines came and went, but the hellish 4-day migraines that arrived like clockwork were the ones that came literally the moment I sent off a piece of work. Not when I was soliciting clients, not when I was interviewing, or writing my articles, but when they were done. Any pleasure I got for having accomplished another article was experienced in the minutes before that migraine exploded in my head like I’d been hit with a baseball bat.

    I had let-down migraines for about two years. Apparently I was resisting the obvious—that freelance WAS going to be my career. Thirty-plus years on, I’m still at it. It’s been a great career for me. But it came with huge stressors in the beginning, and it was only looking back that I saw the pattern. I did experience other migraines at the time, but they were not of the same intensity nor did they come with the predictability of those let-down migraines.

  • Holly Baddour moderator author
    2 months ago

    What a great story, @katetyndall. I’m grateful you shared the process of how you transitioned from working in an office (I assume) to becoming a freelance writer. Isn’t it fascinating how we often resist change out of fear- and then often find that our lives take us just exactly where we are best suited to be.

    Do you attribute the fact that the let down migraine pattern dissipated to the way the work related stress eventually relaxed, even though you continued to have deadlines?

  • Kathy L
    2 months ago

    I too suffer the dreaded pain and fatigue of the Let-down migraine. I work in a very fast- paced, stressful job taking care of cancer patients in an infusion center. I have chronic migraines, which come on every night and when the weekend comes, my brain feels like it’s on fire. I’ve tried Amovig, Ajovy, and now Emgality with very little relief. Any tips on managing the stress that seems to be an unavoidable part of life? Thank you.

  • Holly Baddour moderator author
    2 months ago

    Hi @kathy-l – Such a good question you pose regarding the management of stress to avoid the let down phenomena. We have an article on the topic here which will hopefully provide some ideas: https://migraine.com/blog/keeping-stress-consistent/

    This article has some additional ideas as well: https://migraine.com/blog/10-uncommon-ways-to-reduce-stress-for-health/

    Sounds like you’ve such a stressful (and worthy) job. It certainly seems reasonable and logical that you’d be exhausted and depleted and experiencing an uptick in migraine when ‘coming down’ from work.

    So glad you’re a part of our community. Please stay in touch.

  • Holly Baddour moderator author
    3 months ago

    Such a good question you’re asking, @debsb. I had an appointment with my specialist today and we were talking about this very thing. The topic was about how, in times of extreme stress or trauma, migraines often take a back seat- something having to do perhaps with receptors being shut down- and/or with cortisol/corticosteroids playing a part- but whatever the case it’s VERY understudied. One would almost wonder if there could be a way to weaponize cortisol against migraine.

    I do think some people who know that letdown is a regular part of their migraine pattern tend to treat proactively to try to avoid it hitting quite so hard– perhaps taking a rescue medication before the first sign of a migraine appears, for instance. Food for thought, about which I hope others ring in. Good question!

  • DebsB
    3 months ago

    Thanks for sharing Holly! I really didn’t know the “come down” migraine was a thing…I thought it was just my thing. It is one of my biggest triggers-anything fun, noisy, dance-y, lights, butterfly-giving (eg public speaking), late nights etc. I am not going to stop doing those things, but (strangely) had never considered preparing for the aftermath. But now I will! I wonder if anyone has found a way of managing the “stress” of these things in a pre-emptive way? I am going to think about ways of making (what I assume must be cortisol) stay lower during these events that I know lead to migraine. Has anyone out there in migraine land tried anything that worked to minimise Let Down Migraine?

  • glassmind
    3 months ago

    @DebsB,

    I have had some success with pacing myself for and through “fun” things (staying in the day before and after as well as taking mini-breaks during the even or shortening my time) and also with taking anti-anxiety medication before fun stuff. It isn’t that the fun stuff makes me anxious, but taking the medication seems to help reduce my sensitivity to the migraine triggers.

    I do not like the medication approach, though. I use it when I’ve no other option. The medication makes me slower and I feel “bored” which negates the whole point of doing something fun. So, generally this is my go-to for social obligations like childrens’ plays, a friend’s birthday out on the town etc.

    Otherwise, I’ve grown quite happy with changing my idea of what is “fun”. It’s much more fun for me to watch a movie at home on the small screen with my friends than go to a theater and have a migraine after.

    It’s what works for me.

    May you find what works best for you to have many fun times.

  • sfnative
    4 months ago

    My former neurologist, founder of the California Association of Neurologists (now deceased) termed these migraines “rebound migraines.” During one office visit, he noted that I was complaining of quite a few spikes in chronic migraine on Sundays, which is indicative of one who has had a stressful or intense week.

  • sfnative
    4 months ago

    Regardless, the term “Rebound” is what my neuro used and it makes semantic sense. Yes, I have had two migraine specialists since his passing and after having moved; however, with our last move, we now live in a deplorable medical community. I needed a new internist, because mine literally walked off the job one Friday. Thought I had finally found one, until he uttered the follow, “Chronic migraine? There’s no such thing.” I called him on the carpet for not being current on his journal reading, plus a few other choice words, during our 20 minute back and forth tirade. It was horrible. He was yelling at me about drug addiction! Needless to say, I never went back. Since moving here, I have no migraine doc. I asked my neuro (for other clinical issues) what to do in this city if I have a really bad spike in pain that’s not going away and explained that my spikes can last 3 days to 3 weeks. Could he call in a migraine cocktail to the ER for me? He refused and simply told me to go to the ER. Well, that was a laugh. Went once and was just about laughed out of there. Was given 5mg oxy and told to go home and feel better – and this with a 35 year migraine. Can’t say I’m happy living in this city, where I’m stuck forever.

  • Holly Baddour moderator author
    3 months ago

    This sounds like a waking nightmare. I’m so sorry you are up against this demanding and draining complex neurological disease without a migraine specialist anywhere in reach. This is the unfortunate reality for many as there is a major shortage in the world of this kind of doctor. I’m surprised to hear the cavalier response of your neurologist on how to deal with a severe pain spike as it’s common knowledge that the ER is just about the worst place for migraine management. https://migraine.com/living-migraine/not-drug-seeking-feeling-judged-when-seeking-medical-care/ Might it be worth sending him research on that front? https://migraine.com/?s=emergency+room

    You sound very well-versed in migraine given your long history with the disease, so I’m assuming you’ve looked everywhere for a specialist, but I’ll send you this link to specialists in the US on the off chance it might offer you a lead. https://migraine.com/blog/the-mrf-directory-of-headache-and-migraine-specialists/

    In the meantime, please know we’re thinking of you and are so glad you’re a part of this community. You are not alone in dealing with this and we are here to provide you with support anytime.

  • Holly Baddour moderator author
    4 months ago

    Hi there, @sfnative– thanks so much for chiming in! “Rebound Headache” is actually a separate phenomenon from “let down.” Rebound Headaches occur when we take certain medications repeatedly over the course of several days or more that can end up causing their own headache pattern. Opioids can do this but so can triptans and even OTC medications like excedrin. https://migraine.com/headache-types/rebound-headaches/

    This is a different issue from letdown migraine which can happen as a result of our bodies coming down from an exciting or stressful situation or week (as you mentioned). Some think this has something to do with cortisol levels shifting. These attacks are not medication-related. Perhaps these terms have evolved over time.

    There are so many different feeders that can lead to migraine, it can feel like a minefield – especially when we are living with them chronically.

    So glad you’re a part of our community. Were you able to find a good migraine specialist after yours passed? That in itself can be a symbolic headache. Are you still experiencing the Sunday migraine uptick? Did you find a way to manage that pattern?

    It’s so helpful to find ways to learn from one another. Thank you for sharing your wisdom here.

  • Pateena
    5 months ago

    I had no idea that is was a “type”. I always noticed AFTER a very stressful time the migraine would come. It would be frustrating because I felt relief when the stress was gone only to get a migraine. 🙁

  • Holly Baddour moderator author
    5 months ago

    Glad this article helped you see that you are experiencing something that is common and normal- even if it is such an inconvenience and so painful. Glad you are a part of our community. Please stay in touch.

  • CatMom
    6 months ago

    Ditto! I just had a total hip & my surgeon doesn’t believe in opioids. Rehab was a nightmare. I did take some leftover oxycodone (chronic pain patients don’t abuse oppioids, we hoard them) for a 3-day migaine & the difference was substantial. Opioids do not do anything for all the other migraine sx, but the excruciating pain was less than usual.

  • MigrainesSuck
    6 months ago

    My doctor has always called these opioid headaches. But if I don’t use my fiorinal and still have one, what is that called. I am so frustrated that this “war” on opioids only hurts those of us that need them. I rarely use them but sometimes they are necessary.

  • Holly Baddour moderator author
    6 months ago

    Hi there- I think you might be referring to the phenomenon known as “medication overuse headache” (MOH) or “rebound headache”. These occur when we take certain medications repeatedly over the course of several days that can end up causing their own headache pattern. Opioids can do this but so can triptans and even medications like exedrin. https://migraine.com/?s=Medication+overuse+headache+

    This is a different issue from letdown migraine which can happen as a result of our bodies coming down from an exciting or stressful situation. Some think this has something to do with cortisol levels shifting. These attacks are not medication-related.

    That said, you raise a very valid point about how the war on opioids (an important one) is overreaching and negatively impacting people who have a legitimate need for this class of drugs. https://migraine.com/living-migraine/access-medications-opioid-crisis-era/

    Thanks for chiming in!

  • nana55
    6 months ago

    I suffer from these let down migraines. And planning for.. and telling my loved ones or those I am around that the likelihood of a major migraine. ..seems to help those around me also prepare for me to be out of commission. I try to explain that good stress ( the wedding reception, the wonderful vacation we just went on, etc.) Is still STRESS. People understand bad stress but oftentimes they don’t get how good stress can be the cause of a migraine just as easily.

  • Holly Baddour moderator author
    6 months ago

    Hi nana55- Thank you for doing such a fine job articulating this issue of good stress being just as much of a trigger as bad stress. You’re so right that this is something that most people do not understand. It all has to do with excitement- getting worked up- being in an unusual circumstance- all of this combines to do a job on our cortisol levels- and then the letdown hits! Thank you for chiming in on this. Very enlightening.

  • glassmind
    6 months ago

    Can we call this type of migraine “life hangover”?

    Lol

  • Holly Baddour moderator author
    6 months ago
  • glassmind
    6 months ago

    Very informative.

    I used to have these migraines. I called them “emotional rebound migraines.”

    I say “used to”, because as I’ve grown increasingly aware of my own migraine stages, I realize the migraine for me actually starts during the stressfull event, but I used to be so wrapped up in the event that the looming migraine was ignored.

    Sometimes by accident, as in an event in which I’m having a good time, but there is a lot of socialization, noise, emotional excitement, etc. It’s a real bummer that an extremely happy time can lead to a migraine. It’s like my brain is a toddler at a party. Binging on sugar and then having a meltdown. Ugh.

    Other times, pushing the migraine aside is a subconscious survival mechanism. If I’m attending a sick relative at the hospital, having a migraine will only make things worse. So, “Thank you body for delaying the migraine!”

    Emotional stress in general will push migraine upon me. Heated converasation with a friend? Check. Heartwrenching movie about distressed animals? Check. I’m rather disappointed in my body’s inability to process strong negative emotions without resulting to a migraine.

    I’ve accepted that I am a “delicate soul”. In addition to triggerring migraine, emotional stress exaccerbates my heart conditions (arrythmia and hypotention). I’m the person likely to faint at unexpectly great news.

    Acceptance only goes so far though.

    It’s still annoying and the migraines are still crippling. And the social fallout can be socially debilitating. It’s difficult to explain to others and hard for them to understand that rather than being stoic, standoffish, spoiled, or “high-maintenance”, I’m just trying to keep stress in check less I pass out and wake with a migraine.

    Soooo fun being so frail.

    Thanks for raising awareness on the link between stress and migraine.

  • Holly Baddour moderator author
    6 months ago

    Hi @glassmind– Thanks again for sharing your journey here. I’m grateful for the way you demonstrate how incredibly complex this disease is and how deeply it can challenge us. It is NOT easy to navigate and it IS crippling.

    I do think there’s something to accepting that we migraineurs are different from our peers. I think it’s important, however, to take care in the way we label ourselves. For me, it’s been helpful to avoid terms like “frail” and “delicate” when referring to myself. Indeed, I believe I’m one of the most strong and tough people I’ve ever encountered. The level of severe pain and frequent vomiting that I’m coping with on an almost daily (and sometimes constant) basis is something that has called forth a level of strength and resilience in me that many people never have to access.

    I do believe migraine disease involves a dynamic that makes us more sensitive than most (also, not always a negative thing – in that our senses are more finely attuned). (Did I already recommend that you take a look at the book called “The Highly Sensitive Person”?- I have a feeling you might be interested…) That sensitivity is what leads to our being vulnerable to our environment (noise, lights, stress, etc).

    The disease is something we are born with and is out of our control. How we choose to respond to the disease is a reflection of our character and is in our hands. That said, there are certainly times that I am exhausted by migraine and am left feeling weak, depleted and frail. But I try to see myself as strong as the definition alone can serve to lift my spirits and strengthen me along the way.

    Does that resonate at all?

    I’m grateful to be in touch with you and love the way you think with such care about so many aspects of migraine. Please continue the conversation and stay in touch.

  • glassmind
    6 months ago

    Thanks. I appreciate the exchange also. Hugs

  • Holly Baddour moderator author
    6 months ago

    @glassmind– I LOVE this dialogue and am grateful that you were gracious enough to take such time to illustrate your thinking. No, you did NOT over-explain.

    You educated, illuminated, and enlightened.

    I’m better for having read your words and sat in your chair. I believe this site is most valuable when we invite each other to wear one another’s shoes and to take a walk so we can learn how it feels. To see through each other’s viewpoints. Doing so is how we can genuinely learn and grow as we are all navigating this challenging journey.

    These are very real issues with which I wrestle (I believe we all do). I’ve learned from you and will continue to reflect on what you’ve shared.

    Thank you for such an in-depth, authentic exchange.

  • glassmind
    6 months ago

    Sorry for all the typos. I’d love if we could edit our responses after posting. Alas.

  • glassmind
    6 months ago

    Holly,

    Agreed! Words matter. I encourage each to claim those that work,for them.

    I use the word “frail” only in description of myself. My intention was only ever to refer to my own situation.

    Personally, “frail” and “delicate” are empowering for me. I am also strong. Glass is strong, but also able to be shattered. Silk is delicate and strong. Everything, really, can be found strong against one pressure and weak against another. We mix concrete and steel to combine thier strengths and balance thier weaknesses. Even concrete and steel have frailties.

    The empowerment for me comes in the honor and recognition of my weaknesses.

    A butterfly is frail (so easily bruised) and strong (rides turbulent air and storms as aids rather than hinderances to migration).

    When I admit to myself my delicate nature, I claim it. I honor it, I respect it. When it annoys me, the acceptance reminds me of the benefits. When others try to use such terms with pity or derision such effect fails. I’ve claimed my frailty.

    I spent many years avoiding terms like frail, delicate, or sensitive and tried operating as if I were hardy and impervious. I caused myself undue harm operating as if I was able to handle the same rigors as others or trying to prove to myself I could overcome something.

    When I claimed my identity as having a frail body (in someways), I became much more careful and respectful of my own limits and needs. I became my own best advocate. I stopped causing undue harm by having an m.o. based on a delusional idea of my strengths. I stopped falling ill by accepting social pressures beyond my abilities. The sting of stigma lessened as each “wow your sensitive” Transformed in my mond to “Heck, yeah, I am. It’s awesome!”

    I do bruise and break easily compared to other humans (and less than some). I do fall to migraine at stilmuli others take in stride (and tolerate some others must avoid).

    I have delicate a constitution and a hardy one.

    And I am strong. I pass through and rebound from adverse health events that others might be shattered by. I operate on a daily basis at a pain level that others might find unbearable. I can do handstands. I’ve got an endurance for the daily stressors of life that jas grown put of respect for my limits to those very stressors. My resiliency of spirit is matched only by the morbido my conditions sometimes raise.

    Each to hirn own words.

    For me, I am a very strong kind of frail.

    Frailty is part of my identity and I take that as a high compliment.

    The word just works for me.

    It can actually be fun. I enjoy a mental challenge. It tickles,my mind to figure out, “Okay, how do I accomplish this while being frail? How do I do this an keep my delicacy intact?”

    And it reinforces my strength when I figure it out and accomplish some thing that is difficult for a sensitive body, mind or soul.

    Whew, did I over explain? Lol

    I totally meant “frail” for myself. And that frailty encludes strength.

    Cacti are soft and squishy, easily damaged with too much watering or trampling, and…and they are spiky and resilient to wind and drought.

    Every fraility has a strength as partner in the ying-yang of my life.

    Thanks for calling me out and inspring me to balance the frail with the strong in my language.

    Much love.

  • ezlivin1
    6 months ago

    I’ve learned over the years that it is so much easier and less stressful to basically become a home body. I tell my wife that she is my emissary to the world. Luckily she doesn’t mind it since she loved going to the market almost daily and just getting out and driving her car so she can listen to music and talk loud on her phone. I’ve found that stressful situations can be made worse by asking rate people to please speak softer. After repeatedly asking they get upset and say that why is it I can speak loudly yet they must not. If I’m speaking loudly I really can’t usually tell during a migraine attack which is quite often. Things become more stressful or the migraine causes it too feel more stressful.

  • Holly Baddour moderator author
    6 months ago

    So great that you have a partner who is happily willing and able to do the errands and events that need tending in the world. It can, indeed, be easier to live a quieter life when managing migraine.

    Volume is so skewed when we are in the midst of an attack. Normal noises suddenly can sound incredibly loud. https://migraine.com/living-migraine/living-quiet-place-triggers/

    And as you said, migraine can compound the sense of stress around us. Here is an article with some ideas about how to cope with stress you might find helpful: https://migraine.com/blog/10-uncommon-ways-to-reduce-stress-for-health/

    Thanks so much for your comment and please stay in touch!

  • Bulldog
    6 months ago

    I have this trigger! It’s clockwork. All my migraines begin early in the morning while asleep. Every vacation, after every test, etc.

    Has anyone had any success with anti-anxiety medication (like buspar or Klonopin) to reduce stress during stressful times to reduce the let down effect?

  • BrownT
    6 months ago

    Hi Bulldog
    I too deal with event migraines. They are so predictable that I attempt to address them just before happening or lessen the affects. For instance I use ear protection when dealing with loud noises such as going to the movies. I have electronic head protectors that shut off when the noise is louder than 82dB. Also if I expect it to be mostly loud like on a plane I put in foam ear plugs.
    I terms of medication, as I have migraines constantly, it is challenging to use abortive like imitrex. However, with predictable events I sometimes take imitrex as a preventative. Like fighting the migraine before it has a chance to kick in. Not something the manufacturer would suggest. It has aborted or lessened a number of the predictable migraines. I also use clonazapam as glassmind suggested. It helps to take the edge off and more importantly to keep me calmer. I also have significant anxiety to manage with migraines and this is very helpful. Even muscle relaxants can help so I do not tense up too much when responding to the migraine. I find magnesium also helps as a preventative in that it helps with muscle tension.
    I use sun glasses to help with the brightness of the events.
    All these things help depending on the event and the anticipated migraine response. However, I still find the early morning migraines one of the more difficult to deal with.
    Good luck as you experiment and try to find a solution that works. As you get more success keep in mind that you may need to stay flexible as different things work for different events.

  • Holly Baddour moderator author
    6 months ago

    Hi @brownt– thank you so much for chiming in to share some of your story and to provide guidance and support to others. You sound like a very experienced migraineur (unfortunately) but we sure are grateful to have you here to share your wisdom. And yes, morning attacks are the worst as we sleep through the signals and prodromes and miss the chance to stop the attack before it’s full blown. Awful way to start the day.

    Please stay in touch and thanks again for being a part of our community!

  • glassmind
    6 months ago

    I take clonozapam (an anti-anxiety medication) by prescription, off label for migraine.

    I typically use it only after an attack has begun, but if going somewhere with known overwhelming triggers (a festival, airshow, etc) I will take it as a preventative.

    It does seem to help me tolerate the stress of noise and crowds so reduces those triggers, but has no dampening effect for smells or lights. I still have to limit my exposure to high stress events.

    I imagine the level of anti-anxiety medication I would need to offset the stressful triggers would sedate me too heavily to function.

    I’d rather just avoid the stress and live a boring life than be so heavily medicated that I am mentally absent even while my body is present.

    That is just my experience. I am highly sensitive to medication side effects and others may find more theraputic benefit in anti-anxiety medications.

    May you find a way to enjoy your vacations from the very first morning!

  • DebsB
    3 months ago

    oh yes, smells!!! I never think of them as a trigger…until they trigger. My poor daughters have to pass perfume choices past me before they can wear them in the house!

  • Holly Baddour moderator author
    6 months ago

    Sorry to hear this is an issue for you, but you pose a really good question, @bulldog. I hope our community will respond with answers to this. If you have the time, perhaps pose this question on our Q&A page where it might result in more people seeing it and therefore yield more responses: https://migraine.com/q-and-a/

    Glad you’re a part of our community. Please stay in touch!

  • imatmywhitsend81
    9 months ago

    I have never heard of this before, but this is EXACTLY what I have!! I started getting migraines 4 years ago. They got closer and closer until I had one everyday! I’ve tried everything from lidocaine shots in the back of my head, to burning nerves, to Botox injections, and now monthly shots; none of which have really done much. I teach and do ok while teaching because I’m distracted, but at night and on the weekends I have these catostrophic migraines that land me in the ER sometimes. Other times they drag on through the week until the next weekend, where it is 10 times worse. I never understood why weekends sucked so much, but this makes perfect sense! So now what? Nothing works for my migraines. I have tried it all, and I mean EVERYTHING! I’m glad it has a name. That is comforting. It’s comforting to know I’m not alone, but I’m afraid that I’m going to have to just tough it out the next 45 years!

  • Holly Baddour moderator author
    9 months ago

    So glad you have a name for it! That can be so relieving to know you are not alone and that you are experiencing something very real- very valid. Glad you have felt that comfort and relief.

    So, yes- now what? It does sound like you have the classic episodic morphed into chronic migraine issue. And it also sounds like you must be working with a migraine specialist to have tried all of the therapies you mention. And nothing has been really effective so far. AND you are working! That’s a lot. Many people with your load of pain seek disability because the challenge of working gets too much- but it’s great to hear you feel your work can serve as a positive and effective distraction.

    Still- UGH! So frustrating about the intractable pain. Well- unfortunately you are not alone in this either! There are many of us out here who are struggling each day to get comfortable despite having some semblance of pain or migraine every single day. So, perhaps you do just exactly what you are doing! You reach out and connect with others to find support and understanding – pushing against the isolation that migraine tries to impose- you celebrate the small victories- like gaining comfort in naming certain types of migraine– and you give yourself as much compassion as you possibly can.

    This is a challenging journey- but it’s doable and again, you are not alone. Also, new treatment modalities are being developed as we speak so we keep holding on, waiting and trying new things. My doctor talks a lot about trying new combinations of treatments- like botox AND CGRP- because while perhaps one won’t work, maybe they will work in concert.

    I was also listening to a podcast this morning on mindfulness, and it was all about the importance of naming things rather than getting caught up in them. You gave a perfect example of that today. Giving a name to let down migraine releases its power over you in many ways. It might be also that just acknowledging the frustration of migraine might help alleviate some of the heaviness that comes with living with it. I’m going to try to practice that a bit. Just saying to myself “this is hard!” because it is. But that doesn’t mean the hardship is me. It just means I’m noticing something difficult. Hard to explain, but it does lighten the load a bit.

    So glad you’re a part of our community. Please do stay in touch!

  • glassmind
    6 months ago

    Naming is so helpful!

  • Inoexactlywhatumean
    9 months ago

    My doctor explained it to me as the “weekend migraine.” The stress of the work week and taking care of business keeps symptoms at bay. Often I may be looking forward to fun plans for the weekend, but as soon as Friday night arrives, and I let down my stress, the symptoms begin. Often the whole weekend is shot. Pathetically, I am glad that I don’t have to miss work and deal with possible repercussions or lost wages. It happens so often, and on an objective level, it makes so much sense to me. It’s also so unfair!

  • Holly Baddour moderator author
    9 months ago

    So sorry to hear that the letdown/weekend migraine dynamic is part of your frequent life experience. That is really rough to manage and navigate. So glad you are a part of our community here at Migraine.com. Please stay in touch!

  • wenweb
    9 months ago

    I have not had the exact reaction you refer to, but often get migraines when my (life) situation has COMPLETELY changed, such as traveling.

  • Holly Baddour moderator author
    9 months ago

    Thanks so much for chiming in on this. You are not alone in having travel as a trigger! We have a forum dedicated to the topic and many articles, too.

    https://migraine.com/topic/migraine-and-travel/
    https://migraine.com/video/secret-travel-tips/

    Here’s a link to all of our relevant travel trigger articles in case you’re interested:
    https://migraine.com/?s=traveling+trigger

    Please stay in touch and so glad you’re a part of our community!

  • 38_years
    9 months ago

    Yup. I used to push through the workweek because I couldn’t afford to miss any more days of work. Then, Saturday morning. BAM! The whole weekend was shot. Monday AM, dragged myself back to work and every weekend got worse. It’s a downward spiral.

  • Holly Baddour moderator author
    9 months ago

    Thanks for chiming in on this topic. You use the past tense here so I’m interested to hear how things resolved for you. Did you eventually retire or find a way to manage? Would be grateful to hear more of your story if you’ve got the time to share. It’s so helpful to learn from each other. Thanks!

  • LCW1
    9 months ago

    I think a lot of my migraines are stress- and anxiety-related. I get sometimes get them once an event starts, too. Like going to a new art class that I signed up for! I’ll feel the migraine starting almost upon arrival. Let downs are definitely a reality for me. Does anyone have advice? I am otherwise very healthy.

  • Holly Baddour moderator author
    9 months ago

    Hi there- thanks so much for sharing. I tend to agree that migraine attacks can flare up when we engage in activities that cause our anxiety to rise. Migraine thrives on change in general (shifts in hormones, changes in barometric pressure, etc) so it would follow that the introduction of a new situation would cause our cortisol levels to shift and feed a migraine.

    As for advice, if stress is a known trigger for you, perhaps reflect on ways to calm and center yourself prior to events that trigger stress. Meditation works for some people, yoga or exercise (simple walks) works for others. You might also discuss this dynamic/trend with your migraine specialist as there might be a medication you could take as needed to help navigate stressful situations (diazepam type of thing). Here are some articles on the topic of managing stress that might be of interest to you:

    https://migraine.com/blog/keeping-stress-consistent/
    https://migraine.com/blog/10-uncommon-ways-to-reduce-stress-for-health/
    https://migraine.com/infographic/managing-stress/

    Thanks again for chiming in. Let us know if you find something that works for you.

  • LCW1
    9 months ago

    Thanks so much! I’ll let you know

  • Kas06019
    10 months ago

    The majority of my migraines happen after work or on the weekends, and they make me feel absolutely crazy! It’s so hard to document how debilating they are to my doctor or employer when I’m not missing work. It also leaves me absolutely exhausted and in desperate need of down time and a break from work, but looks ridiculous to employer because I spent the whole evening/weekend with a migraine. I experience so much burnout in full time jobs because of this cycle. I don’t want to spend all my non-pain hours at work. That’s not a life I want to lead. Thanks for the article, I didn’t realize just how common this type of migraine timing was.

  • Holly Baddour moderator author
    9 months ago

    What a great point you raise! That this dynamic of let-down migraine can lead to a very dysfunctional cycle of our spending our only well time working. I remember this very clearly- and it is what eventually led to my being sidelined from my career and having to pursue disability as, eventually, my well-time became less and less until I was in constant pain. But I do remember spending all my energy at work and then getting home and crashing on the nights and weekends where I would watch my kids from my bedroom. It was not the life I wanted. What happened with me is that I eventually started showing up at work exhausted because the weekends were spent fighting migraine, and the attacks would then bleed over into the workdays and weeks. My episodic migraines morphed into chronic. You are not alone in experiencing this cycle and I hope you can work with your doctor to regain some semblance of balance so that you can have a better of quality of life and well-time when you’re at home. Let us know how things go. So glad you’re a part of our community.

  • Kimbo650
    10 months ago

    These used to be called the “Monday Morning Preachers Headache”, for all of the reasons discussed here. I’ve suffered with migraines since I was 15, now at 56 I think I’ve heard it all as far as “reasons” for getting them, what I should and shouldn’t be doing. So far, simply the fact I exist is the only concrete reason I get them

  • Holly Baddour moderator author
    10 months ago

    Truer words were never spoken! Indeed, when we are living with migraine for decades, we are initially desperate to unearth all the causes and triggers. We then do all we can do avoid those things and still, the attacks come. It took me a while to get comfortable with using the term ‘disease’ in relation to migraine. However, eventually, due to this exact process, I came to understand that that’s exactly what migraine is: a complex neurological disease. Our brains are different, our senses are different than those of others. It IS because we exist that we get them. Glad you’re a part of our community, Kimbo. Please stay in touch!

  • suzesuze
    10 months ago

    For over 30 years I’ve said I had let down migraines. Thought I named it.

  • Holly Baddour moderator author
    10 months ago

    Hi Suze- well, if it was over 30 years ago that you began talking about let-down migraines, perhaps you DID coin the term! Either way, I’m sorry to hear you’ve been dealing with this reality for so long. A challenging journey, to be sure.

    Very glad you’re a part of our community. Please stay in touch!

  • sylvest2
    10 months ago

    I remember every Sunday my dad having wicked headaches. As I look back, I would say he was experiencing let down migraines. He was a hard working man with long days and when he tried to slow down for Sundays, he almost always had a headache. As kids, we stayed out of the way. As an adult, my two sisters and I both are plagued with migraines. Our Mom had a stroke; after spending several nights away in Denver where she was taken, we all three ended up with migraines when we got home. One sister didn’t even make it home and was bed-bound for a day. There are many instances when I get a let-down migraines, usually after or during the holidays or stressful events or the weekends after a hard week of work. I hate the times I lose out with my family because of the.

  • Holly Baddour moderator author
    10 months ago

    Thanks so much for sharing this story about your father. I had the same realization in looking back at my time spent with my grandfather on weekends during which we were told to be quiet, with darkened lights. We didn’t know why at the time, but now I understand (and fully appreciate) what he was up against. Also, your situation (with all of your siblings) certainly confirms migraine as an inherited disease.

    Let-down migraines are a bear to manage. I can only imagine doing so among a group of family members who are doing so at the same time!

  • carolelynn
    1 year ago

    My old neurologist used to call them “weekend headaches” and he said they were very common. He told me so many of his patients used to complain about having migraines AFTER work, on weekends or vacations.

    I had a very stressful job and it seemed like this was always happening to me. I used to rationalize that I was lucky they didn’t hit while I was in court (I was a D.A.) but was so frustrated to be down and out on the weekends.

    The doctor told me that this is very common and in fact it’s more opportunistic for a migraine to hit when you’re the most relaxed.

  • Holly Baddour moderator author
    1 year ago

    Thanks for sharing this input from your neurologist. The term “opportunistic” is definitely fascinating!

  • kitkat2255
    1 year ago

    So relieved and happy to see this article! I have been telling physicians, family and friends for years that I often get migraines after stressful events, not during. I often thrive and operate well under stress but am incapacitated afterwards with migraine headache, nausea, and fatigue. Not many have believed or understood this phenomena.

  • Holly Baddour moderator author
    1 year ago

    So glad to provide information to legitimize something you’ve been experiencing for years! Most migraine specialists know of this phenomena. If you’re not working with a migraine specialist, you might consider seeking one out, as they are the best trained to help navigate the complex neurological disease that is migraine. https://migraine.com/blog/the-mrf-directory-of-headache-and-migraine-specialists/ Thanks for your comment!

  • christina
    1 year ago

    That’s me for sure. I can’t really let myself get to upset on a matter because I will pain for it in a severe way.

  • Holly Baddour moderator author
    1 year ago

    How interesting! Thanks so much for sharing your experience. Have you ever noticed that crying can be a trigger too? https://migraine.com/blog/crying-as-a-migraine-trigger/

  • WendyBeecher
    1 year ago

    I often have migraine headaches after intense personal emotional upset. I always just said getting extremely upset triggered my migraine.i didn’t realize this was common.

  • Holly Baddour moderator author
    1 year ago

    I’m so glad to hear this article resonated with you. It sounds like you definitely fit right in with experiencing let-down migraine. Thanks for chiming in! Thankful you are a part of our community! Stay in touch.

  • michelle071
    1 year ago

    I used to get a migraine if I changed my routine, working an extra day in the week. If I normally worked day shift and worked overtime on night shift. Or as another person commented, I would be fine during the week and then get a migraine on the weekends.

  • Holly Baddour moderator author
    1 year ago

    Interesting. Another great example of the way that migraine hates change (or rather, thrives on it). I noticed the way you used the past tense in describing this phenomena and am hoping this means things have improved on this front? Thanks for chiming in!

  • Lind3aA
    1 year ago

    This is totally and predictably me. I have always thought of them as adrenaline hangovers.

  • Holly Baddour moderator author
    1 year ago

    That’s a great term for this! Thanks for sharing!

  • SCBoyMom
    1 year ago

    I get these as well and do my best to plan. I can plan as much as possible and give family and kid-caregivers a heads up; unfortunately, for me, my family and close friends think it’s “all in my head” enough that, maybe this time, I won’t get a migraine and won’t need them. So I’m still left sometimes scrambling for help from them.

    As an example, we are moving this week. I did my best to pace myself between packing, decluttering, and work. I hit it too hard too many days without good pacing, and crashed yesterday. I had a list a mile long from the hubs of things I needed to get done, and I was in bed all day until work. He was really nice about it, but even though I had let him know I was doing too much and would probably crash, he didn’t think I actually would, until I did :/

  • Holly Baddour moderator author
    1 year ago

    Hi SCBoyMom- Isn’t moving one of the top life stressors? How wonderful that you proactively and consciously tried to pace yourself as you navigated the process! I thought you might be interested in this piece on pacing: https://migraine.com/blog/pacing-at-the-holidays-to-cope-with-migraine/. It sounds like you did everything you could’ve ahead of time to have set yourself up for success. However, sometimes even with the best intentions and good planning, Migraine can backfire on us and land us in bed right when we’re needed most. It’s maddening. It can sometimes feel like we’re being punished for overdoing: https://migraine.com/living-migraine/punishment/

    How did your moving day go? Stay in touch!

  • DriverShirl
    2 years ago

    I especially suffer from Let Me Down Migraines and Hangover Migraines seems like it happens about 2 days after the initial one, anyone have any suggestions on how to deal with these?

  • Donut
    10 months ago

    Same here, I wasn’t really sure of what was happening. It would always get me nervous that maybe it’s a neurological problem was worse than I thought in my head because it seemed to last for 2 or 3 days. I’m glad that they finally put something out there that takes the fear away and that now I know it’s part of a normal migraine. I usually get really bad bad pain the first day and then have to pay in the second day and then it seems a little bit of residuals even on the third day. But regardless thankfull for somebody putting it out there.

  • Holly Baddour moderator author
    2 years ago

    Hi @drivershirl – Thanks so much for chiming in and for your question. I hope others might respond to your question here- and you might try posting that question to our Q&A page where more of our community members will see it: https://migraine.com/q-and-a/. We have a couple of articles that might be of interest. I’m not sure if you mean you are getting a migraine as a result of a hangover: https://migraine.com/headache-types/hangover-headaches/ – or if you are talking about the kind of let down/postdrome migraine that follows the first: https://migraine.com/blog/migraine-hangover/ . Either way, I hope one of these articles may provide some more information. The last link has a lot of activity in the comment section below it so you might find some useful information there as well. Keep in touch!

  • mspixiechick
    2 years ago

    My grandmother actually called her migraines “end of the week let down headaches.” And I took after her, ending up with a migraine almost every weekend. Also, the first migraine I ever remember having was immediately after a scholarship dinner when I was 16. I have noticed that when I’m tensed up about something, either through the week with work or a situation that resolved, I would get a migraine. I found out the hard way that massage causes a rebound migraine due to the tension release. Botox has cut the number of headaches and migraines drastically thankfully, but I still get a little anxious if I’m tense about something.

  • Holly Baddour moderator author
    2 years ago

    mspixiechick- thanks so much for your comment. I’m sure many of us can relate to what you shared. I, too, get major migraine attacks following deep tissue massages and have attributed that pattern to the release of toxins that are stored in the muscles during repeated attacks- but hadn’t connected that experience to a let down migraine. I also appreciate the perspective your grandmother’s comment provides. It’s a reminder to all of us that migraine has been around for centuries- and we are still in the midst of trying to figure the condition out! I’m so glad Botox is decreasing the frequency of your attacks. Warmly, Holly B. (migraine.com team).

  • Kpandes
    2 years ago

    I agree that let-down headaches are among the most severe, and so I really want to do a better job of managing stress…. For example, I used to get a migraine like clockwork the day after Christmas. I now try and build in a couple of days after Christmas to unwind before heading on vacation or doing other activities — and guess what, no migraine last year!

  • Holly Baddour moderator author
    2 years ago

    Hi Kpandes- Thanks for sharing such a great example of structuring in some ‘care days’ after what is a universally stressful time. It’s terrific to hear that doing so worked for you. I hope others will follow your idea. Perhaps we can all have a happier new year by doing so. Warmly, Holly B. (migraine.com team).

  • Jan
    2 years ago

    Thanks for this article, Holly. I have an understanding family (and wonderful husband), but it’s tough to describe this lifestyle sometimes.

    These let-down migraines are relatively common for me. And your vacation note really hit a nerve (so to speak). If I’ve had a fun weekend, enjoyed a special occasion, or been on a full-blown vacation, I often “pay for it” afterward.

    Like Tamara, we just moved (across the country!), bought a house, and are selling our original property. During the actual move, I was in pretty good shape. It’s afterward that’s been difficult. I get intestinal migraines along with the “normal” kind, and that combination is a happiness-killer, to say the least.

    I often do just what you advise; I plan on downtime after an event. I actually live my entire life that way, spacing out activities and work so I have recovery time in case I need it. How sad is that?

  • Holly Baddour moderator author
    2 years ago

    Hi Jan- carefully planning your life so that Migraine has as minimal an impact as possible isn’t sad at all! It’s incredibly smart and thoughtful. Coming to terms with the fact that we must live with such care can be a journey, and sadness is often part of that journey. It sounds like you have done your best to make the most of the limitations Migraine places on you while also surrounding yourself with a strong support system to help you navigate it all. Good for you and I hope this article helped remind you that you are not alone! Warmly, Holly B. (migraine.com team).

  • Tamara
    2 years ago

    Yup!! How about being stressed out about being fired (even though you boss will let you work until your house sells) …. selling my house, selling my moms houses and buying one together.

    And when both houses sell within one week, find another house and offer approved the following week and your boss is happy about timing and you set last day end of September ….

    My last few weeks – talk about high stress for months (2 months went by with only 2 showings) and then everything is working out in the correct timing ….. horrible migraine followed! But I knew it would, and I can almost guarantee another one will come once the moving and unpacking is all finished.

  • Holly Baddour moderator author
    2 years ago

    Tamara- Your post made me breathless just to read! That is an awful lot happening at once. Let-downs are interesting in the way that you can almost plan for them. I hope your body might surprise you this time around and give you a break after all these high-stress life-transitions. Thanks so much for checking in. Warmly, Holly B. (migraine.com team)

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