The Migraine Sixth Sense

The Migraine Sixth Sense

Hindsight is 20/20!

We know that abortive medications are always more effective if taken at the first sign of a migraine attack. Great. But how are we supposed to recognize those first signs? Prodrome symptoms can include a whole slew of wacky symptoms, including regular, everyday things like irritability and yawning. It can be really hard to decipher the difference between plain-old irritability, and migraine-induced irritability. To complicate things even further, if you have chronic migraine or comorbidities with similar symptoms, it can be even trickier to pinpoint a specific attack.

Lucky for me, I usually have some sense of normalcy in between attacks now, so I at least have a chance to pick migraine symptoms out of the crowd, but even then, I often find myself waiting until it’s too late. Once a migraine attack has really made itself known to me with some combination of nausea, head pain, and light/sound sensitivity, it’s easy to think back on the previous minutes or hours and attribute that strange feeling in my neck to prodrome, but when my time machine is on the fritz, what’s a girl to do!? By then the chemical chain of events in my brain is already in motion, and the medication will simply not be as effective.

I think I can, I think I can…

Sometimes I am fairly certain that an attack is coming on, so, ever conscious of the dangers of medication overuse, I take a quick look at my planner to see how many triptans I’ve taken recently. Only one in the past week? Okay, time to pop another!

But wait, what’s that little voice in my head? Just wait a bit. Maybe this one won’t be so bad. Maybe it’ll go away on its own. Maybe some deep breathing, stretching, plus some food and water will do the trick. And like a fool, I believe this little voice for a while.

Maybe I believe it because I don’t want to take the drugs. Maybe I believe it because I want to have some control over my body in that moment. Maybe I believe it because my judgment is impaired by the impending attack. But unlike the mountain in the children’s story The Little Train That Could, overcoming a migraine just by virtue of positive thinking HAS NEVER WORKED for me. I get really upset when other people suggest positive thinking and relaxation can have immediate super powers over a raging pain attack, so why on Earth would I believe this little voice?

The Migraine Sixth Sense

(Don’t worry. I cannot see dead people unless I’m at an open casket funeral).

It has taken me years to recognize this self-doubting pattern in the moment in order to change my behavior. Lately, when I find myself conscious of that little voice, I’ve been trying something radical and trusting my gut (literally) instead. A few things have given me the confidence to do this. The first was asking the question “have I ever been wrong about an oncoming migraine?” In early days, maybe, but after five years of dealing with multiple attacks per week, I am very rarely wrong. Another migraine-radar confidence boost happens in those times where I do medicate early. In the moments before the medication begins to work, the attack usually does ramp up a bit, and then the medication tones it down and I know I’ve made the right decision.

Sometimes my sixth sense picks up on a general “off” feeling: maybe some light confusion and fatigue, but often it’s an all-pervasive, barely noticeable soreness or weight that fills my entire body, including my stomach. Sometimes I need to wait for at least a combination of two symptoms to feel absolutely sure that it is time to medicate and/or rest, but mostly I just know. This “sixth sense,” combined with trusting my instincts, allows me to treat attacks much more effectively.

Can you tell exactly when an attack is coming? Do you ever put off taking your medication in hopes that it won’t escalate?

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 (34)
  • mstaryos
    5 months ago

    Anna – This is such a helpful article. I’m fairly new to migraines and this exactly describes the process I go through. You’ve saved me countless days of trying to not take medication. Much appreciated!

  • jlynnegarrett
    10 months ago

    The day before yesterday I m bouncing around, can’t focus on a single task, can’t sleep, can’t calm down, and in the back of.my.mind I’m ticking off the symptoms one by one. I finally take a Melatonin so I can get some sleep. The next day is the tingling and the neck pain, and by 12:30pm I’m vomiting. My insurance will.only cover ten Sumatriptan in a three month period, so I am stingy with them. I finally took one around 4 yesterday, and by 5 they were sending me home from work because I couldn’t hold down water. I had to call in today because I’m OK until I sit up. What’s a girl to do?

  • ClaudiaPutnam
    11 months ago

    If you have migraine, every headache is a migraine; it’s just a matter of seeing how bad it will get. Most likely fairly bad. If hitting it early is the best tactic, hit any hint of any kind of headache early because as you most likely know, a so-called tension or sinus headache is just a warm-up for a migraineur. OTOH. Isn’t the issue w the triptans not just that they have side effects or that we may run out, but that they lead to rebound migraines? And that chronic migraine might be caused by the overuse of the rescue meds? Thats what both my neurologists say. Terrible dilemma when you’re just trying to function. But they’re suggesting that if I drastically reduce my use of the meds and really restrict the diet plus more stuff on a long list of things to fo and not for plus maybe botox, I’ll have better luck. Adamant about the meds though. Reading that in the literature as well.

  • wappaw
    11 months ago

    Great discription of my life with migraines. Being as the abortive medicines are only available 12 per every 25 days, sumatriptan, and being a chronic migraine person, I always want to wait just a little longer to make my supply last, when I know “take it now” is the best option.

  • MDM
    1 year ago

    This is soooo true.

  • Lharbison
    2 years ago

    I am 50 years old and have had migraines since the age of thirteen. I often get a fairly clear warning the day before an attack. The warning takes many forms though. Sometimes it is memory loss, especially of anything numerical, like an ID number. Other times it is abnormal sleepiness. Sometimes it is a weird emotional state where I feel both anxious and unbearably sad about the passage of time and the loss of the past. Sometimes I get tunnel vision Still other times, I feel, for lack of a better phrase, like I am not really there.

    But these warnings don’t do me much good, because the only medication that has ever helped at all is ibuprofen, and it only helps a little if I take it right before the full blown attack starts. Thankfully, my headaches have decreased in both frequency and intensity over the last ten years.

  • mason1776
    2 years ago

    I used to wait ALL the time. I’ve had migraines since I was 10. My mother also had migraines but was somehow convinced I was faking. So, I never got any meds or treatment. Fast forward to college. I finally got treatment – beta-blockers and anti-depressants – nothing at all for pain (1985-89).

    Finally out of college and working, I found a doctor who adjusted my prophylactic meds and gave me my first pain meds. I thought I was in heaven – despite the continued existence of migraines.

    Fast forward again to the advent of triptans. These were extremely helpful! My migraines were coming much more frequently and I could take these and continue to work. Then titans came in injectable delivery. Cool. I felt better faster – even if I’d waited a bit longer than I should – and could work longer.

    Fast forward once more to 2 months after my 40th birthday. Woke up fine. Showered and dressed, still with no headache. In a flash, bring on aphasia – garbled nonsense coming out of my mouth. An ambulance ride to the ER later and a migraine starting to build. Pain meds in ER and a CT. Docs all curious. Pain worsens. More meds. Hospital stay and 5 days later, I can’t feel my arm. Another CT shows a stroke. Leave hospital with major migraine in full swing.

    Now, a sane person would think all of this would lead me to learn to take meds (sadly, no more titans because of stroke) as soon as the pain starts. However, nearly 10 years later and I still delude myself into believing, “I’m overly sensitive. This won’t be too bad. I can wait.” HA! Fortunately, time has taught me a few lessons and somewhat lessened my belief that I can white-knuckle my way through a migraine. Time also left me with a post-stroke diagnosis of Chronic Daily Migraine. So, my “resolve” (read: stubbornness) has crumbled. I now only wait, maybe, 30% of the time.

    It’s just not worth it!

  • KSMc1984
    2 years ago

    LOL! Thank you. This is me all the time. I don’t have many tells but when it’s for sure a migraine my little voice says the same thing, POWER OF POSITIVITY, maybe this will solve itself my grit and will can overcome this migraine! Cut to me puking and crying.

  • blinkylights
    2 years ago

    I’m one of the “lucky” ones whose first alert that a migraine is coming is a dramatic, bright, sight blurring aura. I head right for my nasal spray triptan, which is a miracle drug. I am safe to drive after about 30 minutes. I have noticed the last few years I sometimes get a sad and tired feeling up to a day before a migraine. However, they usually hit completely out of the blue.

  • Turok
    2 years ago

    When I start to feel pain above and behind my eyes or I get an aura I know one is coming. Even with this I still sometimes doubt myself. My wife will ask me “Why do think this time will be different?” I tell her hope but end up taking my meds because I know it’s coming.

  • KSMc1984
    2 years ago

    Every dang time!

  • Feline42
    2 years ago

    I’m 56 and have had migraines since age 11. Used to be I could tell when when the migraine was coming on, and when it was a migraine vs a muscle tension or sinus headache. Now the past 5+ years, my migraines have changed to where there aren’t the obvious one-sided pain. It can be any location of my head or all over. So I question and analyze…”Do I have other symptoms starting?” Am I sure this is a migraine and if I’m not sure, should I wait with the tryptan? I’m learning to trust my instinct, too, that yes, it is a migraine!

  • mrst53
    2 years ago

    I use to be lucky and have spots before my eyes to tell me I was getting a migraine, but now those are gone. Now, the migraine just hits with no warning. I have 2 medications I alternate with, one is a triptan, the other a very migraine med. Some weeks I have no headaches other weeks, like this last one, I have had 5. I have had migraines for 51 years, In early years, I would get sick with my migraines before they would go away, but then I had no medication.

  • Nananina
    2 years ago

    Oh Anna, your post describes exactly what i go through. Having suffered from migraines for the past 30 years, i am always concerned about the side effects and damage to the liver.
    I recently went through a detox period of three long and excrutiating months where i could not use any painkillers. My neurologist suggested i do so before i could start a new treatment.
    I am still struggling with finding the ‘right’ moment to take my triptans, even after 30 years.
    Hang in there, you are not alone!

  • Natalie
    2 years ago

    Living in UK, I could technically have as many/much Triptans as I need at no cost, but isn’t the point that you shouldn’t take Triptans on more than 8 days a month or you are actually making migraines worse? That’s the reason I try to limit Meds. Also because they work by constricting blood vessels,as you get older risks increase. I am in late 60s and very concerned about how much longer I should be taking them and try hard to resist as long as possible.

  • EvilFluorescents
    2 years ago

    I realize that each individual’s circumstances are always different, but my father is 82-years old and he treats with a neurologist at Mayo’s. He still takes triptans quite often, around 20-25 per month. My dad is somewhat fortunate in that although he has very frequent migraines, his generally are not too brain-fryingly severe.

    His philosophy is that he probably doesn’t have a whole lot of time left in this world, and he wants to be able to enjoy every single day that he has been given– and not be sidelined in his recliner with an icepack on his neck and a trashcan by his side, caused by a migraine that he could abort.

    Mayo’s does monitor him fairly regularly and he has no other health issues, if that makes any difference in your decision-making. Good luck with your choice.

  • rossbow13
    2 years ago

    I too live in the UK, am 70 this year and am concerned regarding taking triptans into older age. However I also suffer from bipolar 2 and take atypical anti psychotics which also have long term health risks. After an adult lifetime of unremitting migraine I have chosen to take whatever is necessary to enable me to function, albeit at a different level from others, as both conditions are so depressing if not medicated for. For many years, before triptans, I was taking about 150 analgesics a month in order to keep upright and care for my family. Apart from during pregnancies my life has been one long migraine … either pre, post or just having the three days of symptoms. It’s not easy but quality of life, however poor, is better than feeling so ill all of the time! As my husband has Asperger’s and our three children variations of bipolar, Asperger’s and migraine life is not easy. The choice of taking triptans and hoping some other medications will be released before the end of my lifetime is all I can cling on to in regard to “hope”.

  • terahkuy
    2 years ago

    Because of the way insurance limits the quantity of triptans we can use to abort migraines, we wind up waiting and waiting and waiting to make sure it’s a really really really bad migraine before will take that precious pill or shot. Also, insurance quantity limits don’t take into account episodic migraine disease compared to chronic migraine disease. You get the same 9 pills or 6 shots, despite the fact that chronic migraineurs qualify for that diagnosis because they have 15 or more attack days per month.

    Note: if your doctor will write a script for a larger quantity and you are wiling to pay cash, your insurance has no say and can’t limit quantities. Depending on the medicine, cash only + a GoodRX coupon could be a possibility for you.

    Also, I’m a member of Sam’s Club. You don’t have to have a membership to the club to use their pharmacy but their second level of membership includes steep pharmacy discount prices. It’s worth it to pay the $100 annual membership fee if I’m saving hundreds of dollars per month because of how that affects level of membership.

    You definitely need to check and see if your particular medication would be included. I pay $33 to pick up 30 imitrex tablets.

  • deadeyes
    5 months ago

    The limited 9 pills/ 6 sprays really hinder my pain management. Your suggestions are very helpful. Thank you for sharing this information.

  • tlocker
    2 years ago

    Being part of chronic the migraneurs who can’t tolerate tryptans; it is hard to know when to try to push thru and when to give it up and go to K/O meds and bed. Yes, neurologist who is migraine specialist supervising meds, and yes I take more than I want to. Still, it leaves only two options: awake and trying to have a day of life, or asleep and not in pain. Makes sense that we keep trying until we’re REALLY sure…and by then of course it’s too late. However, it IS possible I can be tired and irritable and NOT getting a headache!, Like the folks I work with who have schizophrenia and other serious neurobiological disorders, sometimes I want to tell people, “I’m allowed to just have a bad day and bitchy mood without being asked if I’m taking my meds!” or in my case,”…getting a migraine!”

  • Kate Koltun
    2 years ago

    I would say that I certainly have doubted myself that a migraine is coming on, and certainly have put off taking medication more times than I can count, but my gut has never ben wrong. I always needed to take those medications. I now try to have some migraine meds as I refer to them everywhere, in my purse, etc. so I can always give myself the relief when I am aware. I do agree that we do not allow ourselves the awareness of how painful or prevalent the migraines are (or at least I do) or we would feel totally out of control and overwhelmed. I think the more aware we are, the better, and it is better when our mind, body and soul are ALL on the same page.

  • rossbow13
    2 years ago

    Yes … daily life with migraine is a learning curve. I do and take all I can to keep the demon at bay … otherwise I would be horizontal, dozing, sleeping and struggling to understand the meaning of my life … keep tuned in, do what is necessary, and believe in having at least some control of your life.

  • er3dxe
    2 years ago

    I used to do this all the time and it can be so frustrating! I can see from my migraine log that, at times, I’ve carried a migraine for two days or more before finally recognizing it and treating it. Here’s my theory, seriously: I think that my brain simply isn’t functioning properly when I am brewing a migraine. I think that I can be incapable of recognizing the symptoms – not all the time, but many times. I’ve made myself a written list of harbingers that I can refer to but I’ve forgotten to look at it. All the reminders in the world don’t work when my brain is unaware that a migraine is looming. It’s actually some comfort to see that others have the same issue!

  • MDM
    1 year ago

    This is illuminating! I believe my mind does the sa!e thing. Crazy!

  • arden
    2 years ago

    This is a real dilemma for a migraineur. The article gets all the reasons why we procrastinate medicating. The advice of my doc is “hit it early and hit it hard”. I did not always do that and used to nibble the triptans every few days instead of really blasting the migraine with my whole arsenal. The latter works better, especially with the added nap or night sleep. If available it helps to have someone close who can encourage you to “take your medicine!!” when the migraine fuzzy thinking advances numerous flimsy reasons to wait.Tell them you think one is coming on and they should know from experience to gently urge you to use the help of modern medicine, now. For me its like a train whistle in the far distance with an unmistakable feeling that its coming and there is no doubt that it will come barreling through my body in a few hours. Unless I take action.

  • alley
    2 years ago

    Anna thank you and all of you who have shared your life with migraines You know how you always think you are the only one I had no idea how many people suffer and have the same fears as I do. Thank You All

  • Natalie
    2 years ago

    After 20 years of Triptans I am now having to inject myself with them. Nothing says “I’ll just wait a bit longer” more than the prospect of sticking a needle into yourself.

  • montanamacarol
    2 years ago

    I’ve had migraines since I was 13 and I’m now 65. Until the triptans came on the market there was nothing that helped but when the triptans came along it was like a true miracle. But then and now I almost always wait until I’m “sure” it is really a migraine; usually when the nausea arrives I accept that it isn’t just a “regular” headache. I know it works better when I take it early but just can’t make myself do that, stupid to wait but I still always do.

  • rlc25e
    2 years ago

    I live in the some level of severity everyday camp. I wait to know how bad it will be to see which drug I should take. I carry five or six with me along with my six or seven daily meds that stay at home. If I manage to wake pain free I think maybe today I will stay this way but it always ramps up to at least a six before nightfall. Its a nightmare merry-go-round that i want to get off. I have noticed yawning spells and irritability. Word confusion and vertigo but I never know if its from the day before migraine or a new one coming. Thankfully im not s sound sensitive as I once was now it is more light. My kids say im a vampire who any bright light might kill instead of sunlight but at least I still have times I can drive and can occasionally go to the grocery store……. Sorry way off topic.

  • Kmglenn
    2 years ago

    Almost every time 15 to 20 minutes before the pain hits I think” I’m going to have a migraine” but this has only happened the last few years so I think there is something that is happening in my body that my subconscious recognizes. But, like you I wait to make sure before I take the meds, even though it has always been one.

  • Tamara
    2 years ago

    I’m the chronic type so it’s hard to know if it’s one migraine ending or another one starting. I have to wait for that second the pain increases and grab the nasal spray and pray it catches it in time. I do have yawning attacks, depression flares up (although I never catch it until after). But sometimes I get them back to back with no warning.

    I have to not take meds because I have some sort of a migraine every day. But the pattern is the same – try and treat without meds, pain gets unbearable, end up having to pain meds to keep myself from jumping off a bridge because it’s so bad, then of course meds don’t work as well.

  • Brooke H moderator
    2 years ago

    Hi Tamara, Thank you for taking the time to post. It sounds like a lot to bear living day in and day out with chronic migraine and its associated pain. It’s not uncommon to have depression as a prodrome, feel free to learn more here: https://migraine.com/blog/depression-as-a-prodrome-symptom/. I hope you will consider continuing to come here for support as well as on our Facebook page: https://www.facebook.com/MigraineDotCom/?ref=bookmarks. You’re not alone in this! Warmly, Brooke (Migraine.com team)

  • bigsue
    2 years ago

    I do this all the time. Partly, because when I was travelling, triptans were hard to get and very expensive, but even now when I have them in the drawer, I think maybe it’s just a regular headache, maybe lunch, maybe a nap, and maybe I’m always wrong about it. Denial. Part of the routine.

  • caengler70
    2 years ago

    I do the same thing. I’m a 30 years sufferer and I still have that I think I can attitude

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