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A lot of people might also feel embarrassed or ashamed of the way they feel. That’s because, according to Dr. Loder, people with migraine might see their symptoms as a weakness. This all can contribute to “a huge barrier in accessing care,” says Dr. Starling. One 2021 study published in the journal Headache found that less than 12% of people with migraine made it through the three main steps to better care—consultation, diagnosis, and treatment.
How you can help.
Supporting someone can be as easy as acknowledging that migraine is more than a headache, says Dr. Seng. By doing that right off the bat, you’re validating a very real, painful experience that people have to deal with every day, experts say. Beyond that, here are a few things experts say can make a difference:
Don’t try to figure out their triggers.
Migraine isn’t a sign of weakness or an excuse to cancel plans, says Dr. Loder. There’s a misconception that attacks are somehow controllable. If someone is having one, don’t say, “‘What did you do? Are you under any stress? Did you have too much coffee?’” These episodes are caused by a lot of factors, and people are rarely triggered by a single thing. “[A person] may have done nothing ‘wrong’ at all and [they] still have symptoms,” Dr. Loder previously told SELF.
Avoid assuming they’re fine just because they don’t “look sick.”
It’s easy to think that if someone shows up at work, a dinner, or to pick up their kids, that they’re “okay.” The reality is that a ton of folks push through no matter what, says Dr. Seng. “These are people who have unpredictable, painful attacks and other symptoms that interfere with their ability to do pretty much anything,” she says. “And yet, they have families. They have jobs and careers and lives.”
That’s because migraine, as we said, isn’t just a single episode of obvious pain: Symptoms come in stages. For example, some with the condition experience aura—where their speech and vision are impaired—right before or alongside an attack, and for some folks, it’s their only issue. (So while your friend might not be clutching their temples in agony, they could actually feel woozy or dizzy.) Similarly, they might be reeling from a severe episode they had days or weeks ago, alongside body aches, dizziness, and fatigue—often called the postdrome stage. Basically, it can look super intense to the outside observer—or it might look like nothing at all. (It’s impossible for anyone besides the person with migraine to know.)
Try to be flexible with plans.
It can be helpful to know what triggers someone’s pain—and accommodate those situations. Maybe you can suggest hanging in a spot without bright lighting or dining at a quieter restaurant, Dr. Starling suggests. Or, perhaps, you make loose, go-with-the-flow plans knowing that things may need to switch up at the last second. That’s because, again, attacks can be wildly unpredictable.
Just listen.
Simply talking more openly could help, suggests Apfelroth. “I’d love for migraine attacks to become as mainstream as cramps or a sinus infection,” she says. If people with the condition feel like they have the space to be more vocal about what they’re going through, others might feel inclined to share as well—and it could potentially lead to better care all around, the AMF says. (Something Apfelroth also agrees with.)
When it comes to chronic health issues, try to give people grace—and that includes yourself if you have migraine. Being intentional with how you speak about the condition can make a world of difference for someone in pain. And it doesn’t have to be hard! Using your words to help rather than harm can sometimes be as easy as removing a single letter.
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