Phases of a migraine chart

Which Phase Are You In?

You may be familiar with some of migraine’s more common symptoms — head pain, nausea and sensitivity to noise — but what about symptoms like irritability, seeing flashing lights and extreme fatigue? The truth is, many people experience a wide range of symptoms when a migraine strikes — and different symptoms can cue you in to which phase of the migraine you’re in. That’s important, because each phase responds differently to treatment — and identifying a migraine before it hits the headache phase might help you avoid it altogether! Read on to learn more.

1 PRODROMAL (early warning)

When it happens
Several hours to up to two days in advance.

Frequency
About 60% of those with migraines will experience this phase.

Possible symptoms
Anxiety, unexplained energy or feelings of euphoria, neck pain, irritability, difficulty concentrating, food cravings, sensitivity to smells or noise, fatigue with frequent yawning

What to do
Take the pain reliever your doctor recommended or prescribed. Doing so right now can help you avoid a full-blown migraine. This is also a good time to think about possible triggers — for example, ask yourself what you’ve eaten or had to drink, how stressed you are and how much sleep you’ve had.

2 AURA PHASE (pre-migraine)

When it happens
About an hour before to right when the headache strikes.

Frequency
About 20% of those with migraines experience this phase, but not necessarily every time.

Possible symptoms
Changes in vision, such as flickering, shimmering or flashing lights, tunnel vision, spots of vision loss or zig-zag lines that cross your line of sight; skin sensations, such as numbness in your extremities or feelings of tingling or “pins and needles” in the face or hands; trouble speaking, writing or understanding words; muscle weakness

What to do
Immediately take a pain reliever or the acute medication you’ve been prescribed for your migraine. Make sure you have your migraine tool kit handy and avoid any triggers.

3 HEADACHE PHASE (during migraine)

When it happens
This is when the actual headache strikes; it can last for hours up to several days

Frequency
100% if the migraine is untreated.

Possible symptoms
Throbbing or pulsing pain ranging from mild to severe, often on one side but sometimes both sides of the head; sensitivity to light, sounds and sometimes smells; nausea and vomiting; blurred vision; light-headedness and/or fainting

What to do
Immediately take a pain reliever or medication you’ve been prescribed for your migraine. Relax in a cool, dark, quiet setting.

4 POSTDROMAL (after headache)

When it happens
After the headache phase has subsided, lasting for a few hours up to two days.

Frequency
Most people who experience the headache phase will experience some form of postdromal phase.

Possible symptoms
Extreme fatigue, sluggishness, confusion, irritability, head pain if you move too quickly or bend over

What to do
If you’ve been taking acute migraine meds, start to cut back so you avoid a rebound headache. Continue to rest and avoid stress and other common triggers.