The four phases of a migraine attack

A migraine attack has structure. It doesn’t just appear — it moves through phases. Not everyone experiences all four, and the phases don’t always come in the same order, but naming them helps.

1. Prodrome (hours to a day before)

The earliest phase. Subtle. Easy to miss until you know to look for it.

• Yawning more than usual.
• Sudden food cravings (chocolate is common, but it is often a symptom, not a trigger).
• Feeling “off” — irritable, foggy, unusually tired or unusually wired.
• Neck stiffness.
• Sensitivity to light or sound that is a little sharper than baseline.

Learning your prodrome is one of the biggest wins in migraine care. Interventions started here — hydration, a rest, a preventive medication if you use one — tend to work better than the same intervention started once pain has arrived.

2. Aura (usually 20–60 minutes)

Roughly a third of people with migraine experience aura. Visual aura is the most common (zigzags, blind spots, shimmering), but sensory aura (tingling that spreads), speech aura (finding words hard to reach), and motor aura also exist.

Aura is a good signal to stop, dim the lights, and give yourself the space that the next phase is going to demand.

3. Headache (4–72 hours if untreated)

The phase most people think of when they hear “migraine.” Typical features:

• One-sided throbbing pain (though it can be both sides).
• Made worse by movement.
• Accompanied by nausea, sometimes vomiting.
• Extreme sensitivity to light and sound, sometimes smell.

Many people describe wanting to lie in a dark, quiet room. That instinct is correct — reducing sensory load is a legitimate treatment.

4. Postdrome (up to a day)

The “migraine hangover.” Pain is gone, but the brain isn’t back to baseline.

• Fatigue and low mood.
• Difficulty concentrating.
• Feeling emotionally flat or delicate.
• Mild residual head or neck discomfort.

Postdrome is real, and it is a phase to rest into, not push through. Underestimating postdrome is one of the fastest routes to the next attack.

Why phases matter

The phases give you levers. Prodrome awareness means earlier action. Aura recognition means fewer surprises. Postdrome planning means fewer boomerang attacks. Migraine becomes a process you can meet, not just endure.