Migraine Misery Can Be Worse After the Holidays

The letdown and anxiety of transition—and COVID—bring on the migraine triggers.

Posted Jan 01, 2021

Usman-Yousaf/-Unsplash
Man with Migraine During COVID
Source: Usman-Yousaf/-Unsplash

Whew! We’ve made it through the holidays. No more baking, shopping, card-writing, wrapping, stress, and exhaustion, right?

Then, why do I feel so down, anxious, and, even more, why am I getting more migraine attacks than I did during the holidays themselves?

Actually, there are a number of reasons, so let’s explore some of them.

We are:

  • Running on no energy reserves
  • Depressed about the transition back to work
  • Experiencing the let-down after the anticipation and excitement of the holidays
  • Regretting that we didn’t get to spend time with the family and friends we normally do because of  COVID
  • Inevitably focusing on those who were not with us this year

Entrepreneur Lisa Evens, in her article, “Six Tips to Fight Post-Holiday Fatigue,” quotes clinical psychologist, Linda Smith: "After any big event—a vacation, a wedding or the holidays—there can be a lull after" (Evens). 

  • After the holidays, many of us may feel a letdown; we feel fatigue, loneliness, and reduced motivation. This year’s holiday celebrations actually caused more reasons for these physical and psychological effects. We did not have the usual social events to host or attend. We didn't have ways of connecting with colleagues “off duty,” or neighbors, whom we rarely see for more than a quick hello, and friends from different segments of our lives.
  • The exhaustion, stress, and anxiety we already feel from COVID actually increased after these holidays because we tried to do what we could to “normalize” a very abnormal season—we still baked and decorated, still bought and wrapped presents (though, again the stress level spiked with so many losing jobs or businesses, causing further agonizing choices regarding paying bills and buying for the holidays), and we Zoomed and FaceTimed—a lot.   

Dr. Joel R. Saper, from the Michigan Headache and Neurological Institute, explains the relationship between increased headaches after the holidays: “Prepare for post-holiday letdown. The holiday season eventually comes to an end and, unfortunately for some individuals, a strong emotional letdown occurs during January and February. This can make them more prone to headaches and depressed mood” (Saper).  

  • In the days and weeks after holidays, we face making the transition back to work and school, in severely altered environments and modes this year. We face the work of putting away all of the decorations, and getting things back to “normal”—this year, even as we face ever-increasing COVID rates and deaths throughout much of the country.
  • This process and reality are very difficult. We are also missing the people and pets that are no longer with us even more at this time of year.
  • Many of us have been off-schedule and routine in terms of sleep and medications, foods, drink, and exercise.
  • Remember, too, migraine attacks very often occur after the major stresses or excitements in our lives. These “let-down” attacks often catch us off-guard, as we think we have made our way through the holidays, only to get hit later.

COVID has made all of these problems worse.

According to a new study conducted by Headache and Migraine Policy Forum and Migraine, the ongoing COVID-19 pandemic has significantly impacted migraine patients' health and ability to receive optimal care. Their national survey of more than 1,000 migraine patients throughout the United States demonstrated overwhelmingly that COVID-19 has made it difficult to access treatment.

The survey also revealed clear opinions about the debilitating impact of migraine disease, as well as the need for health insurers and policymakers to better meet the needs of people living with the disease: “The results from this survey clearly show that people with migraine are dealing with additional burdens during the Covid-19 pandemic. Insurance companies and policymakers must listen and respond to patient needs,” said Lindsay Videnieks, Executive Director of the Headache and Migraine Policy Forum (Dumas).

The spike in monthly attacks shown by this study raises concerns from patient advocates, who are calling for action: “The escalating need to reduce barriers to access much-needed medication, reduce patients’ out-of-pocket costs, and expand telemedicine opportunities are needed now more than ever,” commented Paula K. Dumas, health advocate, and Editor in Chief of Migraine Again. “We can’t stand by and wait when people are in desperate need of care” (Dumas).

The study shows that treating a debilitating condition like migraine disease during a global pandemic can increase stress for patients, many of whom already struggle with day-to-day activities. 

What are some of the tools we can use to help us through this rough transition?

Jennifer McVige, MD, MA, an expert in Headache, Neuroimaging, Pediatric Neurology, Post- Concussion/Head Injury at Dent Neurological Institute in Western New York, points out, “When someone is stressed, they tend to elevate their shoulders, furrow their brow, and clench their teeth… This can cause muscle spasms in these areas which can lead to tension as well as migraine headaches. This is especially concerning if someone has a history of temporomandibular joint dysfunction (TMJ).  The muscle spasm can be much worse for them” (Kelly). 

Clenching

The first step is to realize how many times a day we catch ourselves clenching; honestly, I lose count.

To alleviate this pain and prevent the muscles from tightening in your jaw, pretend that you are holding a grape in your teeth, Dr. McVige suggests. If we can close the jaw but keep our teeth apart, as if there is something between them, we can cause the jaw to temporarily relax. This takes practice. First, try doing this for a count of 20 and then relax. Try to repeat two to three times in a row and then work up to completing this series two to three times a day. In other words, we have to train our jaws not to clench.

Neck, Shoulder, and Upper Back Pain

Dr. McVige advises those of us with tight upper backs and necks, to roll the shoulders back so that the neck and chin are in alignment with the spine and to be mindful of forward posturing, especially if sitting on the computer for long periods of time

Also, if we turn our head to one side with the opposite arm outstretched and flex that hand, we can help stretch the neck. Count to 10 while taking deep breaths in and out.    

Stay Hydrated

A lot of us are not as tempted to drink water in the winter months and may just forget we need to, so consider setting a timer if necessary, as, ideally, we should be drinking eight eight-ounce glasses of water a day, according to Dr. McVige.   

Get Back on Track with Relaxation Techniques, Exercise, and Sleep Patterns

I’m not suggesting this is easy, particularly in the winter, when it’s harder to be outdoors and the skies are grayer day after day for many of us, but we do know, as migraine sufferers, how important all of these benefits are.

Let Yourself Grieve the Past and Acknowledge Your Loneliness

I probably spend too much time grieving losses and contemplating how life has changed as I and my loved ones have gotten older. I know I need to be ok with that grief but not allow myself to dwell in it, because, if I do, or if I spend too much time fearing future losses, I forget the most important part, and that is living in the present, being grateful for all the love and beauty I have in my life now.

Poet Mary Oliver tells us: “it is a serious thing / just to be alive / on this fresh morning / in this broken world.” (Mary Oliver, Red Bird)

We face the new year with the hope of the vaccines, the prospect of uniting as families, friends, and country. We will get to some kind of new normal. In the meantime, though, try to be kind to yourself and others as you continue to struggle with migraine disease after the recent holidays.  

References

Dumas, Paula. "New Study: Nearly 70% of People with Migraine Report Increase in Attacks During COVID-19."Oct 20, 2020. Migraine Again.https://www.migraineagain.com/migraine-covid-survey. Accessed 30 December, 2020.

Evens, Lisa.  “Six Tips to Fight Post-Holiday Fatigue,”  Entrepreneur. https://www.entrepreneur.com/article/230607. Accessed 28 December, 2020.