Skip to Accessibility Tools Skip to Content Skip to Footer
Your Migraine is Showing

Your Migraine is Showing

A stranger told me he could tell I had a migraine the other day. Something about my eyelids, he said. I was conflicted about how to take it. Of course, in many ways, the fact that migraine is an invisible disease makes it very hard to convince others of its serious nature. How, after all, can we possibly be struggling with such crippling pain when we look absolutely fine? This conflict – between looking fine and feeling terrible – adds weight to the widespread belief that we are fakers.

That said, I don’t think any of us would actually want to look as bad as we feel, even if doing so were to serve as the world’s most effective PSA for migraine. I hate to admit that my vanity would get in the way.

If migraine symptoms were visible

We posted an article recently asking our community members to describe what migraine would look like if it were visible. The comments were amazing and terrifying. People described bleeding eyes, knives sticking out of their heads, ice picks, vices, contorted expressions, and much more. The visuals were spot-on and heartbreaking. It was an interesting exercise, though, to consider what it might be like for the world to be able to actually see how we are feeling. If others could have a window into the intensity of our pain, the level of compassion and understanding on the topic of migraine would undoubtedly grow exponentially.

When others see the signs

Thankfully or not, our pain is largely invisible. In the midst of an attack, or when one is unfolding, many of us actually show a sign or two that are perhaps noticeable to those who know us well. I’ve heard many people say that a loved one is often the first to tip them off to an impending attack. My husband has played that role, notifying me that my eyes look a little off. And sure enough, soon after I will have a full-on attack.

When I was staying at an inpatient headache clinic, my roommate had the wildest visual manifestations of migraine I have ever witnessed. One side of her face would become paralyzed (stroke-like) and her eye would turn black and blue, as if she’d been punched. When the attack resolved, so, too, would her normal expressive face.

Cumulative effect

For many of us who battle chronic migraine, there is another potential visible sign of having the condition. It’s one we share with others who wrestle with chronic pain of any sort –  the challenge of aging early. Due to the frequency and severity of pain, our faces and bodies may reflect the cumulative effect of a lifetime of attacks (hours upon hours of wincing pain can lead to furrowed brows and wrinkles around the eyes, tight necks and shoulders might lead to a hunched posture, and so on). It’s no real surprise that years of clenched jaws, and hours spent in the fetal position will have some effect on how we carry ourselves. It surely takes its toll and shows itself eventually in one way or another.

Making peace

Just as with the normal wrinkles and gray hairs that are beginning to show themselves as I approach my fifties, I try to remember that I have earned every single one. They are signs of earned wisdom and experience. They are lessons learned after brushes with some of life’s most difficult challenges.

So, rather than being defensive when a stranger sees an attack on my face, I will strive to remember that my face and body are windows into my experience. Just as a drooping eyelid might portend an oncoming attack, some of the lines of my face that have been created from my endlessly clenched jaw are badges of honor proving my strength, resilience and survival in the face of extreme trauma and pain.

Do you have any visible signs that foretell a migraine? Can loved ones tell when you are about to have an attack or when you are in pain? Does your body show cumulative signs of being a migraine warrior?

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

  • glassmind
    2 months ago

    Beautiful article. There is a struggle between wanting to have some dignity in looking well and in wanting to have one’ suffering recognized.

    Those who know me well can see a migraine coming on my face and hear it in my fading ability to hold a conversation.

    I take extra effort to look nice when I am out, so even aquaintances notice if I look off.

    Generally, in the worst of migraines, I am at home. So no one sees me at all. I’ve taken a photo of myself twice during a bedridden migraine out of curiosity.

    Compared to my “well” self, I look awful as if I have the flu.

    I do try to keep up a smile even in duress, but I believe if we were all more honest in showing our pain we’d be seen more acurately. Also, though, if we were each more attentive in looking at each other, we’d likely see the small signs of individual suffering that peek through the brightest of smiles.

    This reminds me of how in living with multiple chronic pain conditions, my pain threshold is so high that even in great pain, I am just calm and fairly composed, so doctors tend to dismiss my self-reported pain level. I have had one doctor and a few nurses notice the small signals of great pain–a wince, a flinch, the mark of weariness on my face–and I’ve been grateful for recognition from these people.

    I wonder are there truely so many “fakers” seeking treatment or are so many medical professionals callous, that an adult must be wailing to be considered in “real” pain?

    I’m an adult. I actually take pride and dignity in maintaining my composure even when in extreme pain (or heartache for that matter).

    I also find that keeping myself calm helps in tolerating the pain.

    I’m so very confused at the cultural expectations of and response to adults in severe pain.

  • Holly Baddour moderator author
    2 months ago

    Such salient points, @glassmind. I think we do adjust to the constant pain that is knocking at our door. Such that we stop hearing the sound. We incorporate its beat into our day and make due. So many of us out there- almost humming along to the rhythm of the pain because we’ve grown so accustomed to its backdrop. If someone else were to hear it for the first time, they’d leap out of their skin from its volume.

  • glassmind
    2 months ago

    “Humming along to the rhythm of my pain.”

    Exactly!

    Gonna remember to say that next time someone asks “How are you?”

    Life with chronic pain necessitates a song, eh? Keeps up morale.

    Thanks for the new catch phrase, Holly!

  • Marielefevere
    5 months ago

    I haven’t been able to put an exact amount of days of podrome I have before the real onset of total blown nausea, stiffness and headache come on, but thanks to this group I have been able to better identify some of the tell tale signs of an oncoming migraine for me. My loved ones don’t seem to notice, but I have started telling them about possible signs, like slurred speech, not finding the words, not being able to think rationally, to the point of literally forgetting to eat for a whole day or more… which we all know is not a good thing for us… Little things I do a hundred times a day at work, all of a sudden leave me stunned and feel like I have never done them before and have no clue what to do with. It is very embarrassing. I can count to 20 and litterally forget or skip a number as if it didn’t exist, like going from 12,13,14,16,17… The funny thing is, as much as I may know these are signs, I never know exactly when the migraine will come through, it can be a day… or a week or more.
    Physically and mentally, the best way I can describe how I feel during a migraine attack, is like I am being possessed and wrung through an exorcism, squirming into ungodly positions to escape the pain and find one single position that will give me some relief.

  • Holly Baddour moderator author
    5 months ago

    Thanks so much for chiming in to share a bit about your prodrome process. It sounds like you are juggling several challenges, from brain fog (https://migraine.com/blog/migraine-and-brain-fog-tips-and-tricks/), to aphasia (https://migraine.com/blog/recognizing-my-own-aphasia/), to appetite changes.

    And you’re right, there’s no a real science when it comes down to the precise length of time these things last before we are hit with the actual head pain.

    Great explanation of what an actual attack feels like, by the way! Wow.

    Thanks again for sharing- grateful you’re a part of our community. Please stay in touch.

  • Ducecoop
    5 months ago

    My right eye goes black and hideous like I’ve been hit. The left eye puffs up. When the migraine resolves the eyes go back to normal. In addition I wince and screw my face up during the migraine. NOW for the past several years since going chronic the black eye is permanent as is the swelling of the other eye and I constantly grimace and clench my whole face. Sunup till sunup … and I look so very old and wrinkled. It’s like I woke up after many years and my whole body had become crabbed with age. Can’t wait till I’m 75- I’m 67 now with no sign of letting up. I went back on Relpax, steroids and opiates about a year ago and I have at least a partial life instead of suffering on my couch in constant pain. I have to care for my 97 year old Father and even with caregivers I’m here 24/7 and simply can’t check out like I did for the ten years before when Dad could still care for himself. I’m grateful today for what meds I do have and for the joys of crafting I can do between bouts and for the feeling that I’m doing what I can for the earth and it’s people when I can.

  • Holly Baddour moderator author
    5 months ago

    Hi @ducecoop– I’m so glad you chimed in. You are not alone in this. So many people report issues with drooping, swollen and black eyes with migraine. Knowing others have it certainly doesn’t make the experience any better, however. Many of us join you in feeling as if we are being prematurely aged by this disease: https://migraine.com/living-migraine/when-migraines-age-us/

    And when it comes to medication- I’m with you that sometimes we must use what works, regardless of whether or not they are what’s best long term for our bodies in order to have some semblance of a quality of life and/or to be there for others in our life who are in need of our support. Glad you have a combination of medications that work enough such that you can be there for your Dad.

    I’m also a crafter and find there’s such importance to refueling in between or even through bouts of pain.https://migraine.com/living-migraine/getting-creative-chronic-migraine-workarounds/

    Migraine can take a lot from us – so, refilling our cups in order to replenish ourselves so we can find joy and be there for others is key. So glad you’re a part of our community. Please stay in touch!

  • greeneyednanny
    5 months ago

    For me, it’s usually only family and close friends who recognize the subtle, or not so subtle signs that I have a migraine brewing or has already “arrived”. They can hear as the tone of my voice changes somehow, notice the drooping eyelids, the inability to form words or use odd substitutions for certain words. A couple of days ago I had aura, then a couple hours later I became very clumsy and irritable as I tried to perform an otherwise easy task(yes, the uncontrollable swearing began). My husband said, “Babe, you’ve got a really bad migraine coming, let me finish that for you.” He is compassionate and has made it his mission to know as much about migraine as possible. Only a few accquaintances or strangers have noticed symptoms of oncoming migraine for me, it doesn’t bother or embarrass me, I’m just relieved that people seem to be more accepting/sympathetic for a medical condition that only 20 years ago still was “controversial” to the public and even the medical community.

  • Holly Baddour moderator author
    5 months ago

    Hi @greeneyednanny– How wonderful that you have such a loving and attentive husband and circle of loved ones that are clued in to those subtle changes that reveal an oncoming migraine. It is fascinating how sometimes others know before we do. We may be so stubbornly pushing ahead, not wanting to stop and acknowledge an attack is about to halt our plans.

    As I read your comment, I had the same thought about being relieved that more people are beginning to be accepting, and cognizant of migraine and its many symptoms and challenges. This kind of change happens so incrementally and with people like you and me and our family members.

    Thank you for chiming in- glad you’re a part of our community.

  • Janiekelly
    5 months ago

    I know I have tells. My eyes get dull and squinty and I become very pale. I also get chapped lips very quickly if I am not able to keep hydrated. My daughter noticed these signs years ago and would tell me to go to my dark room as soon as I could to try and head off as many of my symptoms as possible. Didn’t always work, but she tried.

  • Holly Baddour moderator author
    5 months ago

    Hi @janiekelly– How sweet of your daughter to look after you like that. Why was it that you wouldn’t respond to her pointing out the signs she noticed? Were you trying too hard to get things done? Or did you not believe you had an attack coming on? Or do you mean you tried to lie down and that didn’t always work? I ask because I think many of us push forward for various reasons in the early stages of an attack.

    Interesting about the chapped lips. That’s not one I’ve heard before but it certainly makes sense.

    Glad you chimed in- thanks for sharing! Please stay in touch!

  • MicheleR
    5 months ago

    My left eye also turns black and blue. I also slur my words and have a hard time making sentences that make sense, and using the right words.

  • Holly Baddour moderator author
    5 months ago

    So you have a combination of symptoms that can be seen and heard. You are not alone. What you describe regarding your struggle to speak is a condition called Aphasia. It is common among migraineurs: https://migraine.com/video/secret-dealing-aphasia/

    Thank you for sharing!

  • Tea-leaf
    5 months ago

    My boss recognises my migraines or my migraine hangovers as she says my eyes are dull. No one else sees it – she’s very perceptive.

    I see the slump in my face, the dullness in my eyes, and hear the stutter or slur in my speech. I can sound drunk or it seems as though I’m suffering the effects of a stroke.

    I also fail to make good decisions – I don’t think to take my triptans or to go home when I should as my brain is foggy. My thoughts are slow and not effective. When I had my first stroke-like migraine I actually lay down alone – fully expecting to die – rather than seek any help.

  • Holly Baddour moderator author
    5 months ago

    Hi @tea-leaf– How nice to have an understanding boss who also is attentive. That’s very unique.

    What you describe regarding the slur in your speech/stutter is a common condition among migraineurs called Aphasia: https://migraine.com/video/secret-dealing-aphasia/

    You bring up a fascinating point about the challenge of responding to a migraine attack at the first sign. Even though our doctors tell us to treat at the first sign of an attack, it’s way easier said than done given that often times at that first sign, we are already wrestling with brain fog and therefore being quick with our treatment plan can feel like a tall order when we may also have to juggle coming up with figuring a way home, or finding the keys, etc. The simplest decisions suddenly feel like an algebra equation.

    Thanks so much for chiming in. Glad you’re a part of our community. Please stay in touch!

  • migrainegrl
    5 months ago

    I also find it hard to think of particular words and my speech becomes slurred.

  • migrainegrl
    5 months ago

    My right eye get extremely bloodshot, puffy and I squint it usually because that’s the side the Migrain is on. I’ve had people notice how red my eye is and ask if I’m ok. Also my nostril on that same right side gets all stuffed up so I can’t breath through it.

  • Holly Baddour moderator author
    5 months ago

    Hi @migrainegrl
    So you have a combination of symptoms that can be felt, seen and heard. You are not alone. I also have a sense of being congested and have heard others speak about that. The eye having a different appearance is also common.

    What you describe regarding your struggle to speak is a condition called Aphasia. It is common among migraineurs: https://migraine.com/video/secret-dealing-aphasia/

    Thank you for chiming in and please stay in touch!

  • MicheleR
    6 months ago

    My left eye droops and turns black like I have a black eye.

  • Holly Baddour moderator author
    6 months ago

    Hi Michele- so sorry this is a symptom for you! It’s fairly common but that doesn’t make it any less problematic or troublesome to experience! Thinking of you and thankful you chimed in. Keep in touch.

  • ParacetamolAppreciationSociety
    1 year ago

    Yup. I go yellowish white and my eyelids puff up too. Funnily enough, I was noticing that I look permanently pained these days, but never put the shape of my ageing down to grimacing. Now it makes sense!

  • Holly Baddour moderator author
    1 year ago

    Love that statement “never put the shape of my aging down to grimacing.” Well put (though I wish it weren’t the case for any of us!). Thanks for sharing.

  • blancj8
    1 year ago

    My migraines are predominately on my right side, and my beard and hair have about 4 times as much gray as my left side.

  • Holly Baddour moderator author
    1 year ago

    @blancj8– that is most fascinating! Wow. Quite an image. Thanks for sharing.

  • debbieleq
    1 year ago

    My husband knows. He just does. It is scary because even when I try to lie to him he knows. I asked him what gives it away and he said its like your face becomes a different person.

  • Holly Baddour moderator author
    1 year ago

    HI @debbieleq – Love the name Pudgy- sounds like he’s definitely got your best interest in mind! And between he and your husband, it sounds like you have quite a team looking out for you. I know what you mean about trying to act like we’re well to our spouses when we’re not just to encounter them pointing out that they can clearly see that we have an attack. We’re not fooling anyone when it comes to our closest loved ones, it seems. Perhaps that’s a really good thing. Thanks for sharing!

  • aks868
    2 years ago

    Hi! My daughter ALWAYS knows when I am getting a migraine–even before I do. She says I blink my eyes differently and one eye’s color fades.I also have noticed that I get really spacey and have a hard time finding the right words before one comes on. When it is in full bloom, I get paler, the circles under my eyes get really dark, and my face looks lopsided. My mother and son also know when I have one–they just say, “You have a migraine today, don’t you?” My husband doesn’t mention it much; I think he just knows and gives me the space I need at the moment.

  • Holly Baddour moderator author
    1 year ago

    Hi @aks868– That’s fascinating! Sounds like you are experiencing some aphasia https://migraine.com/blog/recognizing-my-own-aphasia/ as a prodrome. So many folks are mentioning the eyes being a telltale sign of a migraine in the works. An interesting commonality, to be sure. Thanks for chiming in!

  • Gigi8okla
    2 years ago

    My husband always ask do you have a headache? Your face is really pale and he is always right!!! Does anyone else have this something during a headache?

  • Holly Baddour moderator author
    2 years ago

    HI @25uaq9i– So nice to have an alert and kind husband. Sounds like he’s very keyed in to how you appear. That can be so helpful! Sometimes our loved ones can see that we have a Migraine attack coming on before we are aware of it ourselves! Are you asking if others experience their faces becoming pale prior to an attack or if others have aware spouses who help them identify their attacks in advance? I hope others will read your question and give their thoughts here- however, in order to get more answers from our resourceful community, you might post your question here: https://migraine.com/q-and-a/ . Thanks for sharing!

  • onehsancare
    2 years ago

    Close friends and family will look at my eyes and say, “You have a migraine, don’t you?” This is, as Debbers says, a comfort, that they love me enough to notice what I try to hide.

    It’s also helpful, because my first symptom is often brain fog, and the concomitant inability to recognize the need to take an abortive. “Have you taken something?” is ALWAYS a welcome question, because all too often, the answer is, “Oh, yeah, that would be a good idea!”

  • MDM
    1 year ago

    What is it about that ,that we can’t remember to take something? I do it all the time. Denial?

  • Holly Baddour moderator author
    1 year ago

    Now, THAT, is a good question @24xhi66. It might be due to the fact that migraine is a neurological disease and has been shown to impact clarity of thought. https://migraine.com/migraine-symptoms/difficulty-concentrating/. Additionally, the side effects of several migraine preventative and rescue medications impact our ability to think clearly and quickly. All this doesn’t even take into account the emotional aspect of denial that you mention which sounds quite reasonable. I hope others will chime in with their ideas as well.

  • Holly Baddour moderator author
    2 years ago

    Hi @onehsancare– So wonderful of you to give a positive directive to friends and loved ones regarding what is welcomed when we are wrestling with migraine. There are so many things that can be said that aren’t so helpful- that it’s terrific to let folks know what IS helpful. I was going to send you a link to an article on “things to say to a migraineur” but it turns out we actually only have articles on what NOT to say! And we have 4 articles on that topic! https://migraine.com/?s=things+to+say&submit=Go. Perhaps it’s time to create an article with tips on what TO say. And we could start with your helpful advice. Thanks for sharing!

  • headake
    2 years ago

    My chronic cluster migraine syndrome has resulted in a ptosis in my right eye. My pain specialist notices it when I have a headache and my GP says it’s my ‘barometer of pain’. The worse the headache, the ‘droopier’ my right eyelid becomes.

    Anyone else have this visible migraine ‘tell’?

  • elle
    1 year ago

    I had to google the term ptosis, but I think I have this too, or something very similar. My migraines are usually on the right side, often involving my right eye, and I think it’s permanently a little droopier. I’ve had migraine disease my whole life.

    I don’t think very many people can see it in my face, but both my husband and my mother can hear it in my voice. The instant I pick up the phone and say hello, if I’ve got a migraine, they know it.

  • Holly Baddour moderator author
    2 years ago

    Hi @headake – First, love your username- second- also, love the idea of thinking of the eyes as a window into what’s happening inside. Several people are mentioning the right eye- I wonder if the right eye is more common to be droopy than the left? Also- is your pain more centered on your right as is AnB’s below? As to your very good question- I hope others will see it and answer it here, but if you’d like more “eyes” on your question in hopes of inspiring more of a discussion, you might post it here: https://migraine.com/q-and-a/ . Thanks so much for joining the conversation. Stay in touch!

  • Holly Baddour moderator author
    2 years ago

    Hi @headake – First, love your username- second- also, love the idea of thinking of the eyes as a window into what’s happening inside. Several people are mentioning the right eye- I wonder if the right eye is more common to be droopy than the left? Also- is your pain more centered on your right as is AnB’s below? As to your very good question- I hope others will see it and answer it here, but if you’d like more “eyes” on your question in hopes of inspiring more of a discussion, you might post it here: https://migraine.com/q-and-a/ . Thanks so much for joining the conversation. Stay in touch!

  • anbb
    2 years ago

    Yes, I am at the tail end of a 3 1/2 day migraine, and my right eyelid was droopy yesterday at the peak of the pain…the majority of the pain seems to center in the right temple, like an ice pick and “show” in the drooping eyelid on that side.

  • Holly Baddour moderator author
    2 years ago

    Hi @1wn7qkr – Hoping that attack has resolved completely. That’s a long one. Eyes and eyelids seem to be a “tell” for many. Interesting about having the pain on one-side and the drooping eyelid on that same side. Really validates migraine as the complex neurological disease that it is. Also, many migraineurs speak of the ice pick sensation-https://migraine.com/living-migraine/what-if-migraines-were-visible/ . Thanks for sharing and please stay in touch!

  • Debbers
    2 years ago

    ive always had ‘migraine eyes’. those closr to me know them well. my daughter also gets them. we have dark circles and we kinda look drunk. which is fine cause some times we feel that way. our brains slow down and our ability to focus greatly diminishes. we actually call it ‘pain drunk’. my cousin, with R.A. is the same too.
    when someone notices it i find it to be a kind of mercy. i find comfort in the people who love me enough to notice the things i try to hide. i cant pretend with them and there is freedom in that.

  • Holly Baddour moderator author
    2 years ago

    Hi @debbers – “Pain drunk?” What a great term. Very apt. And yes, there is such a comfort in the people who know us so well that they can see our pain regardless of our attempts to hide it, and sometimes they can see it before we even know an attack is coming. Glad you have those kind of people in your life and so glad you are a part of our community!

  • Luna
    2 years ago

    If I have any visible signs of migraine the cats never let on.

  • KCatMama
    1 year ago

    Ha! My husband and I used to have a cat (Toby) who was quite sympathetic when I had a bad migraine. I swear Toby could sense it. He didn’t have predictive powers, unfortunately. But once I crawled into bed feeling miserable, he must have known something was up; he would always join me, lying down near or on top of me. You’d think the pressure of a large cat on me would have been annoying, but it was reassuring and calming.

    If only he could have caught my symptoms earlier. He could have meowed 5 times for “Take your abortive med now, mommy.”

  • Holly Baddour moderator author
    1 year ago

    @kcatmama – Amazing how pets can provide such comfort to us- keeping us calm when the pain is feeling out of control. https://migraine.com/living-migraine/pets-giving-company-and-comfort/ . Sounds like Toby was extra special. Some of our community members have talked about pets seeming to predict an attack. That really would be amazing. Thanks for chiming in!

  • debbieleq
    1 year ago

    That is true. My boxer Pudgy does not leave my side when my pain gets too bad. (I have migraines everyday so the episode never really ends). It is almost like he is just waiting for me to keel over. He will just put his head on my knee and wait. If I get up he gets up and follows behind. I laugh when I imagine him barking like Lassie to my husband. “What’s that Pudgy? We have a man down in the kitchen? Mommy fell again?”

  • Holly Baddour moderator author
    2 years ago

    @luna – That is hilarious. Thanks for the laugh!

  • marycr8on
    2 years ago

    I do have visual symptoms. My eyes, especially my left eye get very swollen. They look like I’ve been crying for a week straight. When I’m having a particularly bad migraine, the upper lids swell out farther than my eyebrow and I normally, have slightly sunken eyes. My husband will take one look at me and say something like “I see you’re not having a good day.”

  • Holly Baddour moderator author
    2 years ago

    @marycr8on– great to hear from you, as always! The eyes certainly sound like they are a window into migraines for many of us (there were a lot of comments along these lines on the facebook page in response to this article as well). So nice to have a husband who is tuned in!

  • marycr8on
    2 years ago

    He’s had a lot of practice! ; )

  • dmae
    2 years ago

    Thank you for posting this, Holly. I once had a coworker who could tell I was unwell. He would look at me and say, “You’ve got a headache. You need to go home.” I brushed it off, soldiered through. I don’t know what the coworker saw, I’ve experienced some of the same symptoms you have. I suppose some people just notice subtle changes in behavior and appearance.

  • Holly Baddour moderator author
    2 years ago

    @dmae– It sounds like your coworker saw it before you felt it? That’s an interesting dynamic, isn’t it? Makes you want to take that person around with you so they can tip you off when a migraine is coming!

  • Poll