Migraine is a common and debilitating neurological condition that affects millions of people worldwide. Many people say “I have migraines” However, that refers to migraine being an acute condition – when rather it’s a chronic condition that has acute attacks. Migraine disorder causes migraine attacks. One type of migraine attack (the acute presentation of migraine the neurological disorder) that is often overlooked is the “let down migraine.” This type of migraine attack is triggered by a sudden drop in stress levels after a period of high stress. In this blog post, we will discuss let down migraine attacks in more detail, including what they are, what causes them, and how they can be treated.

What is let down migraine?

A let down migraine is a type of migraine that is triggered by a sudden decrease in stress levels. This can happen after a period of high stress, such as during a busy work week, a major project, or a significant life event, such as a wedding or the birth of a child. Once the stressful period is over, the sudden drop in stress can trigger a let down migraine.

A significant decrease in stress from one day to the next, within 6 hours of the reduction, and Increase the likelihood of migraine attack to happen (1).

Symptoms of a let down migraine attack are similar to any other migraine attack you may have and can include:

• Headache: A severe, throbbing headache that can last for hours or even days.
• Dizziness: A significant increase in dizziness, vertigo, and imbalance
• Nausea and vomiting: Many people with migraines experience nausea and vomiting.
• Sensitivity to light and sound: Migraine sufferers may become sensitive to light and sound, making it difficult to be in bright or noisy environments.
• Fatigue: A let down migraine can leave sufferers feeling exhausted and drained.
• And any other migraine symptom that you may experience!

What causes let down migraine attacks?

The exact cause of a let down migraine attack is not well understood. However, it is thought that the sudden drop in stress levels can trigger changes in the brain that lead to a let down migraine. Stress hormones, such as cortisol, can also play a role in triggering migraines, and a sudden decrease in this stress hormone can trigger a let down migraine.

If you know you’re going into a period of high stress, you may be at a higher risk for a let down attack. If this is the case, talk to your healthcare provider about treatment options, like pre-treating for an attack you know is impending.

How are let down migraines treated?

There is no cure for migraines, but there are several treatment options available to help manage the symptoms. Treatment options for let down migraines include:

• Over-the-counter pain relievers: Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or aspirin, can help relieve the pain of a migraine. Be careful with these, are they can lead to medication overuse headache is used more than 9 times in 30 days!
• Prescription medication: Triptans, CGRP’s, and other medications  exist to help relieve the symptoms of a migraine.
• Lifestyle changes: Lifestyle changes, such as getting regular exercise, practicing stress-reduction techniques, and getting enough sleep, can help reduce the frequency and severity of migraines.
• Alternative therapies: Alternative therapies, such as acupuncture, massage, and cognitive-behavioral therapy (CBT), can help manage the symptoms of migraines.

All of these can be used for pre-treatment. When you’re in a period of high stress, and you know it may end soon, for instance if you’re a student at the end of the semester (or your child is) ask your doctor what you can take as the come down period approaches. This could be anything from using your neuromodulation devices to prescription medications to ensuring your reduce your own personal stress level. It’s incredibly person dependent, so you should be sure you know what you need during high times of stress.

Remember, you cannot give from an empty cup – a cliche, I know. But, really, you need to make sure you fill your own personal cup with whatever makes you happy, whether that’s yoga, meditation, a walk, exercise, art, asking for support, and more!

3 Tactics to manage let down migraine

One: Fill your cup first. You cannot give from an empty cup, and when one thing happens, it tends to all break down at once. We all know the quote ‘when it rains it pours,’ right? Yes. So, when something stressful happens whether it’s directly or indirectly to you, be sure to make time for yourself for something that feels good to YOU!

Two: Pretreat your migraine attack. When you know the letdown period is about to come, treat the attack. If you’re planning a wedding, treat the day before and day of the wedding. If you’re going through something hard with your family, be mindful of when the ‘let down’ may come and practice getting

Three: Keep up with your routines. When life gets hectic, we start to drop the little things first. Why we do this, I don’t know, BUT I know that we start to let the things in our own lives slide when the rest of life gets tough. So, make a concerted effort to keep up with your workout, food, hydration, and de-stressing routines. It is absolutely vital during this time!

If you want to better prevent your vestibular migraine attacks, let down migraine attacks, and more, join us in Vestibular Group Fit for the most comprehensive group program for vestibular migraine!

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Sources:

(1) Montefiore Medical Center. “Migraine attacks increase following stress ‘let-down’.” ScienceDaily. ScienceDaily, 26 March 2014. <www.sciencedaily.com/releases/2014/03/140326181915.htm>.