From a young age, Jimmy remembers his father, Tommy, having “sick headaches”—Tommy’s migraines would make him nauseated, cause him to throw up, and leave him sick in bed for several days. When he was about 45, Jimmy began having these headaches, too. “It’s one of the worst feelings in the world. A building pressure will grow worse and worse until it almost feels as if your head is going to explode.”

Much like his father, Jimmy, now 58, experiences dizziness, sensitivity to light, and nausea when he has a migraine. He must stay in a dark room to help relieve his photophobia. He may take over-the-counter pain relievers to ease the pain, but he doesn’t find real relief until he’s able to throw up. “It’s really the only thing that works for me, but the headache will still linger for a few hours more even then.”

Jimmy’s son, William, a junior in college, experienced his first migraine when he was 13. “I had never really had a headache before that point, so I wasn’t entirely sure what I was experiencing,” William says. He explained the symptoms (blurry vision, sensitivity to light, and pain behind the eyes) to his parents, who immediately recognized the similarities between William’s symptoms and his father’s. They took him to their family doctor, who prescribed naproxen. Later, as William’s symptoms became worse, his doctor prescribed Maxalt, which he takes when he feels a migraine beginning. Now, at age 21, he averages one episode a year.

“I started having migraines at a much earlier age than my dad, but I know what to be aware of for my own children,” William says. “It’s in my genes, and it will be in theirs. I will want them to get treatment as quickly as my parents got treatment for me if they ever start having problems.”

“I hate drinking because I know it gives me headaches,” says Katelyn, a 22-year-old public relations account manager. “When I wake up hung over or with a wine headache, I feel awful because I just gave myself [a migraine], and it could have been avoided.”

Katelyn, whose grandmother and aunts also have frequent migraine headaches, discovered that alcohol was a trigger for her migraine headaches by diligently keeping a log of her symptoms, what she ate, what she was drinking, what medicines she took, etc. “My goal was to avoid preventative medication,” she says. “I didn’t want to be taking medication every day.”

Using her migraine logs, Katelyn and her doctors came to the conclusion her headaches might be the result of her birth control pills. “It’s taken me nearly four years to realize that estrogen may be a big trigger for my migraines. I am now on a birth control that does not have estrogen. The hormone [in the pill] is progesterone, and that seems to have balanced out my hormones and my headaches,” she says. “I still get headaches, but now I can treat them with over-the-counter Excedrin.”

Finding the triggers that cause your headaches and learning to avoid them helps you live a more balanced, pain-free life, Katelyn says. “I make sure to eat at the same times every day. I still find myself getting migraines if I don’t eat breakfast, or if I don’t eat a balanced meal with enough protein. It’s so important to take care of your body,” she says.

Michelle, an elementary school teacher, has a vivid recollection of her first migraine. “I was 8 years old. I carpooled home from school with neighborhood friends to an empty house. My mother was running late from work, and I had to sit on the front steps with what felt like a headache that was going to cause my eye to explode from the inside out,” she recalls. “As soon as my mother got home, I rushed inside and threw up. The rest of the day is a blur.”

By 21, Michelle’s headaches were consistent and “frustrating.” By 23, they were chronic and debilitating. Now 29, she has not been headache-free in more than seven months. The headaches do not consume an entire day—they typically last only a few hours.

Michelle’s efforts to treat her migraines have been mostly unsuccessful thus far. By her own account, the first attempts were ineffective because the doctor (a family practitioner) didn’t seem to know how to treat her headaches. “He told me to take Aleve. After more migraine attacks, I returned to be given another medication, Maxalt, which did nothing for me,” she says. “After returning a third time, I was given a prescription dosage of naproxen, which is basically two doses of Aleve. It did nothing.”

She saw a neurologist for the first time when she was 24 and found the first real relief for her migraines since they began. “He was wonderful and gave me medications that made me feel so much better. He listened to me, he understood my pain, and he made me feel better,” she says. This relief, however, was short-lived, as Michelle quickly worked her way through the medicines that were effective until she had reached the highest doses she could take. Not willing to suffer endlessly, she sought out another neurologist who is working with newer migraine treatment technologies, including Botox injections. Though most of these have also had limited results, Michelle and her doctor have not given up hope.

“The most important thing is to find a doctor who believes and understands you,” she says. “And find someone who supports you. Many people will not understand, but some will try to at least support you.”