What Not to Say to Someone With Chronic Migraines

The cruel things are easy to avoid. Nobody needs to be told that “you’re always ill” is unkind.

The problem is the other category: the sentences said by people who love the person, in the exact moment they most want to help, that land as a small additional weight. Those are worth going through one at a time, because the reason each one fails isn’t obvious from the outside.

“Have you tried…”

Whatever follows, they’ve tried it. Magnesium, riboflavin, cutting caffeine, adding caffeine, more water, less cheese, a chiropractor, an elimination diet, yoga, a different pillow, blue-light glasses.

Someone with chronic migraine has typically spent years running experiments on their own body, most of them unsuccessful. The suggestion isn’t new information; it’s a reminder of a long list of things that didn’t work, delivered by someone who assumes they haven’t thought about it.

There’s a second sting underneath. “Have you tried” quietly implies the problem persists because they haven’t looked hard enough. It moves the fault to them.

Instead: “Is there anything you’ve been wanting to try?” If they want to talk treatment, that opens it. If they don’t, it closes cleanly.

“It’s just a headache”

Or the softer versions that do the same work: “I get headaches too”, “I had a bad one last week.”

Migraine is a neurological condition, not a severe headache. Depending on the attack it can involve nausea, vomiting, visual disturbance, numbness, difficulty speaking, and a recovery phase that flattens the following day. Some attacks involve no head pain at all.

Comparing it to your tension headache isn’t solidarity. It resets the scale downward, and it implies they’re handling a normal thing badly.

Instead: call it a migraine, and don’t compare.

“You get a lot of these, don’t you?”

Usually said neutrally, sometimes with real concern. It’s heard as accounting.

People with chronic migraine are often already tracking their frequency anxiously, aware of how many days they’ve lost, aware of what colleagues have noticed. Saying the number out loud adds nothing they didn’t know and confirms that other people are keeping score.

Instead: if you’re worried about frequency, say the worry directly and privately, and once. “I’ve noticed these have been closer together lately, and I’m concerned about you” is a different sentence entirely.

“Is it stress? You should relax more”

Stress is a genuine and common trigger, so this feels reasonable. It fails for two reasons.

First, it reduces a neurological condition to a mood problem they could fix by trying harder. Second, “relax more” is unactionable advice given to someone whose life is already being interrupted several times a month.

There’s also a nasty loop here. Being told to relax is stressful.

Instead: remove a stressor instead of naming one. Take something off their list.

“My aunt had migraines and she cured hers with…”

The cure story is the most confidently delivered and the least useful.

Migraine responds very differently between individuals, which is exactly why the research is so hard to read. A 2025 systematic review of barometric pressure and migraine found associations with attack frequency in several studies, almost none with severity, and none with duration — and pressure is one of the most-studied external factors there is. One person’s recovery is an anecdote, not a protocol.

Instead: nothing. This one has no good version. Skip it.

“You look fine”

Meant as reassurance. Received as doubt.

Most of a migraine is invisible, and people who have them frequently get very good at functioning through the early stages because the alternative is missing everything. Being told they look fine tells them the performance worked, which is not comforting when they feel like this.

Instead: “How are you actually doing?” The word “actually” does a surprising amount of work.

“Feel better soon!”

Harmless with a cold. Odd with a chronic condition.

It frames the situation as a temporary blip on the way back to normal, when the reality is a recurring condition managed indefinitely. Repeated over years, it starts to sound like impatience.

Instead: “Hope this one passes quickly.” It acknowledges the specific attack without implying the condition should be over by now.

“At least it’s not…”

At least it’s not a tumour. At least it’s not chronic pain all the time. At least you can still work.

Every version asks them to feel grateful while in pain. Comparative suffering is never comforting, and it usually ends the conversation, which is often its actual function.

Instead: let it be bad. “That sounds awful” is a complete sentence.

“Are you okay?” — for the fourth time

Repeated checking during an attack is the most common mistake made by people doing everything else right.

Answering costs speech, and speech costs effort they don’t have. Every check-in also means the door opening and light coming in. Ask once, get the answer, then act on it. How to help someone having a migraine goes through what to do with the silence instead.

What to say

The replacements are short, which is the point.

• “That sounds awful.”
• “What do you need from me right now?” — asked once.
• “I’ve cancelled it, don’t worry about it.”
• “Take the day. I’ve got this.”
• “I’ll be in the other room if you want me.”
• Nothing at all, plus a bowl and a glass of water by the bed.

Notice that most of them are logistics rather than sympathy. Sympathy asks for a response. Logistics don’t.

If the real problem is that they don’t believe an attack is more than a bad headache, no replacement phrase fixes it. How to explain migraines to someone who doesn’t get it has scripts for that conversation instead.

The part that’s hard to admit

If you live with someone who has chronic migraine, you will at some point feel frustrated, or resentful about a cancelled plan, or tired of rearranging things. That doesn’t make you a bad person, and pretending otherwise is how it comes out sideways as a sharp comment at the wrong moment.

Feel it somewhere else. Say it to a friend, or a therapist, or nobody.

One thing genuinely does help with the frustration, and it isn’t emotional: understanding the pattern. Attacks feel random from the outside and much less so once six months of them are written down next to sleep, stress, and the weather. How to track migraine triggers covers how to record them in a form that’s actually readable later. Migraine Journal exists to make that recording take under a minute, because a diary that takes ten minutes during a bad week stops getting filled in.

If attacks are becoming more frequent, or the pattern changes noticeably, that’s a conversation for their GP or neurologist rather than a tracking problem.