Bright Lights, Loud Rooms, Big Pressure: Why The Holidays Are So Hard On People With Migraine

For people living with migraine, the holiday season is more than busy—it’s a convergence of triggers, expectations, and emotional pressure. From crowded dinners and rich foods to disrupted routines and fear of judgment for cancelling plans, the struggle often goes unseen. As Lundbeck Canada launches Home for the Holidays with Migraine, we talk to Maya Carvalho, founder of the Canadian Migraine Society, about breaking stigma, creating flexibility, and how simple understanding can change the entire season. —Noa Nichol

The holidays are often described as joyful, but for people living with migraine, they can feel like a sensory minefield. Can you walk us through what makes this season uniquely challenging from both a neurological and emotional perspective?

Holidays come with extra activities, extra sensory inputs, and extra pressure to enjoy ourselves. From a neurological perspective, the holiday season tends to present a number of triggers all at once. The extra activities require energy, and depleting energy can be a significant trigger. People who live with chronic migraine experience intense fatigue from constantly pushing through pain and symptoms, so the pace of the season is challenging. There are also holiday lights, loud music, strong scents from candles and foods, and typically some disruption in sleep. All these triggers stack up and tip people into migraine attacks. From an emotional perspective, people living with migraine want to participate as much as anyone else — they want the social and family connection, the traditions, the joy that comes with the holidays. Missing out on events creates feelings of guilt as well as frustration, and it can also make people feel even more isolated.

This campaign highlights something many people don’t talk about—the fear of being judged for cancelling plans or needing accommodations. Why is that guilt and pressure to “push through” so deeply embedded in holiday culture?

I think the pressure to push through is highly prevalent in all invisible illnesses. Friends and family cannot see the pain, and therefore there is the tendency to minimize it, invalidate it, or in some cases, dismiss it. Rather than constantly having to explain and defend, people just push through and try to make others happy. Our culture puts a lot of weight on celebrating holidays and what those celebrations should look like. In some ways, our celebrations and traditions are a type of societal glue, but for people with migraine, it can feel like pressure.

You live with chronic migraine yourself. What does “home for the holidays” realistically look like for you when it comes to protecting your health while still wanting to feel included?

Despite the fact that I founded a patient advocacy organization, I also force myself to push through, and I tell myself I will recuperate afterwards. No matter what I do, there will be a cost, and I have learnt to accept that. I enjoy entertaining, but I do it at a smaller scale. My home will have music that isn’t too loud, dim lighting (which is my aesthetic preference anyway), and I do a lot of preparation in advance so that I can manage my energy. It might take me a week to prepare for something that a healthy person could do in a day. I also ask people to come to my home because it is too difficult for me to go out…. I am very fortunate to have wonderful friends who accommodate me.

Holiday triggers don’t happen in isolation—lights, scents, food, disrupted sleep, travel stress all collide at once. How does this convergence amplify migraine attacks compared to everyday life?

Trigger stacking is an important concept in migraine management — you can think of it as a bucket and each trigger gets poured into the bucket until it spills over and starts a migraine attack. We teach people to manage their triggers as much as possibly but during the holiday season this is often not something that can be controlled. 

For loved ones who genuinely want to be supportive but don’t know how, what does true understanding look like in practice—not just in theory?

Actually, I just had this experience this past weekend. A very close girlfriend of mine was having a holiday party. I really wanted to attend, but I had migraine attacks almost every day last week. I kept thinking I could get the attack under control, but by the morning of the party, I realized that wouldn’t happen. I reached out to my girlfriend, explained that I was sorry to miss the party but I couldn’t manage it. Her response was perfect. She told me she was sorry about my pain but that she understood completely. She also suggested she come over for a visit. She offered empathy while also reassuring me that we could connect another time — that helped to lessen the sting of missing out.

Workplace holiday events can also be tricky to navigate. What are some realistic accommodation strategies employers can put in place to be more inclusive without singling people out?

Employers can implement some really easy accommodations that can have a big impact. They can ask all employees to be scent-free for the party, they can arrange for there to be a dark, quiet room for people to escape to, and they can be understanding if the employee has to leave early.

The campaign emphasizes that “holiday joy doesn’t require identical participation.” Why is that idea so important for reshaping how we think about inclusion—not just for migraine, but for chronic illness broadly?

We need to start to understand the seriousness of chronic illnesses and the idea that people are trying their best to be involved and participate within the limitations of their health issues. We need to understand that people with chronic illnesses may not be able to participate as fully, but that connection is really what the holidays are about.

From a patient-advocate lens, where do you still see the biggest gaps in public understanding around migraine as a serious neurological disease?

Unfortunately, the public perception is still that migraine is a headache rather than a serious neurological disease. People do not understand the myriad whole-body symptoms that are involved outside of head pain, and they do not understand how debilitating severe attacks really are. The World Health Organization (WHO) classified severe migraine attacks “as among the most disabling illnesses, comparable to dementia, quadriplegia, and active psychosis (Shapiro & Goadsby, Cephalalgia, 2007). It’s time for us to start speaking about migraine with the seriousness it deserves.

If there’s one message you hope families, friends, and employers take away from Home for the Holidays with Migraine, what would you want them to change about how they show up this season?

As humans, all we really want is to be understood. If you can be flexible and accommodating, that’s all anyone living with migraine really needs. Taking the pressure off is the best gift you can give.