How to Help a Friend in Pain

I would love to read a post on what migraine sufferers would like to hear from others and what others can do or offer to help them.

— Shreeda Segan

Though I have been writing about migraine since 2013, Ms. Segan’s request took me by surprise. I read her response to one of my posts and immediately thought, “What a good idea!” Much of the writing on chronic pain, and migraine specifically, focuses on the experience of pain, how hard it is to live with, and other themes that cast similarly painful conditions under the umbrella of hopelessness. Although I write about my own experience, I don’t often read others’ writings on migraine for this reason. And I’ve never read anything that answers the simple question, “What can others do to help?”

Unfortunately, online migraine communities frequently host complaints about suggestions made by people without migraine. Such suggestions sound something like, “Have you tried X? A coworker of mine said it cured her of migraines!” Though I don’t ever complain when someone tries to help me in this way, I can understand why it frustrates others. To the outsider offering the suggestion, it is a way to connect with the other person’s experience, to try and help. But, alas, most migraine sufferers have tried many different treatments — medical or otherwise — to no avail, and likely find it difficult to seriously consider a suggestion from a good samaritan with no medical degree or personal experience with the condition. So a simple question of, “Have you tried [insert food, herb, supplement, etc]?” comes across as rude and presumptive. And don’t even get me started on the word cure as it can be triggering to someone who has struggled for years with a disease and finally accepted that a cure may never be found.

In addition to my own experience of chronic pain, I work as an occupational therapist at a hospital and treat people in pain on a daily basis. My own pain helps me empathize and understand my patients’ pain, although I rarely disclose this. Instead, I act as a problem-solver and cheerleader, trying to brainstorm ways to cope with the pain, and help people live their lives as fully as possible once they go home.

The following suggestions are taken from my own personal experience, both managing my own pain and working with patients in pain:

Forgive.

Pain affects cognition and the ability to think, specifically in the areas of memory, processing speed, and attention. It’s also very common for someone in pain to be more emotionally labile. This means when I’m in pain I am forgetful, get more easily upset, have trouble paying attention and making decisions, and often cannot concentrate for very long before needing a mental break. I also smile less, and am less social. Sometimes I tell people that I am in the midst of a migraine attack when I sense that my cognition is especially affected, hoping they will understand what I am trying to communicate. By anticipating these changes, you are saving the person in pain the thought-intensive effort of trying to explain what is happening to them, if they can even put it into words. And forgiving their cognitive mishaps will go a long way in building trust and friendship.

I also have to frequently cancel plans last-minute, which can be easily interpreted as unreliable or flakey. Then I feel guilty, and sometimes avoid making plans as to not inconvenience others if I were to back out. If you have a friend with chronic pain, I encourage you to take over some of that emotional burden. Initiate social events, but don’t take it personally when your friend cancels last-minute. They may be doing so because they’re in so much pain they can’t leave the house, but that doesn’t mean they don’t want to leave.

Also, remind your friend or loved one that it is okay to mourn and forgive him- or herself. Many of us focus so much on what we can’t do anymore, that we never move beyond this barrier. Recognizing that life is ever-changing and the future will hold something different, quite possibly better, can ease the mental burden of pain.

Offer to help. Now, or in the future.

I always feel so alone and helpless when I am lying in bed in so much pain that I don’t want to move. I often worry, “Who can I call for help?” especially when it is an odd time of day. In a culture where individuality and self-sufficiency are so highly praised, it is hard to ask a friend, “Hey, sometimes I need help, can you be there for me?” Not too long ago I woke up at 3 am with such a bad migraine that I immediately thought, “I won’t be able to make it into work, but more importantly, if I need to go to the hospital how will I get there?” If you offer to be the person your friend can call in the middle of the night for a ride to the hospital, they will be forever grateful.

Though it may not be your first instinct, offer to help with the seemingly simple day-to-day tasks. Instead of generally asking, “What can I do for you?” make specific offers. Taking out the trash, cleaning up around the house, doing laundry, or even prepping meals or grocery shopping all seem like insurmountable barriers to a person debilitated by pain. And it’s embarrassing to ask for help with these things. If a friend has kids, offer to take over some of the parenting responsibilities for a few hours so the friend can rest, or focus precious energy on something important but deviously challenging like taking a shower.

Pain makes your world very small and unpredictable. I’ve gone from being a super-reliable and competent person to someone who cancels things constantly and can barely work, let alone perform the basic tasks of living. I have many days when my migraine is so bad I can’t eat or sleep.

— Lisa Levy

Offer emotional support and companionship.

I especially appreciate when friends or family carry on conversation with me as a distraction. Yes, usually we acknowledge the obvious — that I am in terrible pain — but moving past this superficial detail to a deeper conversation can be really enjoyable to anyone, in pain or not, and laughter can truly make the pain feel less intense. Many times I have forced myself to leave the house with a migraine to see friends, and after laughing the whole time, came home feeling significantly better.

Stay positive but realistic.

Talking with someone in pain about pain can be uncomfortable. I have found that as I have become more open about my own pain, my friends have begun to reach out and ask “Hey, how are the migraines doing?” I’m going to make an educated guess and say the average person in chronic pain is not like me. Most people do not reveal their pain when it is happening, or they do so by downplaying the extent to which it affects their life. If you know someone who is in pain please understand this: you are lucky they shared this intimate knowledge with you, and they probably aren’t telling you the whole truth. Acknowledge the reality of the situation, yet offer tangible hope. You can never know what the other person is feeling, so don’t pretend like you do.

Here are some examples:

  1. Friend in pain says, “I just can’t deal with my pain today.” You reply, “I can’t even imagine what that is like, but maybe today is a bad day and it will be better tomorrow. What do you think?” This open-ended question gives your friend the opportunity to expand on their feelings and vent if needed. You can also problem-solve ways to make the pain better tomorrow.
  2. (Taken from my experience with Cognitive Behavioral Therapy, which I recommend for anyone coping with chronic pain.) If you notice that your friend in pain is making negative or overly dramatic statements like, “This pain is so bad, it’s never going to go away. It’s ruining my life.” You can say, “I’m really sorry about that, but I bet it will go away, or at least get better. This is just how you feel today. I’m sure it’s made your life hard, but there have to be ways you can still feel good, right?” This identifies their overtly negative statement and puts it into perspective. You can even say outright, “Everything you’re saying is really negative, you’ll feel better if you speak more kindly to yourself”. Whenever I do this with someone, they almost always say “Wow, I had no idea I was being so negative!”
  3. It helps to ground someone in reality when they have all-consuming chronic pain. Friend in pain says, “I don’t know how I can do this anymore.” You reply, “I know you can do it because you’ve been doing it every day up until now. You’re strong and I know it seems impossible right now, but just take it one day at a time, one breath at a time, and you will see there is light at the end of the tunnel.” Telling someone to focus on the present, breathing, and to not worry about the future, can alleviate stress associated with chronic pain.

Ask questions, and listen.

Perhaps the most important role my friends play is they are really good listeners. Whether through text message, in person, or over the phone, I know I will be able to find someone to talk to genuinely about my feelings or experience. I know when someone asks, “How are you doing?” I can honestly share the truth, and this opportunity alone is a big help. The flood of support I receive from people ranging from best friends to mere acquaintances has been overwhelming at times, but it always boosts my emotional and mental health.

Similarly, when a friend shares with me that they have been having frequent headaches or pain of their own, I first let them say as much as they are comfortable with, and then offer to help as best as I can from my own experience. I respect their privacy and autonomy, but give them the option to share with me if they want to.

I hope these tips will help you help your loved ones and friends in chronic pain. Feel free to ask specific questions in the comments, and I will update this piece with more suggestions as they come to me.

To a pain-free future,

❤ Mel

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Melanie Concordia

Melanie Concordia

Neuroscience — UX — OT. I write for myself, but I hope you enjoy the journey.