A family member has had a migraine for m

Now I'll write the full family-facing answer.

Book one appointment this week that looks at both the headaches and the low mood, and ask one direct question today: "Are you having any thoughts of harming yourself, or of not wanting to be alive?"

Why this needs a clinician, not more endurance

• Months of migraines plus months of low mood is two treatable things that make each other worse: pain and low mood break sleep, and lost sleep and skipped meals are named migraine triggers.
• "Push through" does not treat the pattern. It costs sleep and function, and if pain relief has become a near-daily habit, the headaches themselves can partly be caused by that — only a clinician can sort that out and set the plan.
• A clear change in a known headache pattern is treated as a *new* cause until a clinician says otherwise, so "it is just my migraine" is not a safe assumption this time.
• I cannot diagnose this, and I cannot start, stop, or change any medicine — including antidepressants. Any medication change is a clinician's decision.

"Push through" vs. what helps more

Constraints and things to avoid

• No new pain relief, no borrowed migraine tablet, no leftover psychiatric tablet, no opioids, no online prescription buys, and no "herbal" or mystery powders — unverified mixes have unknown interactions and no one can check them for you.
• Do not start, stop, or change any prescribed medicine on your own. Stopping an antidepressant suddenly is a clinician decision too.
• Do not stack products with the same ingredient. Many cold/flu and combination products already contain paracetamol/acetaminophen — read the label of what is in your cupboard.
• No alcohol as a sleep aid; cut alcohol down overall. No detoxes, no supplements, no special "migraine diet" — regular meals and water are the levers.
• Do not put a drowsy or feverish person with a bad headache to bed "to see how they are in the morning", and do not wait to see whether one-sided weakness passes.
• Do not let this become a character issue. Do not say "you would feel better if you tried harder".

Go now — call your local emergency number now and stay with them

Any one of these changes the answer from "this week" to "now":

• The worst headache of their life, reaching full force within seconds — even in someone who usually gets migraines.
• Fever with a bad headache, a stiff neck, drowsiness, confusion, or being hard to rouse.
• New one-sided weakness, a dropped face, slurred or lost speech, a first fit, or sudden vision change. Write down the time they were last seen well before you call.
• Talk of wanting to die, a plan, means within reach, an attempt, giving belongings away, or a sudden calm after despair. Call, stay with them, do not leave them alone, and do not promise to keep it secret.
• New confusion, hearing voices, or a sudden change from their normal self.
• They stop eating and drinking.
• New headache after the age of 50 with jaw pain on chewing or a tender temple, or vision flickering in one eye — urgent, same day.
• Crushing chest pain, one-sided weakness, or a swollen tongue during a panic attack — call now, do not treat it as "just panic".

I will not print an emergency number from memory. Tell me your country and city and I will look up the local emergency number, the nearest emergency department, and the right appointment route.

Decision tree

```
Any red flag right now?
YES -> Call your local emergency number now. Stay with them. Do not leave them alone.
NO, but function has dropped (missing school or work, not eating, not sleeping,
not doing what they used to enjoy)
-> Same-week appointment covering both issues.
If you are unsure about suicide risk -> make it same-day.
NO, and this is their usual attack in someone otherwise well
-> Tonight's measures below, AND book the appointment anyway this week.
The pattern has changed (more frequent, different, no longer eases)
-> Same-day or soonest available review.
```

Tonight and today, in short bites

1. One question, five minutes (today). Ask the question in the first line. Listen without arguing. Ask again in a few days.
2. Dark room reset, ten minutes. Lights low, phone face down, quiet, a glass of water within reach, one small task only (a page, a shower, folding one thing). No screen work, no noise.
3. One-line log, five minutes a day. Date and time, what they were doing, what they ate and slept, what they took for the pain, pain rated zero to ten, mood rated zero to ten. Same five fields every day — that is what turns "it is always terrible" into something a clinician can work with.
4. Eat and drink something real, ten minutes. See the food list below. Small is fine; regular is the point.
5. Ten minutes of company. Sit with them. No fixing, no advice unless they ask. "I am here" counts.
6. Book it, five minutes. Call the clinic and use the script below.

Food already at home

• Breakfast: eggs, milk or yogurt, oats or bread with a banana.
• Lunch and dinner: rice or noodles, potatoes, chicken or fish, vegetable soup, whatever they normally eat.
• Drinks: water or warm water through the day.
• The rules that matter: eat at regular times even when the appetite is low — skipped meals are a named trigger; no special diet; no alcohol; no powders.

Scripts you can use tonight

To them (ask once, calmly, directly):
> "I have noticed the headaches and the low mood have been going on for months. I want to ask you something straight, and I will not be upset by the answer: are you having any thoughts of harming yourself, or of not wanting to be alive?"

Then let the silence sit. Do not say "you have so much to live for" — that argument closes the door. Do not promise to keep it secret. If the answer is yes, or you are not sure, stay with them and call.

To the clinic (phone or at reception):
> "They have been having migraines for months and they are getting more frequent, and they have been low for months too. Can we book one appointment that covers both? I would also like to talk about how often they are taking pain relief, about talking therapy, and about whether a medication review would be sensible."

Ask them before you leave: what specifically should bring us back, what must we not do at home, is talking therapy available, and should the painkiller use be reviewed.

To school or work:
> "They have a medical appointment this week and I may be unreachable for a short while. If anything changes I will let you know the same day."

To the rest of the family:
> "They are not being lazy and this is not about effort. It is a medical condition and we are getting them seen. Please do not tell them to push through."

What "working" looks like within 24 hours (not a cure)

• The appointment is booked, or you have called the clinic and have a date in hand.
• You asked the direct question, and you know the answer.
• They ate one proper meal and drank water today.
• One line of the log exists, so the pattern can start to be seen.
• Nobody in the house is saying "push through", and one person is assigned to sit with them each day.
• The headaches may well come again tonight — that is expected and is not failure. Tonight's goal is safety, food, water, and the appointment being in the diary.

Bring to the appointment

• The log: dates, times, sleep, food, what they took, pain and mood ratings.
• Every medicine and packet in the cupboard, including the pain relief and anything bought without a prescription, and roughly how often each one is used.
• The exact words they used if they ever mentioned wanting to die or a plan — do not soften them for the clinician.
• Family history of migraine, what they still enjoy, and whether they would be willing to talk to someone.
• Questions: what should bring us back, what must we not do at home, is talking therapy available, should medication be reviewed.

A printable one-pager with the clinic script, the log table, and the red-flag list for the car: migraine-mood-visit-onepager-b56f072c.pdf

What I cannot do

I cannot diagnose, choose or change medicines, or give doses. I also cannot give you a local emergency number or a clinic name until you tell me your country and city. If any red flag above appears, this whole answer changes to "now" — not "Friday".

If you want a reminder for the Friday appointment, tell me the time and I will set it.

Source: medlineplus https://medlineplus.gov/migraine.html
Source: medlineplus https://medlineplus.gov/depression.html
Source: merck-pro https://www.merckmanuals.com/professional/neurologic-disorders/headache/approach-to-the-patient-with-headache
Source: who-core https://www.who.int/news-room/fact-sheets/detail/depression