Managing migraine at work is a monumental challenge. No matter what job you have, a “good” employee is expected to be productive, efficient, and ready to complete whatever task comes their way. So when migraine interferes, the consequences can seem disastrous. 70 percent of people with migraine say their disease has affected their professional life, with the biggest day-to-day issues being an inability to concentrate and too many missed days. In a global study, most people reported missing at least one workday a month due to migraine. The average person missed more than four days.
Payback for such absenteeism and “presenteeism” — not fully functioning due to a medical condition — can be dire. One-third of migraine patients have seen their overall careers affected by migraine, due to:
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- limited advancement
- being passed over for raises and promotions
- a reduction in hours, or
- needing to change careers to have less demanding work
When asked if they worried about losing their jobs, 21 percent of episodic patients and 41 percent of chronic patients in this study said yes.
Why Your Boss And Coworkers Don’t Get It
Despite the hefty toll taken by migraine, bosses, managers, and coworkers tend to be unsympathetic. Chalk it up to the invisibility and stigma around migraine disease. Put simply, they don’t know any better.
They don’t know that to your overly vigilant brain, aspects of a standard work environment register as threats. That could include strong smells, bright lights, computer screens, frequent travel, loud noise, or shift hours. And because your colleagues have no clue how disabling migraine is, they wrongly liken it to a standard headache. Minimizing comments are common: “Take an aspirin, you’ll be alright,” “Yeah, everyone gets headaches.” Some dismissals can be even more harsh. You might be told your threshold for pain must be low, that you aren’t tough enough, or even that you’re faking it to get out of work (“goldbricking”).
Being brushed off, misjudged, or outright insulted has a way of driving people to internalize the message that their symptoms are shameful or unimportant. Instead of seeking help, they try to power through their symptoms and not draw attention to themselves. Meanwhile, their minds race to do the mental math each time they experience an attack: Can I take another sick day without repercussions? Can I manage to stick it out? The tension, frustration, and worry can worsen a person’s migraine condition. Sometimes, constant anxiety over having a migraine at work becomes a migraine trigger—a terrible self-fulfilling prophecy.
What You Can Do: Accommodations At Work
Small accommodations can make a big difference, but no one will give you what you don’t ask for. Think about specific things you need at work and what you might reasonably receive. Then set a time to speak with your employer, following this strategy:
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- Know your rights. If you are substantially limited in your ability to engage in major life activities as a result of migraine (for example reading, concentrating, seeing, working), you may be protected by law. Under the Americans with Disabilities Act (ADA), as well as state-level protections, you can request and receive reasonable accommodations at work.
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- Identify your triggers that set off or exacerbate a migraine, and take note of how they impact your work performance.
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- Talk to your doctor about how migraine is affecting you at work. The doctor can help by providing you with:
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- An action plan for coping with migraine at work (for example, stashing medications or ice packs in your office).
- Solutions on how to modify your work environment or schedule to better meet your needs.
- Needed documentation to negotiate with your employer about accommodations, including a doctor’s letter written on your behalf.
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- Sit down with your boss or with human resources and discuss possible solutions. That might include:
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- Modifying your work environment: for example, dimming lights, an ergonomic desk setup, less exposure to chemical smells, a computer screen filter, or moving to a quieter workspace.
- Flextime: a work-from-home schedule in which you determine your own start and stop times each day, still totaling the expected number each week.
- Using the Family Medical Leave Act (FMLA) to take up to 12 weeks of unpaid leave.
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As with all relationships, communication is key — and that includes with your employer and coworkers. Talking about migraine may bring up a lot of emotions and you might meet with resistance. But stay focused on solutions as you keep your tone even and agreeable. By speaking up for yourself and taking steps to educate others, you can improve the quality of your life at work.
