Chronic migraines are an event that many sufferers would describe as traumatizing. Headaches are no fun in their own right, either. But if you’ve experienced migraines, you know you are dealing with something that goes far beyond your general headache. There’s no question you’ve entered another realm of experience.

Many of you reading this may know by now that one of my main specialties is working with people who struggle with migraines (as well as related emotional components of migraines, such as anxiety and depression, which many migraines sufferers can experience hand-in-hand). I work with migraine sufferers all over the world, helping each person learn, understand, and work through their contextual emotional life connections to their migraine experience; also helping people emotionally manage the global impact migraines have on their lives; and, further, working on how to still realize life goals even with the invasion of chronic migraines.

For people who struggle with migraines, they will be the first to tell you it is often a very lonely struggle. What makes it even more difficult is that people who don’t experience migraines tend to also not understand the severity of a migraine experience. When many non-sufferers hear, “I have a migraine”, they tend to interpret it as a person just having a “bad headache” — you know, a headache — that annoying pain that accompanies you through your day and hurts. You may take a few over-the-counter pain killers, but it doesn’t derail the course of your life. That’s what a non-migraine sufferer often tends to hear when someone says they have a migraine.

If you want to draw the ire of a migraine sufferer, dumbing down their migraine to something on the level of a general headache is a quick way to do it.

I’m not going to provide a symptom list to explain the different between a headache and a migraine. But what I will do, as a psychotherapist and migraine coach, is give an experiential picture of someone’s life with chronic migraines.

A person who lives with chronic migraines generally lives every day in fear of the next one. Each person has a very individual experience of a migraine, and therefore each sufferer doesn’t necessarily experience the same presentation as another person might. Regardless, none of the experiences are in any way pleasant.

A migraine is so significantly debilitating that the moment a migraine strikes, the person generally knows their day (if not a few days) is likely over. Not just over in the “I’m going to go home and lay on the couch” manner…over in the sense that they will be in bed with the lights off and blocking out all noise as much as possible. Any sound or light during a migraine can heavily exacerbate the entire experience — increase in throbbing headache sensations, nausea, vomiting, etc. The amount of sensitivity a person experiences during a migraine is so great that a migraine sufferer almost has pretend to not be present at all in order to get through it.

The experience of a migraine is so intense, so painful, and for many, so neurologically incapacitating (confusion, vision trouble, flashing lights, numbness, slurred speech, fainting, vertigo, etc.), that even when there isn’t a migraine currently happening, it impacts almost everything the person does every day of their lives: what they should or shouldn’t eat, how much sleep to get and what sleep schedule to follow, how to control the climate around them, if/where they should travel, what jobs they can hold, how it impacts sustaining a relationship, if they can exercise or have sex without it triggering them, or if they should plan to go to that event in two weeks and what if they get a migraine en route or when they’re not close to home? And then, what other pleasures may eventually become triggers? The list of possible impacts go on.

There are many medical and alternative forms of interventions for attempting to treat migraines. However, many people are not effectively treated by what is available. For some people, what is out there to treat the medical component of migraines brings little to no relief.

I have written extensively on the role emotional history can have in chronic migraines, and the importance for each migraine sufferer to learn about their own emotional life history as a necessary piece of lowering their internal migraine threshold. While I have seen quite positive results with this for people, chronic migraines seems to respond best to a “kitchen sink” approach. Hopefully with the right combination of treatments and supports, including a neurologist, a therapist who specializes in migraines, and whichever alternative treatments are preferred (acupuncture, naturopathic, herbalist, reiki, yoga, and many other possibilities), each person can hopefully get to the core of, and manage their chronic migraines.

In the meantime — and back to the point about the difference between migraines and headaches — a person who “has a bad headache” likely doesn’t have to surround their whole life around it. Sure, a bad headache is unpleasant, and who wants that? But migraines are truly life changing. People who don’t realize the severity of this and imagine that a migraine sufferer is just babying themselves — this is a lot of the reason that migraine sufferers tend to feel alone, and feel that even the people closest to them don’t understand what they endure.

Support and understanding are key. Migraines are a tough affliction because people from the outside can’t see what’s happening inside (and people who say it’s all in the migraine sufferers heads just make it even worse). But it’s real, and it’s torture. Give the benefit of the doubt that it’s as bad as the person says. And support them in getting the appropriate level of care. Remember, even when a migraine sufferer is having a good day, they are likely still wondering when the next one is coming.