When it comes to migraines, I’m textbook. I’m well-acquainted with my triggers, and I’m on a first-name basis with my version of symptoms. I find migraine illness to be rather straightforward, and yet a cloud of confusion hovers around the term “migraine.”

The non-migraine portion of the population often has a hard time wrapping their minds around the basic elements of migraine illness. Their confusion baffles me. I’m not sure if the problem lies in a lack of empathy or the belief in an inaccurate definition of what migraine disease really is. Or maybe it’s simply a fundamental breakdown of good old-fashioned manners.

Allow me to remove a small part of the cloud of confusion by discussing what not to say to someone who lives with migraine. Let’s call it “Manners for Migraines 101.”

1. “I had a migraine once and it was awful.” No, you probably didn’t. A migraine is a recurrent episodic neurological disorder. Recurrent means repeated and periodic. The definition dictates a migraine will likely not happen only once. If it was only once, then you had a bad headache, which would be like comparing a dizzy spell to an epileptic seizure.
2. “Maybe you wouldn’t have so many migraines if you didn’t think about it so much.” Worst. Advice. Ever. Don’t say this. Migraines are biological, not psychological. I can’t think myself into or out of a migraine. My best defense is migraine management, which requires a great deal of thinking. Bad advice can do more harm than good.
3. “When I get a headache, I don’t have to go home and lie down. You must have a low tolerance for pain.” Quite the opposite. Many migraine warriors have learned to function with the pain as much as possible to hold down a job and take care of a family. Only at its worst do we succumb to the pain and retreat from life. A migraine headache is intensified by normal household lighting, moderate noise volume, and mild odors. Waves of nausea and even vomiting are common, and yet we persevere. Be impressed by our strength instead of insulting our need to heal.
4. “Maybe you’re hypoglycemic.” No, I’m not. I’ve never understood the non-migraine person’s desire for me to have hypoglycemia instead of migraine. My first known trigger is changes in eating patterns. This means I must have three meals a day and I have a window of opportunity within which to eat those meals. This is a common textbook trigger for migraine – plain and simple. You don’t know more about my triggers than I do.
5. “You don’t think that fragrance smells nice?” It’s not a question of personal preference or where the smell lands on a scale from disgusting to delightful. I don’t get to decide which odors are triggers. Powdery perfume and many home fragrance products are triggers for me, skunk and rotten eggs are not.
6. “There’s a good filtration system so the cigarette smoke there isn’t too bad.” Not too bad is all it takes. I can’t go to a casino or an outdoor concert. If you are a smoker, I can’t go to your house or ride in your car. You wouldn’t tell someone with a peanut allergy that there are only a few nuts in the food, so you’ll be fine to eat it. Migraine is real and serious. Have a little respect.

To summarize, think a little before you speak. Be courteous, respectful, understanding, and caring. There are many things a migraine warrior will appreciate hearing from you. A good start would be to turn down the lights and quietly ask, “What can I do to help you?”

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