Migraine at the workplace: How to cope without burning out

Migraine is a neurological disease, not “just a headache.” Attacks can involve moderate to severe head pain plus symptoms like nausea, vomiting, light and sound sensitivity, dizziness, and brain fog. Some people also experience aura. Migraine can disrupt daily functioning before, during, and after an attack.

How does migraine affect work?

Migraine can get in the way of productivity at work in two big ways.

One is visible: missed hours, sick days, and needing to leave early. The other is often invisible: showing up but functioning at a much lower capacity. Researchers often call these absenteeism (missing work) and presenteeism (being at work but not operating normally). Presenteeism matters because it can be exhausting, and it can look like “slacking” from the outside when it’s actually symptom management. Work productivity loss in migraine is often driven by presenteeism, not just time off.

On top of symptoms, migraine adds a heavy cognitive load: scanning for triggers, managing medication timing, worrying about judgment, and trying to “perform wellness” so no one asks questions.

What toll can migraine take on productivity, income, and job security over time?

Migraine hits hardest during prime working years, which is part of why it can feel so unfair.

Some people may reduce hours, switch roles, avoid promotions, or turn down opportunities simply because their bodies cannot take the unpredictability.

Frequency matters a lot. In a large population study in the US, people with chronic migraine were less likely to be working for pay, and they lost far more work time per week than those with low-frequency migraine.

That same paper also shows how a smaller group with high-frequency migraine accounts for a disproportionate share of lost work time.

And it’s not only about “working more.” More headache-free days are linked to lower disability and fewer missed work and household activity days. In another study, each additional headache-free day was associated with fewer workdays missed and a lower overall burden.

If someone feels like work is always on the edge of falling apart because of migraine, that is not weakness. It is a predictable outcome of living with a condition that can be disabling and unpredictable.

Can work itself make migraine worse?

Yes, and this is where many people feel trapped in a loop: migraine affects work, then work conditions increase the chance of migraine, then the cycle repeats.

Common work-related aggravators include:

• Irregular sleep or early starts
• Skipped meals, dehydration, caffeine swings
• Stress, high cognitive load, conflict, long meetings
• Screens, glare, harsh or flickering lighting
• Noise, strong smells, poor air quality
• Long commutes and limited access to rest or medication timing

Even when someone knows their triggers, avoiding them perfectly is rarely possible in a real workplace. So, the goal becomes: reduce exposure where you can, plan for flare days, and build a work setup that requires less masking and less self-punishment.

Why is migraine at work so often misunderstood?

Migraine is often invisible, and that creates a painful double burden: suffering through symptoms and then having to prove they are real. Legal and medical discussions often highlight that migraine can be hard to “show,” which contributes to stigma and disbelief.

This also makes disclosure complicated. Some people never share because they fear judgment, lost opportunities, or being treated as unreliable. Others disclose because accommodations and flexibility can be the difference between staying employed and burning out.

There is no one correct choice. The safest option is the one that protects health, income, and emotional well-being in that specific workplace.

What accommodations can genuinely help, without turning work into a battle?

Small changes can add up. When migraine is triggered or worsened by the workplace, accommodations are not a “special favor." They are a practical way to reduce attacks, protect recovery time, and make work more sustainable.

Light and screens

• Reduce screen brightness and glare where possible
• Use anti-glare or blue-light filters if they help
• Avoid sitting directly under harsh lighting or facing bright windows
• Build in short screen breaks; even 1 to 2 minutes can take the edge off

Noise and sensory overload

• Access to a quiet space for short breaks during symptoms
• Fewer back-to-back meetings when possible
• Noise-reducing options if the workplace allows it

Air, smells, and ventilation

• Better ventilation or seating away from strong smells
• “Fragrance-light” norms in shared spaces when feasible

Flexibility and pacing

• Flexible start times after a night attack
• Protected breaks for medication, hydration, food, or rest
• The option to work from home during flares when possible

Work structure and expectations

• Clear priorities so the most important tasks are not competing at once
• Fewer last-minute deadline surprises when possible
• Written follow-ups after meetings to reduce memory load
• Less multitasking and fewer rapid context switches

If someone chooses to ask for accommodations, it can help to frame it as "These changes prevent attacks and help me do my job consistently,” rather than “I need special treatment.”

How can you cope at work and protect your quality of life day to day?

This is the heart of it: not how to “push harder,” but how to suffer less.

Build a migraine-aware work rhythm

• Treat food, hydration, and sleep as part of treatment, not “nice extras.”
• Add tiny nervous-system resets, like a 60-second pause between tasks, or a brief walk to the bathroom, shoulders down, jaw unclenched.
• If mornings are risky, schedule heavier cognitive work for later when possible.

Create a flare plan that reduces panic

A plan removes some of the chaos. It can include:

• A small kit: water, a snack, sunglasses, earplugs, medication as prescribed
• A pre-written message you can copy-paste on bad days (simple, factual, no apology required)
• One or two “low brain” tasks saved for symptom days (admin, tidy-up tasks, reading, light planning)

Reduce guilt with more accurate self-talk

Migraine can shrink the day. That is not a moral failure.

• “I’m lazy” becomes “My brain is in a neurological flare.”
• “I should be able to” becomes “I’m doing what I can with the symptoms I have today.”
• “I’m falling behind” becomes “I’m prioritizing stability so I can keep going long-term.”

Be careful with the “overcompensate” trap

Many people try to make up for migraine days by working too hard on better days. That can backfire. Gentle pacing can protect the next day, not just today.

When should you consider medical support or a work conversation?

If migraine is frequent, escalating, or threatening work stability, it is worth bringing into medical care more directly. More headache-free days are associated with less disability and fewer missed workdays, which is meaningful for both functioning and quality of life.

It can also help to know that workplace migraine programs and coaching approaches have shown improvements in migraine disability and gained working days, alongside improved self-management.

Consider reaching out for support if:

• Attacks are becoming more frequent or harder to recover from
• Medication use is increasing or feels risky
• Anxiety, low mood, or burnout are building around migraine and work
• Work is being reduced or threatened because of symptoms

Key takeaways

• Migraine affects work through missed time and through invisible reduced capacity while present.
• Work can worsen migraine, which creates a painful feedback loop.
• Small accommodations can reduce attacks and reduce the need to mask.
• A flare plan can lower panic and protect energy on bad days.
• The goal is not maximum productivity. The goal is a more livable life while working.
• If migraine is frequent or threatening work stability, medical support and structured management can help.

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Take care!