Canceling plans is never fun—and when migraine is to blame, telling friends can be particularly difficult.
Migraine affects one in six American adults and is the second most common cause of disability worldwide. But people without the condition sometimes don’t understand how disabling migraine headaches can be, said Dharti Dua MD, a neurologist at The Ohio State University Wexner Medical Center.
“Patients can often feel misunderstood at school, work, or with family and friends,” she told Health.
In fact, one 2024 survey of migraine patients in Japan found:
- Nearly 42% of respondents said migraine affected their leisure time
- About 32% said migraine interfered with their relationships
- 18% said it interfered with their social activities
So how can you navigate your social life and maintain friendships, even when migraine attacks sometimes get in the way? Here are the seven tips experts recommended.
Because many people do not know the difference between a headache and a migraine, sharing your experience is important if you want a friend to understand what you’re going through, said Nathan Feiles, LCSW-R, an integrative psychotherapist based in New York City.
“People tend to respond negatively when they don’t really know how bad it can be,” he told Health.
The best time to explain migraine to a friend is early on in your relationship, before you’ve experienced a migraine attack, Dua said. She suggested broaching the subject by asking an open ended question such as: Do you know anyone who suffers from migraine?
“Keeping the conversation short and direct is helpful,” she said. “If you have already shared with friends and family that you are a migraineur and that migraine attacks can come out of nowhere beforehand, that might help in setting the ground for D-day when you have to cancel or change plans last minute.”
Migraine triggers look different for every person, and can range from stress to strong odors to hormone fluctuation.
If you have definite triggers for a migraine, it’s reasonable to let your friends and family know. They can help you navigate and avoid any potential risk factors that might spur a migraine attack.
For example, if alcohol is a migraine trigger for you, tell your friends before you go to a gathering so they can make sure they have non-alcoholic drink options available for you.
Even if your migraine triggers vary or are inconsistent, that’s helpful information for friends and family to know, too.
“For example, certain red wines [and] cheese can trigger a migraine for a particular patient. However, this may not happen 100% of the time,” Dua explained.
If you have an established relationship with a friend and they’re still struggling to understand your migraine experience, Dua said giving them more information could help. Online resources about migraine from the National Institutes of Health or other sites can help them learn more.
Or, you could even offer to bring them to one of your physician visits.
“A true friend should listen, learn, and be open to understanding how to comfort the migraineur,” said Dua.
If a migraine attack comes on during an event or hangout with a friend, you may need them to assist you. So it’s a good idea to ensure you’re on the same page beforehand, Feiles said.
“Some will travel in groups of three or more in case rest time is needed for a migraine attack,” he said. “Or, if you are doing something just you and your friend, some have found it helpful to have a conversation when making plans about the unpredictability of migraines, how it may disrupt a day, and how this should be handled.”
If a migraine happens before or during a social gathering, Feiles recommended apologizing if you have to cancel or miss plans.
“Some have protested this and feel an apology shouldn’t be necessary for something you didn’t cause or want to have happen,” he explained. “But it is still a disappointment for your friend if plans have to be canceled, so there is a world in which an apology can make sense, as well.”
Though the migraine certainly isn’t anyone’s fault, an apology lets a friend know you’re upset about missing the opportunity to see them, and you recognize that they may be upset, too.
“These messages [or apologies] can be helped by including some way of making sure there’s a next time with the friend soon, so they know you want to actually see them,” said Feiles.
Having to skip an event when your friends or family are having fun can lead to feelings of FOMO (fear of missing out).
It can be a difficult thing to manage—there will sometimes be “tears and disappointments, pain, and sadness” over skipping events, said Feiles.
However, regular support is key, he said.
“This includes not only therapy for self-care, but also surrounding yourself with people who understand migraine and are sometimes willing to do something a second time so you can enjoy it, too,” said Feiles.
Some of his clients have created the rule that for every event they miss, they get to choose something else fun to do instead.
Avoiding scrolling on your phone until you feel better can be helpful, too. Research has shown that social media-related FOMO may be linked to depressive symptoms.
“Everybody wants to not be limited, and sometimes people have managed to ‘push through.’ But often, for many, it’s not that simple,” said Feiles. “It’s important to [be aware] of limitations that may show up at times, or how you can work around limitations if it’s possible to.”
