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

View Comments (24)
  • carolelynn
    3 months 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
    3 months ago

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

  • kitkat2255
    3 months 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
    3 months 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
    6 months 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
    6 months 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
    6 months 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
    6 months 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
    6 months 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
    6 months 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
    6 months ago

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

  • Holly Baddour moderator author
    6 months ago

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

  • SCBoyMom
    8 months 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
    8 months 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
    10 months 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?

  • Holly Baddour moderator author
    10 months 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
    1 year 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
    1 year 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
    1 year 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
    1 year 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
    1 year 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
    1 year 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
    1 year 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
    1 year 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)

  • Poll