How to Help Someone Having a Migraine: What Actually Works

They’ve gone into the bedroom and shut the door. You can hear them being sick. You are standing in the hallway holding a glass of water you’re not certain they want, and you genuinely don’t know whether walking in helps or makes it worse.

Almost everything written about migraine is written for the person having one. This is for you.

Ask once, early, then stop asking

Get your questions in before the attack peaks, because talking becomes expensive fast. One round: do you want the water here or by the bed, do you want the door open or shut, do you want me to check on you or leave you alone until you call.

Then honour the answer, including the one that stings. “Leave me alone” is not rejection. Speech takes effort, light comes in when the door opens, and answering “are you okay?” for the fourth time costs them something they don’t have.

If you can, settle these questions on a good day instead. A three-line note on the fridge covering what they want during an attack removes the entire negotiation from the worst possible moment. The free action plan card is that note as a one-page template, if you’d rather not start from a blank sheet.

The room is most of the job

You can’t touch the pain. You can control the environment it happens in, and that’s not a consolation prize.

Dark means properly dark. Not curtains drawn at 2pm with light bleeding around the edges, but a towel along the bottom of the door and a hand over the standby LED on the television. Light sensitivity during an attack isn’t a preference; the technical term is photophobia, and ordinary daylight can be physically painful.

Quiet means the washing machine too. Sound sensitivity works the same way, and a spin cycle two rooms away is louder than you think when you’re lying still in the dark.

Cool helps most people. Turn the heating down before they ask.

Smell is the one people forget. Don’t cook anything with garlic or onion, don’t make coffee near the room, skip the scented candle you lit to be nice. Smell sensitivity is common enough that The Migraine Trust lists it among the symptoms worth recording, and frying something at the far end of the flat can restart nausea that was finally settling.

Most of this is worth setting up once rather than improvising each time — one room that can go properly dark, a bowl and a glass of water kept where they can reach them. Living with someone who has migraines covers the changes to a shared home that pay off repeatedly.

Bring the right things, quietly

A basin or a bowl, within reach, before it’s needed. Asking for one mid-nausea is humiliating and slow.

Water in something they can drink lying down. A tall glass is useless flat on your side.

An ice pack wrapped in a tea towel, plus a spare in the freezer, because the first one stops being cold in twenty minutes and getting up to swap it is exactly the thing they can’t do.

Their medication and a note of the time you handed it over. That last part matters more than it sounds. Afterwards, nobody remembers whether it was taken at 2 or at half past three, and that timing is one of the few genuinely useful things a doctor can work with.

Move slowly and don’t narrate. Set things down, don’t announce them.

Doing this once teaches you what should already be within reach next time. What to put in a migraine kit is the version of that list organised by where it lives, since a well-packed pouch in a hall cupboard helps nobody at two in the morning.

Take the outside world off their plate

This is the part only you can do, and it’s worth more than anything you do inside the room.

Cancel the dinner. Message their sister back. Take the kids out, or at least out of earshot. Answer their phone if they’d want you to. Deal with the delivery driver before the second knock.

Do it without a running commentary and without making them approve each decision. The mental load of managing an attack while their life keeps making demands is a real, separate weight, and you can simply lift it.

If you have to tell someone why plans changed, say “they’ve got a migraine” and leave it there. No apologising on their behalf, no editorialising about how often this happens.

Don’t hand them your feelings to hold

You will feel useless. That feeling is accurate in a narrow sense and irrelevant in every other.

What you should not do is bring it into the room. “I hate seeing you like this” and “I wish I could do something” both sound like care and both land as a small task: now they have to reassure you, from inside a migraine. The same goes for hovering, and for sighing audibly in the corridor.

Put it somewhere else. Text a friend. Do the washing up. Sit in another room and feel it there.

The bit nobody warns you about

When the pain stops, it isn’t over.

Migraine has a recovery phase, often called the postdrome, and it can leave someone wrung out, foggy, slow, and strangely emotional for a day afterwards. Plenty of people describe it as feeling hungover without having drunk anything.

Knowing this changes how you behave the next morning. Don’t treat the end of the pain as a return to normal service and start asking about the weekend. Don’t read the flatness as sulking. Keep the plans light for another day, and let them come back at their own speed.

Noticing is a job too

Over months, the person having the attacks is the worst-placed person to spot the pattern, because their memory of each one is compressed and distorted by pain. You’re the one who might notice that the bad ones cluster after short nights, or the week before a deadline, or when the weather turns.

You need something better than memory. A paper diary works. So does the notes app on your phone. What matters is that it gets recorded within a day, in a consistent shape: when it started, how bad it got, what happened in the preceding twenty-four hours, what was taken and when. The Migraine Trust suggests keeping this up for three months or more before expecting the pattern to be readable, which is longer than most people last.

If you want the specifics of what to record and what to skip, how to track migraine triggers covers it properly. Migraine Journal was built for exactly this handoff, and it captures the barometric-pressure change automatically at the moment of logging, since that’s the one variable nobody can reconstruct afterwards.

None of this is a substitute for a proper conversation with their GP or neurologist, particularly if attacks are getting more frequent or the pattern changes.

Say less than you think

The single most common mistake is talking. The second is asking how they’re doing every fifteen minutes. Most of what helps is quiet, physical, and done without discussion: the door closed, the bowl within reach, the phone answered, the evening cancelled.

And when they surface, resist the urge to debrief. What not to say to someone with chronic migraines covers the phrases that go wrong, and most of them are things people say out of genuine kindness in exactly that moment.