What a Migraine Attack is Like
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This “guided visualization” is a way to help non-migraineurs understand what a migraine attack is really like. It walks the reader through the most common symptoms of the pain phase of a migraine and details the physical sensations. By visualizing a migraine vividly and imagining themselves in migraineurs’ shoes, I hope people without migraine can get a little bit better grasp on how complicated and painful this illness is.

Next time you have a headache, don’t take any medicine for it. This is both so you can feel the full extent of the headache and to simulate the experience of the migraineurs who get no relief from medication.

Consider where’d you rank the pain on a scale of 0-10: 0 is no pain, 4 is an average toothache, 6 is a bad back pain, 8 is childbirth, and 10 is the most severe pain imaginable, so agonizing that you’re on the verge of unconsciousness1.

Pay attention to how long the headache lasts. How often do you think of the headache in that time? How much does it interfere with your activities, thoughts, or mood? Is your productivity decreased or are you able to function at full capacity?

At this point, most people are surprised to discover how much a simple headache interferes with the normal tasks of life.

Now imagine that pain multiplied by a factor of five. You probably think I’m exaggerating, but I’m completely serious. In fact, I’m toning it down so you don’t dismiss this whole exercise as melodramatic. The comparative pain scale, which I used to illustrate the pain levels above, ranks a severe migraine as causing the same amount of pain as childbirth.


The pain of a migraine can be so intense that it literally feels like you will die. Again, I am not exaggerating. The pain is so agonizing that it seems inconceivable that the human body can withstand and survive it. Not every migraine is like that, nor does every migraineur necessarily experience that much pain, but many of us do.

So you’re imagining yourself in horrendous pain. Just when you think the pain can’t get any worse, you move and it shoots through the roof. Not just when you walk, but when you cough, roll over, or even move your legs to try to get more comfortable in bed.

Maybe you’re thinking you can handle this. It’s only pain, after all. But, no, it’s not. Pain is only one of the many potential and often debilitating symptoms of migraine.

80% of migraineurs have nausea with their migraine attacks2. Remember the nausea of the worst stomach flu you’ve ever had and add that on top of the pain you’re already imagining. Not everyone with nausea during a migraine vomits, while some people vomit once or twice, and others vomit nonstop. Remember that any movement intensifies pain, so the full-body experience of throwing up ratchets up the already excruciating migraine pain.

Of course, the flu isn’t just nausea. Fatigue, lethargy, and malaise (that general discombobulated and yucky feeling) are present during a migraine as well. Any movement feels like it requires monumental effort. The World Health Organization determined that a person with severe, continuous migraine is as disabled as a quadriplegic3. How they came up with this is too complicated to summarize here, but my (too) many years of personal experience supports this finding. It can literally be impossible to move during an attack.

In addition to torturous pain that skyrockets when you move, nausea and possibly vomiting, fatigue and malaise, envision all your senses turned up as high as they go.

You’re as sensitive to light as if you’d just walked out of a movie theater at noon on a bright July day. Every sound is magnified as if through a megaphone, even whispers. Every scent — from perfume to dog poop — smells as if it had been sprayed directly up your nostrils. You can’t stand for anyone too touch you, your hair feels heavy and painful, your clothes feel too tight.

All five of the senses you learned about in elementary school are assaulted during a migraine. Some people even have fantom sensory experiences, hallucinating smells, tastes, or sounds that aren’t actually present.

There you have a “typical” migraine that represents the most common symptoms, but there are many others I haven’t mentioned. Migraine is a neurological illness. Just like your nervous system plays a role in every function of your body, migraine can affect any part of the body. Partial paralysis, problems understanding written or spoken language, dizziness, trouble finding words, urinating frequently, diarrhea, blood pressure changes, sweating, hyperventilating, tooth sensitivity, ear pain, irritability, and depression are just a few of the many other symptoms of migraine.

Now you have a better idea why migraineurs get angry when migraine is dismissed as “just a headache.” Not only is migraine far more painful than an ordinary headache, it is accompanied by numerous other symptoms, some of which can be even more debilitating than the head pain. Please believe that migraineurs aren’t just looking for attention or trying to get out of housework. This is a real, serious, and often debilitating illness. We need your compassion, understanding, and support.

view references
1 - Comparative Pain Scale, Jack Harich, International Pudendal Neuropathy Association. http://www.pudendalhope.info/node/18 2 - The Migraine Brain, 2008. Carolyn Bernstein and Elaine McArdle. 3 - Harwood, R.H., et al. Bulletin of the World Health Organization, 2004, volume 82.
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9 comments on “What a Migraine Attack is Like

  1. Sandy says:

    thank you for this. good “teaching tool” for lack of better words for us to email to friends or family.not because we are mad at them, but because we love them, they love us. it is hard for them to understand what it is like for us. they don’t understand how migraine affects the senses. Kerry you put it into words so beautifully. thank you.

  2. tina gascon says:

    Reading your article made me think that someone had been writing about my miraine experiences. Even with at least a dozen members of my family suffering from them as well, it’s (almost) nice to know that I’m not alone. Thank You!

  3. Janet says:

    Kerrie
    You have done it once more. I have shared this with our daughter who is 28 and seems to be following in my migraine footsteps

  4. laurawestkong says:

    Wow! Thank you for putting that so eloquently into words. I can’t put my finger on exactly why, but it felt helpful for me to read it, even though I am very familiar with the experience.

    I’ve never seen that particular pain scale before. I wonder how people’s individual pain tolerances and perceptions play into that. Natural childbirth seemed more like a 4 or 5 to me, but maybe that’s cause I was in great shape at the time, or perhaps a lifetime of migraines and menstrual cramps raised my pain tolerance, maybe it’s just the genetic luck of the draw, or that childbirth has a concrete goal to focus on and work towards, whereas migraines have no useful purpose.

  5. Luna says:

    I was one of those that had very quick and relatively easy child birth in the labor room. Migraine attacks are extremely worse than child birth to me.

  6. Kerrie Smyres moderator author says:

    Thank you all for your kind words. I’m glad the post is helpful for you.

  7. mia says:

    Thanks for this, wish I could get everyone to read it 🙂

  8. Lora says:

    I got a little choked up reading this article. So many people just don’t understand. I hear “Oh, I get them too… I have some Ibuprofen or Excedrin Migraine if you need it”. WHAT? It’s not just a headache. It is so much more. Besides the symptoms you described, there are emotional scars. I’ve been battling migraine headaches for 19 years, and I can tell the toll its taken on my brain. My memory is foggy and fading. I’m constantly searching for words. My depth perception is off. I worry constantly that I’ll be out of medicine when a migraine strikes. Or struggle making future plans because I’m worried I’ll have a migraine that day. It’s so much more than a headache. Thank you so, so much for putting that into perspective.

  9. AmyBabee says:

    YOU NAILED IT! The day after I saw my Dr. the first time. I requested to see my medical report and was shocked and scandalized to see she wrote that I have ‘headache and dysmenorrhea’ instead of ‘menstrual migraine’ for the past 9 years then. Its been 10 yrs now since my first migraine. I made her correct it instantly. I also asked her why she prescribed Imitrex if she thinks I was having an ordinary ‘headache’?(well, she is not a pain Dr.). I wish many non-sufferers will read this and understand what we go thru, because believe me, I get more migraine from trying to each and every symptom and the level of pain you would never wish on your worst enemy.Thanks for writing this. I will print and give to friends, co-workers and family members.

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