Why Every Church Member Needs to Understand Migraine Disease

As a pastor of a healthy church in Mississauga and as someone engaged in church planting in rural Ontario in partnership with Send Network, I am a busy man. On top of this, I am renovating our home, completing my doctoral studies, and attempting to remain faithful in my responsibilities as a husband and dad. I share all of this not to boast, but to express why many well-meaning people determine that such a schedule is the reason I experience weekly exhaustion, irritability, and headaches, which at times are debilitating. In addition to these quick determinations, many express that, in my business, I do not get enough water, drink too much coffee, get too little sleep, and have a poor diet. While grateful for concerns and cares, what many fail to understand is that behind the smile, behind the pastor, is an invisible disease: chronic migraines.

As a migraine sufferer, I want to share what it means to be affected by this affliction, and what seems like an innocent suggestion, at times, is equal to just advising a paraplegic that if they stop drinking coffee, and eat more asparagus, they could get up and walk (sarcasm).  It is my prayer, being transparent about what I go through, that the church body has a deeper understanding of the complexity of it all, and that the symptoms they see are not necessarily violations of the character requirements in 1 Timothy 3 or Titus 1 for an elder but an opportunity to love those who love them so deeply.  

The Prodrome.

If you have not heard this word before, it is what happens pre-migraine. Prodrome can occur hours, or even a day or two, before the actual migraine physically presents itself. [1] The individual who suffers from migraines understands what this looks like, but for those not familiar, the evidence may come across as a bad mood, tiredness, laziness, or simply not being able to get the job done. Why is that? They are experiencing pre-migraine symptoms.  Some common symptoms are,[2]

·      Irritability (or a short temper episode)

·      Anxiety or feeling on edge

·      Depression or sadness episodes

·      Difficulty concentrating (“brain fog”)

·      Fatigue

·      Neck stiffness

·      Frequent yawning

·      Food cravings.  

For me, some of these are a weekly occurrence. Specifically, the irritability, yawning, cravings, and fatigue. In fact, the fatigue lasts beyond the day of the headache and extends into the following few days. This is important as there are times when well-meaning people say, “Oh, your headache is gone; why are you not getting more done?" Those after-days are post; let’s stay focused on the prodrome. Many of you know that when you look out the window and see the dark clouds move in, and the trees start to sway more intensely as the temperature drops, a storm is about to hit. These prodromes are like that for a migraine sufferer. This is why, when a person knows a migraine is on the way, there is a feeling of dread at times, or even withdrawal from wanting to be around people, coming across as defensive, or projecting because a storm is coming. There is a need to brace oneself for the possibility that this may be debilitating. There is one thing I dread, knowing I am about to get a doozy. I dread the pain I am about to face. I dread the lack of ability I can achieve in my vocation. I dread letting my family and others down, as all I can do is sit or lie down until I can function again.

What do You See or Experience?

As a precursor, there are no excusable reasons to deliberately and willingly walk in a manner that brings reproach against the name of Christ, or in habitual patterns of pastoral disqualification. Yet when believers are not familiar with the suffering an under-shepherd endures, criticism can arise. Once the nature of migraine suffering is understood, there is a shift from criticism to compassion, and this is part of a healthy church.

When you see a person (or your pastor who suffers from migraines) become unusually quiet or withdrawn, this is a good time to walk with grace. Making it personal or thinking the individual is simply grumpy will not benefit anyone. I know there are times when I will seem irritable or emotionally sensitive. I may not track my thoughts well or follow through in a conversation. This is not because I devalue or underappreciate the individual; these are symptoms of the migraine. Not just an active migraine, many simply call a headache, but also part of the prodrome, before the migraine manifests fully.

Some things to recognize. Maybe the pastor leaves his office lights off (I do and work with a lamp) to help mitigate potential migraine triggers. Maybe there are days when eyes look tired and in pain. There are times when maybe the smallest task or request seems too monumental to the individual. Granted, all of this could be a characteristic problem, but a simple, “Are you doing okay today?” could go a long way.

Prayer and Discernment go a long way with this, and understanding that your pastor loves you, cares for you, and would do anything to protect your spiritual well-being does not disappear when you see or experience these prodromes or a full-on headache.

Migraines are an Invisible Disease

It is important to understand that the person who suffers from migraines is not a person who simply gets a headache from time to time. Migraines are a neurological disease. As part of this disease, a person can experience many symptoms, such as nausea, dizziness, vision changes, exhaustion, light sensitivity, and sensitivity to smells, sounds, and movement.[3]

Remember, there are no cures, and no one really understands why they happen. This is why assuming it is too much coffee, not enough water, diet, or other factors cannot be a cookie-cutter response. Personally, here are areas that I know trigger my migraines, which are verified by the situation, and prodromes to the migraine headache.

·      Sudden changes in the weather

·      Not enough sleep (sleep often affected by headaches)

·      Strong smells

·      Stress

·      Bright Lights, or flashes

These are just some of the listed causes for some migraine sufferers according to the National Institute of Neurological Disorders and Stroke.[4] When I am preaching, our church uses lighting for our online streaming, which triggers me. Certain background slides often create nausea leading to dizziness, which is why most Sundays I come home with a migraine, with an exhausted Monday both physically and spiritually.

Yet this is why it is called an invisible illness: most people cannot see it. From the outside, people look fine and healthy, and those who do not suffer often underestimate the severity of pain. Many express skepticism, including congregants, family, and even health care workers. All of this can bring levels of guilt and shame. There are times when the prodromes and the headache itself lead to increased emotional tension. Having to cancel plans, feeling anxious that people will misunderstand, being anxious over the next attack, affecting all relationships, including the one with Jesus. Why?

They can be disabling at times. There are days you cannot work, socialize, or complete basic tasks, as all you want to do is either sit or lie down and beg that the amounts of Tylenol and Advil or whatever prescription the doctor has you on actually work for this round, which is always a gamble. There are potential reliefs, but it doesn’t always work. What works on one may not work on the other. It is trial and error over and over. Let us cover the last topic and close.

The Biggest Problem: Stigma.

I can share personally that the worst part of suffering from migraines is that no one really believes you. “Sure, you have a headache, just take an Advil, avoid coffee and drink more water.” Worse is the accusation of being in a bad mood, being grumpy, or being overworked. There have been days when all I can do is barely function, and I have been accused of many painful things. I cannot stress this enough: the migraine is not just a headache. It occurs before and after the actual pain. It is a neurological, legitimate disease and all-around illness. It affects all aspects of life and ministry. It affects family and relationships; it is a battle to function and work through it all.

How to Love Someone Who Suffers from Migraines.

1.        Lead with Grace, not assumptions.

We covered a lot, but remember when your pastor or family member seems unusually quiet, irritable, or withdrawn, resist the urge to diagnose their attitude and instead assume there may be a battle you cannot see.

2.        Believe their Pain, even when you Cannot See It.

Migraines are an invisible neurological disease, and one of its greatest burdens is the stigma of feeling misunderstood by the very people they love most. If your pastor suffers from migraines, love on them the same way you would love on a widow, or another person in need. Loving them is not diagnosing them; it is “What is it you need right now?”

3.        Pray, be Patient, and remain Present.

Your quiet compassion, faithful prayers, and willingness to simply walk alongside them often minister more deeply than another suggestion about coffee, sleep, or water. If you feel the pastor may have been irritated with you, ask. Do not assume. I have had this happen. The moment I became aware I may have offended a dear lamb in my pain, I am always quick to ask for forgiveness, be transparent, and have learned care goes both ways.

In closing, the church is called to bear one another’s burdens, not explain them away. When we choose compassion over criticism, grace over assumptions, and presence over easy answers, we reflect the heart of the Chief Shepherd, who knows every hidden struggle under His Sovereign care for His people. Some battles are invisible, but they are no less real, and sometimes the most Christlike thing we can do is simply believe, pray, and love well.

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[1] “American Migraine Foundation, “Migraine Prodrome: Symptoms and Prevention,” last modified March 17, 2022, https://americanmigrainefoundation.org/resource-library/migraine-prodrome-symptoms-prevention/

[2] “L. Gao, F. Zhao, Y. Tu, and K.Liu,” The Prodrome of Migraine: Mechanistic Insights and Emerging Therapeutic Strategies,” Frontiers in Neurology 15 (2024): 1496401 https://pmc.ncbi.nlm.nih.gov/articles/PMC11638031/

[3] “National Institute of Neurological Disorders and Stroke,” Migraine, last modified July 2, 2026, https://www.ninds.nih.gov/health-information/disorders/migraine?

[4] “National Institute of Neurological Disorders and Stroke,”