We all have that crazy uncle, the well-meaning aunt or the embarrassing friend who despite having good intentions, just doesn’t get it. This article reveals a list of what not to say to someone with migraine.

The worst situations arise from people you don’t know as well. Often it will be in a group situation where you don’t feel as comfortable going into detail about your ongoing personal health problems.

Usually, those with migraine are too polite to say anything directly to the offending individual. But it’s important that they are made aware. It’s not an easy task, but often the individual may not have realized they are causing offense.  

Below is the list of the most common- sometimes inadvertent- insults from those closest to us.


Migraine Insults

"But You Don't Look Sick"

– What NOT to say to someone with migraine.

1) “But you don’t look sick”

Those with migraine spend an enormous amount of energy trying to fit in and look as normal as possible. In one sense this it may seem like a compliment but usually it comes across as a condescending lack of empathy and judgment of the chronically ill. As if the disease isn’t real unless you can see it. People with chronic migraine endure more stigma than epilepsy for this reason. (1)

"Just Take Some Aspirin"

– What NOT to say to someone with migraine.

2) “Just take aspirin”

Many chronic migraine patients are taking preventative medications every day to help prevent attacks. Acute attacks can involve dizziness, vertigo, blinding lights, severe stabbing pain, nausea vomiting, hypersensitivity to light, sound and touch amongst other things.

It isn’t anything like a regular headache. Some people experience symptoms resembling a stroke after losing function in one side of their body. Migraine attacks can last for days and standard painkillers are often ineffective. See evidence-based proven treatments for migraine.

"I Get Headaches And I Don't Need Time Off Work"

– What NOT to say to someone with migraine.

3) “I get headaches and I don’t need time off work”

A migraine attack can render someone hugging the toilet bowl between bouts of nausea and vomiting, curled over in bed, requiring ice packs on the head to numb some of the pain. Often those with migraine require a dark, quiet room to see off the worst of the attack.

"It's Just A Headache"

– What NOT to say to someone with migraine.

4) “It’s just a headache”

Many women have said their migraines are more painful than childbirth. Migraine is a neurobiological disease that affects the nervous system and sensitizes the brainstem which affects the entire body.

"At Least You're Not Dying"

– What NOT to say to someone with migraine.

5) “At least you’re not dying”

Unfortunately migraine does take lives each year through rare migrainous strokes, suicide and death from accidental overdose, depression, medical mistakes, side effects and related accidents. (2)

Chronic migraine patients are the group most at risk of these potentially fatal health issues and professional help should be sought if migraine is affecting your quality of life.

"You're Just Stressed Out"

– What NOT to say to someone with migraine.

6) “You’re just stressed out”

Migraines are a genetic and neurologic disease which results in a sensitized brainstem that overreacts to otherwise normal stimuli. Consequently, many of us have healthy levels of stress in our lives and still experience migraine attacks.

"I Wish I Could Hang Out At Home All The Time Like You"

– What NOT to say to someone with migraine.

7) “I wish I could hang out at home all the time like you”

Another insensitive comment. Perhaps you’d like a day or week or more off work. Sure, who wouldn’t? But would you trade your health and quality of living for it? Would you give up your freedom, self-esteem, confidence, and happiness for it?

Being chronically ill is lonely, debilitating and dangerously depressing. You, on the other hand, can reach your full potential to be a productive, active member of society.

"Is It That Time Of The Month?"

– What NOT to say to someone with migraine.

8) “Is it that time of the month?”

Whilst menstruation is a common trigger for women it does not excuse this kind of statement. It is simply poor manners and inappropriate.

Migraine is not limited to females. Around one-third of patients are men. There are millions of male migraine patients around the world. From personal experience as a man, getting hit with a migraine unprepared without treatment is excruciatingly painful and completely debilitating.

"Have You Tried Going Sugar-Free?"

– What NOT to say to someone with migraine.

9) “Have you tried going sugar-free?”

Whilst changing your diet can eliminate trigger foods and help prevent attacks, there is no cure for migraine, dietary or otherwise.

"It Can't Hurt That Bad"

– What NOT to say to someone with migraine.

10) “It can’t hurt that bad”

The World Health Organisation (WHO) has ranked migraine in the top 20 most disabling diseases worldwide. The WHO also rate a severe migraine attack as comparable to dementia, quadriplegia and active psychosis.

"You Really Need To Do Something About Those Headaches"

– What NOT to say to someone with migraine.

11) “You really need to do something about those headaches”

I wouldn’t wish migraine on my worst enemy, so it’s particularly insulting when you assume an that we aren’t making an effort to get better. Most people feel like they have tried everything and spent a fortune trying to get better. From treatments, vitamins, diets, holistic medicine, physical therapy, acupuncture and so on.

"Get A Hobby To Take Your Mind Off The Pain"

– What NOT to say to someone with migraine.

12) “Get a hobby – it will take your mind off the pain”

If you just broke your leg, would doing crossword puzzles or take your mind off the pain? Didn’t think so.

Migraine is a primary disease meaning it’s not caused by any underlying disorder. Neurotransmitters such as serotonin are thought to be involved in the migraine genesis. As you might appreciate, it is not unreasonable for those with a chronic disease to become depressed with a lack of progress and inability of the doctor to help. It’s therefore common for clinical depression to occur in migraine patients.

It takes an incredible amount of personal fortitude to withstand the sense of helpless and lack of empathy from the outside world.

"Just Go For A Walk, That Always Gets Rid Of My Headaches"

– What NOT to say to someone with migraine.

13) “Just go for a walk, that always gets rid of my headaches”

Exercise is can be helpful for migraine patients if they are not having an attack. For chronic patients often there is little free time between attacks, which leaves little opportunity for exercise.  Additionally exercise or overheating can be a trigger for some people. Walking outside in bright sunlight and noise with a migraine attack is more likely to make the pain worse than provide relief.

"Have You Prayed About It?"

– What NOT to say to someone with migraine.

14) “Have you prayed about it?”

This can be insensitive and hurtful regardless of an individuals’ religious beliefs. There is no single treatment, behavior or action that acts as a cure-all for migraine.

How strong is your friendship?

If you’re a friend or family member and you’ve read this far well done! You’ve demonstrated you really do care and want to help. Migraine patients often go through a world of a pain and now that you have a glimpse of our world, we are both better for it.

If you’ve read this list a feel guilty that you’ve said some or all of things don’t despair. The fact that you made it here shows us that you are a true friend and that we are lucky to have you.

In fact, now it’s our turn to apologize.

On behalf of the person with migraine who sent you here I’d like to say thank you for putting up with us. I know we are all far from perfect. Over the years I’ve taken meds which have made me gain weight, lose weight, be happy, be cranky, and you’ve been there through the up’s and down’s. That means a lot to us and we really appreciate it.

Thank you. I don’t say it nearly enough.

What other comments have you heard? No judgment here, we’ve all been guilty at one stage. Please share them in the comments below.

Now go share this with a friend or family member.

Article References

1. William B. Young, Jung E. Park, Iris X. Tian, Joanna Kempner. The Stigma of Migraine. PLoS ONE, 2013; 8 (1): e54074 DOI: 10.1371/journal.pone.0054074

2. Velentgas, P., Cole, J. A., Mo, J., Sikes, C. R. and Walker, A. M. (2004), Severe Vascular Events in Migraine Patients. Headache: The Journal of Head and Face Pain, 44: 642–651. doi: 10.1111/j.1526-4610.2004.04122.x