About 38 million Americans get migraine. Chances are you know someone who has this often debilitating pain.

While the offer of the aspirin from your desk drawer came with the purest intentions, was it helpful?

When asked about the things they wish people close to them would stop doing, here’s what some folks with migraines had to say.

Don’t call it a headache.

Even if you have the best of intentions, calling your co-worker’s migraine "a headache" can be pretty cold comfort.

“I get a headache if I bump my head, or don’t sleep well, or I’m hung over,” said Omid Iravanipour, a landscape designer in New York City. “This is different.”

Calling migraines “headaches,” Iravanipour says, only fuels skepticism about how they really affect people.

“People say to me, ‘I get headaches, too, and I don’t have to leave work for that,’” he says.

A migraine isn’t a run-of-the-mill headache. It’s a neurological condition than can bring many symptoms besides severe, throbbing head pain (as if that weren’t enough).

Those things might include:

  • Nausea
  • Vomiting
  • Dizziness
  • Tingling
  • Numbness in the face and limbs
  • Extreme sensitivity to sound, light, touch, and smell

It can affect your vision, too. That doesn’t sound so much like your average headache, does it?

Don’t doubt me.

When your friend feels a migraine coming on, he needs to act fast. Maybe he needs to go home from work or class. He may need to turn off the lights and lie down under his desk.

When you question if his pain is real, you give him more pain.

Washington, D.C.-based marketing executive Meredith Braselman got her first migraine in kindergarten. Her teacher’s response? “Kids don’t get headaches,” Braselman says. Today, she still gets the same skepticism.

“I had a boss one time who seemed to think that maybe I was just trying to get out of work early.”

If you’ve never had a migraine, it can be hard to understand.

“It’s like, ‘How can you look so normal at one point and then say you have this horrible headache?’” says Gretchen Tietjen, MD, director of the Headache Research and Treatment Center at the University of Toledo in Ohio.

The World Health Organization ranks migraines as the sixth most disabling illness in the world. Doubting the existence of a migraine isn't just hurtful to your friend, Tietjen says. It also contributes to the stigma people who get migraines face.

That might keep people from getting help for their migraine when they need it.

“It’s frustrating when people won't get help for their migraine because they compare themselves to me or other people who have chronic migraine," says Janet Geddis, an Athens, GA-based bookstore owner. 

"If a headache interrupts your ability to function normally or to enjoy life, talk to your doctor -- even if your symptoms don't seem to you as bad as they could be,” she says.

Even folks who get migraines can be guilty of second-guessing others.

“Some people with migraine dismiss other people’s migraine complaints because they don't match up with that person's typical attack symptoms,” Geddis says.

In fact, no two folks with migraines are alike. Triggers, pain, symptoms, and preferred treatments can vary widely from one person to the next.

Don’t give me advice.

Yes, you were trying to help because you care. Still, tips on how to prevent or cure a migraine can be frustrating to someone who may have already tried everything, or who knows very well what her triggers are.

Put simply, your friend probably has a lot more experience with migraine prevention and remedies than you do. Your advice might even come off as a little judgmental.

“I know people just want to be helpful, but when you tell me I’m getting migraines because I’m not living healthy, it’s kind of an intrusion,” Iravanipour says.

Even what helped ease your mother’s migraines might not work for someone else. Even something a doctor suggests may not work.

“It’s all trial and error,” Tietjen says. “For one person, [something] might make a huge difference, and for someone else it makes no difference at all.”

What can you say to your friend then? “Is there anything that helps?” might sound a little kinder than “You should eat more kale.”

Don’t hover.

It’s hard to see your loved one in pain. You just want to help. In reality, probably the most helpful thing you can do is leave your friend alone.

The most common symptoms of migraine are extreme sensitivity to light and noise. All your friend might want is a dark, quiet room. For some, it might actually hurt to move. So don’t even rearrange those pillows, no matter how badly you want to.

When Iravanipour got a migraine in college, his roommates were so worried they checked on him every 10 minutes. It was excruciating. It hurt just to speak the words, “I’ll be fine.” But it’s not easy to tell well-intentioned friends to get lost. 

“My husband can be a great nurse,” says Braselman, “but there are times when I just need him to draw the blinds, turn off the TV, and leave the room.”

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