How to Handle Unexpected Migraine Symptoms When They Strike

After 20 years of living with migraine, Kylie Meyer, a 34-year-old woman living in Exton, Pennsylvania, still can’t predict when she’ll experience an attack. She typically feels fine for weeks at a time—and then, out of the blue, she wakes up with throbbing head pain accompanied by nausea that occasionally leads to vomiting and dizziness. Often these symptoms are so severe that she can barely stay upright.

Meyer’s symptoms can be debilitating: “If I wake up with a migraine, the day is just shot,” she tells SELF.

Though often labeled as “just a bad headache,” migraine is a neurological disease that can bring forth a wide-ranging mix of symptoms in addition to head pain, including brain fog, fatigue, distorted vision, and gastrointestinal (GI) problems like nausea, diarrhea, and vomiting. What’s more, migraine affects everyone differently. Because symptoms associated with migraine can vary so much, the process of finding relief will differ from person to person too.

“There’s not a single solution that works for everyone,” David Watson, MD, the chair of the WVU Rockefeller Neuroscience Institute’s department of neurology and director of the WVU Headache Center, tells SELF. “What works and what doesn’t work is very, very individualized.” That means you may have to experiment with a handful of methods to find the pain relief approach that helps you the most.

Below are a few different ways to cope with some of the most common symptoms associated with migraine attacks, even when you least expect them.

Head pain

A telltale migraine symptom, head pain tends to be far more pronounced than your typical headache. Dr. Watson likens the sensation to less of an annoying ache and more of a throbbing, pounding feeling—similar to what you might experience after a night of heavy drinking.

Lauren Aymen, DO, a neurologist who oversees the Headache, Migraine, and Facial Pain Center at the Michigan Institute of Neurological Disorders, tells SELF that if you treat that head pain as soon as you feel it coming on, the other symptoms associated with the condition (which we’ll get into in a bit) will usually improve too.

The best way to treat head pain associated with a migraine, according to Dr. Watson, is through the right medication regimen for you. While over-the-counter pain relievers like ibuprofen and aspirin can help many folks find relief, others might require prescription medications, such as oral drugs, nasal sprays, or even certain types of injections.

Dr. Watson says the key to finding an effective solution is speaking with a doctor who specializes in migraine (usually a neurologist should be your first visit). They can walk you through medication options based on your unique symptoms and weigh what may cause the least amount of potential side effects.

Equally important in reducing the intensity of that pulsing, throbbing head pain? Finding a quiet, dark space to relax in. The brain can become hypersensitive during a migraine attack, so eliminating any outside stimuli, or “noise,” as Dr. Watson calls it, can keep pain from growing.¹

Staying hydrated and applying ice packs to your head (one of Meyer’s go-to strategies) can provide some relief too. “Dehydration can either trigger the migraine [attack] or make it worse,” says Dr. Aymen.

Vision problems and vertigo

During her migraine attacks, Meyer sometimes gets so dizzy that the room “spins” and she loses her balance. She’s found that the only solution is lying down horizontally until her vision stabilizes and she can comfortably move upright again.

According to Dr. Watson, Meyer’s approach is one the best things you can do for vision problems and vertigo during a migraine attack. Pushing through and carrying on with your life as you would normally can sometimes make the symptoms worse, he says.

If your schedule (and pain) allows, aim to lie down or nap for at least 30 minutes, if you can, as the attack is happening. “Sleeping can be very restorative for the brain and for the headache,” says Dr. Aymen.

That said, naps (when taken too frequently or for too long) can sometimes throw off your sleep cycle, which can worsen migraine symptoms for many people with the condition, Dr. Watson says. If naps seem to disrupt your sleep—say, you have trouble waking up and going to bed around your usual hours—and a migraine attack shortly follows that lack of rest, skip napping entirely and simply lie down horizontally.

Again, migraine symptoms vary in intensity—and if your distorted vision, dizziness, or lightheadedness doesn’t pass with extra rest, it’s time to seek professional help. Some doctors might recommend vestibular rehabilitation, which is a type of physical therapy that uses gentle strengthening, stretching, and balancing exercises—coupled with eye-movement training—to combat dizziness, vertigo, and unsteadiness associated with migraine.²

Gastrointestinal issues

During a migraine, the GI system can slow down in some folks (known as gastroparesis or gastric stasis), which can cause nausea, vomiting, and diarrhea.³ For many people who experience migraine, nausea is their most pronounced symptom, says Dr. Watson.

The key to combating migraine-associated GI issues, says Dr. Watson, is to fuel your body. If you eat a big meal before or during an attack, the food may sit for an extended period in your stomach and not get digested properly. Conversely, if you don’t eat anything, there won’t be any food in your stomach to jumpstart your bowels back into action once the attack passes. Plus, if you’re taking any medications for migraine, having some food in your stomach will ensure they’re digested properly, says Dr. Watson.

The type of food and beverages you consume also plays a role, adds Dr. Watson. Plain carbohydrates (think: cereals, crackers, or bread) tend to digest more easily than alcohol, citrus fruits, dairy, and chocolate.⁴Ginger and bubbly, carbonated drinks (like seltzer water or soda) can settle an upset stomach too, Dr. Aymen says.

When Meyer experiences migraine-related nausea, she opts for plain, carb-y foods (her exact order: a cheesesteak and a Coke)—it’s the only thing she can handle. (Again, it’s important to note that everyone’s body is different!)

Drinking lots of water, juice, and other liquids can aid in digestion and keep stomach problems at bay. That’s because GI symptoms can lead to fluid loss, which can make you even more dehydrated (and potentially worsen migraine symptoms).⁵

If the above tactics don’t do the trick, talk to your doctor about trying a prescription anti-nausea or antidiarrheal drug, recommends Dr. Watson. They can also recommend a food sensitivity test, which can potentially help identify specific ingredients that might be messing with your GI tract,⁶ says Dr. Aymen.

Fatigue and brain fog

Meyer’s migraine attacks almost always lead to prolonged fatigue. She says it often takes a day or two for her energy levels to return to what they were prior to the episode (something she calls a migraine hangover). “It’s this feeling of being drained and a little bit off and out of whack the day after,” she explains.

Fatigue, along with brain fog—a feeling of mental fuzziness—can strike before, during, or after a migraine attack. This can mess with your concentration and ability to think quickly, which can make everyday life, like working or caring for children, more challenging, says Dr. Aymen.

Though exercise might seem like the last thing you want to do when heavy fatigue or brain fog hits, Dr. Watson says that some movement can be helpful, as long as you’re not in debilitating pain. “The biggest thing people can do for brain fog is to get out and get moving,” Dr. Watson says. You don’t need to sprint on the treadmill—yoga, gentle stretching, or walking can help keep you energized. “Anything that gets your heart rate going is beneficial,” says Dr. Aymen. (Of course, if certain types of movement have triggered your migraine symptoms in the past, steer clear of those.)

Staying fueled with nutritious food throughout the day can also sometimes fend off fatigue, says Dr. Aymen. (Try to focus on protein, fruits and vegetables, and fiber-rich carbs.) And again, while naps can help some folks recharge and emerge from a period of mental fogginess, be sure to observe how frequent midday snoozing is affecting your sleep quality (and prevalence of migraines) overall.

Migraine attacks may be common, but headaches, visual issues, and fatigue that leaves you unable to function shouldn’t be the norm, says Dr. Aymen. Play around with different coping strategies to see what sticks. It may take some trial and error, but in the long run you’ll likely have a plan of attack when symptoms strike again.

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