10 Things Not to Say to Me When I Have a Migraine

I suffer from chronic migraines. I have a headache at least four times a week.

In fact, I’m having a migraine right now.

Chronic migraines are defined by the medical community as having fifteen or more headache days per month, with at least eight of those days meeting the criteria for migraine.

Given that I’ve had migraines since I was thirteen years old, I can conservatively estimate that I’ve had over 8,000 headaches in my lifetime.

That’s a hell of a lot of headaches.

Sometimes people will see me rubbing my head and ask me if I have a headache. Sometimes I have to cancel plans because my head hurts. Sometimes migraines just come up in conversation.

Then the advice starts.

I know people mean well but believe me when I tell you that after over 8,000 days with headache pain I am an expert in my own migraines.

Although I appreciate your concern about my health, your suggestions really are not helpful. If you don’t experience chronic migraines like I do, you have absolutely no idea what my condition is like, or what helps. Trust me when I say that whatever idea you have, I have already explored it. Whatever medication you heard about, I already know about it. Whatever folk remedy you read about, I have already tried it.

Here are ten things that you should never say to me — or any other migraineur.

1. Have you talked to your doctor? No, I have been in pain for forty years and never mentioned it. Of course, I have talked to the doctor. Over the years I have discussed my chronic migraines with a variety of doctors, specialists, alternative healers, naturopaths, chiropractors, and energy workers. Sadly, the brain is still mostly a medical mystery and there is no “one size fits all” magic cure for migraines.

2. Have you tried (insert over-the-counter remedy here)? It helps with my headaches. I’m glad the “asp-tyl-iprofen migraine” you bought for seven bucks at the Walgreens helped you. Truly I am. I am even a little bit jealous that you have such minor headaches that over-the-counter medications work. But my migraines, like most chronic migraines, scoff at most pain relievers. Seriously, I can hear my brain laughing hysterically at the very thought of an OTC migraine medication — right before it cramps up again.

3. Can’t your doctor give you a prescription for that? Yes, prescription pain meds are one of many tools in my migraine arsenal. The truth is, if I took medication every single time I had a migraine, I would be popping pills non-stop. The more you take medications, the more your brain builds up a tolerance for them, making them less and less effective over time. Plus, many “rescue meds” have bothersome side effects like knocking you out, and my employers frown on me sleeping at my desk. I have learned to manage the pain until it’s so bad I want to die, and then if it gets to that point I break down and take a rescue med. Every migraine responds differently. Sometimes a rescue med will knock it out, and sometimes the medication is as effective as aspirin. As in, not. I often alternate between prescription meds, CBD, cannabis products, and kratom.

4. Have you tried avoiding red wine/chocolate/noise/cheese/other random things that I read in a magazine cause migraine? Why yes, I have. There are many, many diverse and seemingly unrelated migraine triggers, and everyone is different. Also, every migraine is different and might be triggered by something new. I have spent many years figuring out what is most likely to make my head angry with me. In my case, migraines are most often caused by weather changes and hormonal fluctuations, so those two glasses of red wine I had last week did not cause my migraine today.

5. I read on Facebook that if you sniff lavender your migraine will go away. Believe me when I say that if that were true for me, I would sleep in a lavender field every night and weave my clothes out of lavender stalks. It also won’t help if I put Vick’s vapor rub on my feet and wear thick socks, or put an ice pack on my neck, or do some kind of a cleanse. I’m sorry to say that none of the “migraine hacks” you saw on Facebook are effective for me — or most people with chronic migraines. I wish they were.

6. You’re probably just stressed out. You need to learn to relax. If only it were that easy. We could all benefit from more relaxation, but you know what stresses me out the most? People who know nothing about my disease telling me how to manage it. Sometimes “relaxing” activities like yoga, massage, or sleeping will actually make my migraine worse. I know, it’s a mystery to me — as well as migraine experts. Although some migraines are triggered by stress, migraines are primarily a brain disorder

7. You will stop having migraines when you go through menopause. That ship has sailed and no, they did not stop. I was sure hoping for a miracle though. If anything, they have gotten worse during menopause. When I was younger, people would tell me that my migraines would go away if I got pregnant. I never tested that theory though.

8. I had a migraine once. It was terrible, my head hurt for at least an hour. No, no you did not have a migraine. You had a bad headache. I have had migraines that lasted for days. A migraine is not just a bad headache. It’s accompanied by a range of other unpleasant symptoms that can include nausea, sensitivity to light, digestive issues, aura, neck or shoulder stiffness, pressure in your head, inability to concentrate, and dizziness — and those are just the most common symptoms. If you ever really had a migraine, you would definitely know the difference. Come talk to me when you've had 8,000 headaches.

9. You were fine a little while ago. Yes, I know. Sometimes I can tell a migraine is coming, like if there’s a big storm coming or when my period was due. But often I will feel perfectly fine and suddenly it feels like someone stabbed me in the head, taking out my eyeball on the way through my skull. I’ll go from perfectly fine to wanting to die within a few minutes. Migraines are sneaky that way.

10. Maybe you’re just dehydrated. Maybe I just have a migraine. Again.