The intense headaches, nausea, and light sensitivity have made running a business, starring in a TV show, and parenting a toddler even more challenging. Here's how she's regaining control over her health.

Khloé Kardashian can’t remember if she ever dealt with those short-lived, minor headaches most kids suffer after eating too much candy or staying up past bedtime. But she can pinpoint the exact moment in sixth grade she endured her first migraine

To be honest, “it was excruciating and terrible,” she tells Shape. During that migraine and the countless others she had afterward, she felt debilitating pain throughout her head and experienced impaired vision in her left eye, extreme sensitivity to light, and nausea that, at times, led to vomiting, she says. But no one in her family had dealt with migraines before, nor did they know what they were or how to handle them. In turn, Kardashian’s distressing symptoms were treated as an exaggeration, she says.

“I remember being almost embarrassed or ashamed to continue saying [I was] in this much pain because I kept kind of being convinced that I wasn’t,” says Kardashian, a partner with Biohaven Pharmaceuticals. “[People would say things] like, ‘Oh, you’re being dramatic,’ ‘you’re not in that much pain,’ or ‘you’re still going to school,’ and I was like, 'This isn’t an excuse to get out of school. I literally can’t function.'”

Today, Kardashian says she still frequently suffers from migraine attacks with those same miserable side effects. But unlike wine and cheese that only get better with age, her symptoms have gotten worse since her middle school days, she shares. “I have had migraines where I’ve had the lingering effects for two days,” she explains. “It’s horrible, and you’re in all this pain. But the second day, you're just in a fog. It’s so hard to function.” (Related: I Suffer from Chronic Migraines — Here's What I Wish People Knew)

Luckily, she’s fine-tuned her bodily awareness and can now pick up even the smallest cues that a migraine is coming, giving her a few breaths to mentally prepare for what’s ahead. Her eyes will start feeling more sensitive to light and she’ll start squinting a bit more, or she’ll just start feeling nauseous out of the blue, and she knows she has about 30 minutes before the intense pain just washes over her, she explains. 

Since escaping to a dark, quiet room whenever she’s on the verge of a migraine isn’t always an option, Kardashian has learned to make do with the few measures she *can* take to reduce symptoms. “I try to make sure that I’m not in bright-light environments, but if I’m working and I’m on camera, you’ll see sometimes I film wearing sunglasses, [even when] we’re inside,” she explains. “That’s not because it’s a fashion statement. It’s because I genuinely am trying to have a barrier and diminish the light sensitivity that I'm experiencing.”

But when the COVID-19 pandemic struck, the overwhelming stress of it all made her migraines take a turn for the worse. “At the beginning of the pandemic, they were way worse,” Kardashian explains. “I don’t think anybody knew what was happening, and every day you’re hearing different stories in the media, and it was scary. My migraines escalated for sure...and I think that was due to the amount of stress that was going on.”

Kardashian’s situation isn’t all that uncommon. At the start of the pandemic, an analysis of data from the app Migraine Buddy showed that the incidence of migraines among its some 300,000 users jumped 21 percent between March and April. What's more, of those who already had migraines before the health crisis, 30 percent reported in another Migraine Buddy survey that their headaches have gotten worse since March, says Charisse Litchman M.D., F.A.H.S., a neurologist, headache specialist, and medical advisor to Nurx. “It’s really the perfect storm,” she explains. “You’ve got increased stress, change in diet, change in sleep, the fear that you can’t get to your doctor or that you can’t get to the pharmacy, and sometimes the panic of not having what you need around you to take care of the headache can just aggravate it further.”

Here’s how it works: Migraines are typically triggered by a drop in serotonin levels, aka the hormone that stabilizes mood and feelings of well-being and enables brain cells and other nervous system cells to communicate with each other. During stressful situations, your serotonin levels can also drop, explains Dr. Litchman. For those who are predisposed to migraines or already suffer from them — like Kardashian — this connection means a stressful event can prompt a killer headache, she adds. (BTW, dietary, physical activity, and screen-time changes, in addition to your menstrual cycle, and alcohol, can all potentially spark a migraine too, adds Dr. Litchman.)

But these stress-induced migraines do more than just make you feel like you’re super hungover. For Kardashian, they also create challenges for her in her roles as a businesswoman, mother, and entertainer. “I think it’s tough as women, we’re so great at multitasking, persevering, and pushing ourselves to be the best you, [but if] you suffer from migraine, life doesn’t stop,” says Kardashian. “We still have jobs, and people rely on us, so you do have to find ways to push through.” While Kardashian recognizes that she’s surrounded by people who empathize and are ready and willing to lend a hand when she’s experiencing a migraine — including her family and her Good American business partner — she notes that not everyone in her life can completely understand what she’s going through.

One of those people: her 2-year-old daughter, True. “The mom guilt is something that I know so many women who suffer from migraines also suffer from,” says Kardashian. “I’m still there for my daughter, I’ll still be there and hang out with her, but it’s not the same. I know she knows something is going on, but that’s when I throw those sunglasses on, I drink a ton of water, and I try to still be with her and be present as much as possible.” (Related: Dietitian-Recommended Foods to Try When You're Recovering from a Migraine)

To be the best momtrepreneur she can be, Kardashian’s taking the idea of "putting on your own oxygen mask before helping others" to heart. At the first sign of a migraine, she takes Nurtec ODT (BTW, she's a partner with the brand), a dissolving tablet that she calls a “game-changer” for relieving her symptoms. And in an attempt to reduce the frequency of her migraines, she’s made staying active one of her top priorities, whether that be powering through a workout or taking a gentle walk with True, she says. “I’m aware that when I work out more and my body is moving, that’s a stress reliever for me, so it takes off some triggers for my migraines,” she explains. “Every person is different, and for me, the stress of the world does trigger migraines. By working out a little and just being outside, it really diminished that.”

After she takes the well-deserved time to keep her mind *and* body strong, though, she uses her extra energy and platform to educate others on the severity of migraines and validate the experiences of the nearly 40 million migraine sufferers in the U.S. “I think [migraines are] still so misunderstood, and people feel like they suffer in silence,” she says. “I think it is important for people to know that they’re not alone. There is help, there are platforms, there are forums out there, and people do not [need to] feel so isolated like they once were.”