Strengthen Your Migraine Brain: Staying Organized

Patient Expert & Health Professional

Even the most organized person can feel out of control after a prolonged Migraine attack. Sudden increases in severity or frequency can also disrupt our lives. After four years of successful symptom control, my preventive treatment plan started losing its effectiveness. Six months ago, the preventive benefits of onabotulinumtoxinA (Botox) wore off a few weeks before my next scheduled appointment. I wasn’t worried, just eager for that next round of injections that would bring sweet relief.

One week later, my Migraine attack frequency was still stuck at two or three attacks each week. Botox should have kicked in, stopping most of those, but it didn’t. I called my doctor to discuss my options. Neither of us was eager to make major changes to my treatment plan. I agreed to keep in touch and pay careful attention to trigger avoidance.

Three months later my attacks had returned to pre-Botox frequency. With three or four attacks every week, chronic Migraine had returned. I was now getting more Migraine attacks than I could safely treat without risking medication overuse headache. Not wanting to give up hope, we agreed to try one more round of Botox and a prednisone burst to break the cycle. Hopefully that will work. If not, we’ll keep trying. In the meantime, I need to put my life back in order.

Migraine’s impact

Smart But Scattered defines organization as “the ability to create and maintain systems to keep track of information or materials.” That’s not happening in my house right now. My naturally adept skills have been impaired by a sudden change in Migraine attack frequency.

My normally organized home has suffered in the wake of this relapse.

  • Clean laundry is pulled from baskets as needed, never making it to the closet or dresser.

  • In an effort to slow the growing pile of dirty dishes, I’ve raided the emergency stash of paper plates.

  • Groceries and medications have been ordered online for weeks.

  • Don’t even ask about the condition of my office or the last time I made the bed.

  • At least the toilets and showers are clean.

  • I’d be in so much trouble without electronic bill pay.

Signs that our organizational skills are impaired:

  • Losing track of important documents or items

  • Forgetting appointments

  • Feeling overwhelmed by clutter or mess

  • Getting behind in projects or tasks

  • Running out of essentials

Strategies to get back on track:

1. Get a reality check.

Take an honest look at the disaster. Resist the impulse to ignore it, make excuses for it, or postpone addressing the problem. We all need to be organized, Migraine or not. Own the mess.

2. Make organization a priority.

Organization doesn’t happen by accident. Skip the “too busy” excuse and schedule time to get it under control. Ask for help if needed. Pace yourself. Consider the time spent on this project an investment in your physical and emotional well-being.

3. Evaluate the cause of relapse.

Identify areas of weakness in the previous organizational strategy. Create new strategies to shore up the vulnerable areas. We can’t always control changes in our Migraine attack frequency. But we can control our attitude by viewing the changes as an opportunity to create new, Migraine-friendly life hacks.

4. Relapse prevention plan.

Accept that loss of organization will happen again. Prepare for it. Make a corrective plan before life falls apart again.

Migraine may make a mess, for a time, but we can clean it up. Who’s with me?


1 Dawson P, Guare R. Smart But Scattered: The revolutionary “executive skills” approach to helping kids reach their potential. New York: Guilford Press; 2009.

2 Gil-Gouveia R, Oliveira A, Pavao Martins, I (2014).Cognitive dysfunction during Migraine attacks: A study on Migraine without aura. Cephalalgia. 2014;35:662-674. Doi: 10.1177/0333102414553823

3 Huang L, juan Dong H, Wang X, et al. (2017).Duration and frequency of Migraines affect cognitive function: evidence from neuropsychological tests and event-related potentials. Journal of Headache and Pain. 2017; 18:54. Doi: 10.1186/s10194-017-0758-6.

4 Koppen H, Palm-Meinders I, Kruit M, et al. (2011).The impact of a Migraine attack and its after-effects on perceptual organization, attention, and working memory. Cephalalgia. 2011;31(14):1419-1427. doi:10.1177/0333102411417900.