How To Set Boundaries Around Migraines Without Feeling Guilty

When Kelleigh, 38, was planning her wedding, her biggest worry wasn’t the guest list, the décor, or even her vows. It was waking up with a migraine. One bad flare-up, she knew, could derail the day she’d spent months carefully planning, and that fear sat in the back of her mind throughout the entire process.

Despite years of tracking triggers and symptoms, Kelleigh’s migraine attacks can still strike without warning. They usually begin as a sharp, one-sided pain in her forehead, often paired with sinus pressure — and on her worst days, debilitating nausea and vomiting. So instead of pushing through and hoping for the best, she decided to plan around her reality. That meant scheduling her rehearsal dinner two days before the wedding, rather than the night before, to avoid potential food or alcohol triggers.

That one boundary made all the difference. On her wedding day, Kelleigh stayed migraine-free — fully present, at ease, and nowhere near a bathroom. For her, setting limits ahead of time isn’t about being difficult; it’s about giving herself the best possible chance to actually enjoy her life.

“Setting boundaries is so important for people living with migraine, because stress is such a huge trigger,” says Theodora Blanchfield, a Los Angeles–based therapist who also deals with migraines. “When you have predefined rules for yourself, you reduce some of the cognitive load of not having to decide every single time how you’re going to deal with a situation.”

When it comes to migraine flareups, boundaries aren’t selfish — they’re strategic. Here’s how to set them without guilt.

1. Be Upfront With Your Manager And Colleagues

When starting a new job, one of the first things Kelleigh does is mention her migraine episodes to her boss and her colleagues, as well as what she needs in the event of a debilitating one. While she has a treatment plan that can usually stop symptoms within a few hours, on occasion a migraine attack may be more severe, and ‘powering through’ won’t help her productivity (or make her feel better any sooner).

Kelleigh’s experience is far from rare. According to The American Migraine Foundation, businesses lose more than 113 million workdays due to migraine every year. While frustrating, setting boundaries for her professional life and being upfront with her boss and colleagues allows her to take the time she needs to be a better employee — whether that’s taking the morning off to rest, or occasionally taking a sick day until her symptoms subside.

2. Anticipate, And Say ‘No,’ To Peer Pressure

Planning ahead isn’t just part of Kelleigh’s routine. For Leanne, one area she’s had to be particularly firm with when setting boundaries is going out with friends, especially when alcohol is involved. Just one drink or slight dehydration can be a trigger for a migraine. But being firm in her decision to practice moderation and/or skip alcohol entirely has helped her avoid many painful migraine attacks — and she has just as much fun.

“Through the years I have felt peer pressure or judgement for not taking that shot, or having that martini,” she explains. “But as I’ve gotten older I’ve cared less, and my friends say my headaches have taught me to be just as fun sober!”

3. Explain Your Triggers *Before* They Happen

Telling others about your triggers before they happen is an important precedent to establishing a boundary, Kelleigh explains, because if and when the trigger occurs, you’ve already established what you will do in the event that it happens.

“I find being honest and up front is always a good first step, especially to get ahead of it,” Kelleigh explains. “If people know this is something you deal with, they’re less likely to get upset or assume you’re just trying to get out of something.”

4. Establish A ‘Give & Take’ Mentality

Like Kelleigh and Leanne, Azra, now 29, has spent years learning how to set boundaries around migraine. In the past when a migraine would hit she would cancel all her plans instantly, but today, she’s learned to follow her own schedule and listen to her body, establishing a ‘give and take’ mentality.

“For example, if I stay out late, don’t expect me to be available early the next morning, because I prioritize sleep,” Azra explains. “On a multi-day trip, I may not participate in activities every day, because my body needs rest. I’ve set clear boundaries like these, and everyone around me respects them. I don’t feel like I’m missing out, because how I feel is what matters most.”

5. Don’t Expect Everyone To Respect Your Boundaries

While establishing boundaries is important, it’s not enough to rely on others to respect them, Blanchfield cautions.

“I think where people really get tripped up by boundaries is that they put all of the ownership on other people respecting their boundaries, which is absolutely the ideal,” Blanchfield explains. “But part of boundaries is enforcing them yourself.”

So while your boundary might be leaving a loud place if you feel like it may trigger a migraine, you have to actually do it — despite the fact that your friends may want to stay.

Presented by BDG Studios.