A silhouette of a person with their head opened up like a box lid with overlapping speech bubbled representing "the committee" in the authors head.

Day 3 of Migraine: When the Rubber Meets the Road!

We all have our little secrets – things that we simply don’t want to talk about or don’t want others to know. Mine is dealing with the emotional impact of a long-term chronic illness and its friendly comorbid conditions! More specifically, anxiety and depression. It’s something I don’t like to talk to my doctors about because there is a tendency to blame everything on stress, and that is sadly especially true for women. I don’t like to talk to my friends about it because… well, if you don’t have chronic pain then it’s really hard, if not impossible, to “get” chronic pain and what it’s like living with it! And my family… for a long time, it was a non-subject because I was simply too busy “putting a face” on it.

This one’s not going to go away!

However, there are some days when it’s simply unavoidable to face, and for me, that tends to be day 3 of a bad migraine. Don’t get me wrong, I have some level of pain almost every day, and if not in my head then it’s my joints, back, or elsewhere. But, it’s those really bad migraine attacks that simply don’t respond well to rescue medications. It's those ones which keep coming back day after day as the meds wear off which really get to me.

Day ONE, I try to focus on being hopeful that it will be short-lived, respond well, and the meds will knock it out permanently the first time. By day TWO, after 24 hours of little success, I’m already starting to think about how to manage an intractable migraine, risk versus benefit, and the consequences of staying in bed too long. Panic is starting to set in. However, it’s on day THREE that the rubber really meets the road. The “committee in my head” (as I like to call it) is shouting loud – “This one’s not going to go away!”, “You’re in trouble”, and “Welcome to the rest of your life!”

What is going on?

It’s hard to figure out why there are often these breakpoints for so many of us. I have my theories, but as for everything else with migraine, it’s complex with no real solid answers! I really want to try and understand things – I guess in some way that gives me back a little bit of control – and so for me, it helps to realize that there are multiple factors impacting how I feel:

  • The physiological effect of taking multiple rescue or abortive meds over a period of days or weeks
  • The emotional impact of ongoing physical pain that isn’t stopping and the exhaustion that so often comes along for the ride
  • The fear of side effects from taking multiple medications to try and stop the pain
  • The physiological impact of the migraine attack itself

Looking ahead - have a plan!

Maybe for most of us it’s a combination of all these four factors, or maybe there is something my foggy migraine brain hasn’t thought about yet! Hopefully one day the researchers will figure that out, but for now, when you’re at that point where the rubber meets the road, whenever that may be for you, here are some thoughts:

  1. Take a breath! You’ve survived this far, and as challenging as this is, you are going to survive this too! Sometimes just realizing that you’ve been through something before can help reduce the panic. Knowing that for me, day 3 is a landmark, helps me plan and be able to hold on. It’s normalizing in some way.
  2. Talk to your doctor about what is safe to take, as well as how much is safe, when it comes to treating the pain. It’s often a balance between risk and quality of life, so those conversations are super important. Often when we are in pain it’s hard to make wise decisions, so try to have a plan ahead of time!
  3. Be kind to yourself, whatever that means to you because when we do that, we often find the anxiety and depression gets less - or at least they become easier to manage.
  4. Be gentle on your body and give it the rest it needs. It’s so easy to fight or try to “push through”, and sometimes that is necessary, but healthy boundaries help us become more resilient.

You are not alone!

Finally, know that you are not alone! There are so many of us who struggle with migraine and other forms of chronic pain, and it impacts our lives in every way. Try to connect with others who “get it.” Trying calling, texting, messaging or emailing a friend when things are the hardest, or post in one of the online migraine groups, and discover the strength that comes from a community!

Do you have a specific day or time when the rubber meets the road? Do you find that anxiety or depression are worse during a migraine attack? If so, what helps you get through those hard times?

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