Tips for Dealing with Migraines at Work

Migraines at Work: Tips for DealingA migraine striking while you’re hanging out at home is bad enough, but migraines at work are even worse. Not only do you have to deal with debilitating pain and other symptoms, but you have to consider how to handle the situation in a professional way — when all you want to do is go home. Taking a few steps while you’re not in the middle of a migraine can make times like that a little easier. How do you deal with migraines at work? When you have to go home during the workday or call in sick, do you specifically say that you have a migraine? Is your boss usually understanding? 

Psst: We’ve also talked about how to function at work without sleep, how to explain an embarrassing illness (not that migraines should make you embarrassed!), how to handle a client meeting while drugged with cold medicine, and how to handle frequent doctors’ appointments. We’ve also had at least one great reader discussion with advice about migraines.

Here are some tips for how to handle migraines at work:

  1. Consider giving your boss (and your assistant) a heads-up that you may have to occasionally miss work because of migraines. You shouldn’t feel obligated to divulge private medical information, of course. Some people with chronic conditions find it’s better when their boss and coworkers know the details, while others prefer to be vague. But if you anticipate making any phone calls to say you can’t come to work, or leaving in the middle of the day because you’re feeling horrible, it’s definitely easier (and more pleasant) to provide an explanation while you’re feeling good rather than suffering from severe pain, vertigo, nausea, and so on.
  2. If you have to call in sick with “morning migraine and you decide to give the specific reason for missing work, tell your supervisor how long you could potentially be out, if you can. If you feel the need, explain that you couldn’t have informed her any earlier, because you felt just fine the day before.
  3. If you think your boss is getting suspicious about the time you’ve missed, either because, like a lot of people, she doesn’t understand the severity of migraines, or because she thinks you might not be telling the truth (e.g., a boss who has it out for you), Alison of Ask a Manager suggests simply not mentioning migraines anymore. If you feel it’s necessary, make sure (or try to make sure) that your boss knows migraines are a genetic, neurological disorder — not just bad headaches. Don’t offer a doctor’s note unless you’re required to provide one.
  4. If you worry that your absences will affect your job, tell your boss how you’re addressing the time you miss — not to apologize for your condition, of course, but to show that you take your work seriously and want to minimize the hours that you’re out. Explain that you will take precautions to try to prevent migraines (e.g., stay hydrated, limit caffeine — but you don’t have to give specifics if you don’t want to) and point out that your employer can help by making accommodations such as providing an anti-glare screen for your computer monitor, relocating your desk if it’s under direct fluorescent light, or moving your office/cubicle/desk to a quieter area).

Here are a few quick tips from Corporette readers on enduring a migraine at work: (1) take Excedrin Migraine and have a big cup of coffee, (2) turn down the brightness on your computer screen, (3) wear sunglasses while at your computer, and (4) if you can, turn on the lights underneath the bookshelves/cabinets in your cubicle.

If you have migraines, do they cause you to frequently miss work? If so, how do you handle migraines at work with your supervisor and coworkers? How much do you go into detail about your condition, if at all? Have you had a boss who wasn’t understanding about, for example, having to leave work in the middle of the day due to a migraine? 

Stock photo: Shutterstock / Voyagerix.migraines at work - tips for dealing

What are the best practices for dealing with a migraine at work? How do you stay professional if you have to call out sick at the last minute, go to frequent doctors' appointments, or are distracted during the meetings you DO have to grit your teeth and get through? We rounded up some great tips on how to stay professional if you suffer from migraines -- and how to deal with a migraine at work.

Comments

  1. Button down :

    Tips on a nice white button down with some stretch, that does not gap but is not boxy and wide?

    Much appreciated.

    • Anonymous :

      So this is a bit out there, but the Riders by Lee Easy Care Woven shirts are my secret wardrobe weapon. They’ve got a great shape and have an extra button over the bust. They resist wrinkles and are under twenty bucks at Walmart or on Amazon.

  2. I should’ve written this post. My biggest tip – see a neurologist! There are prescription meds that can treat a migraine (or prevent them if they are frequent) that are much much more effective than excedrin migraine. But early action is important. Honestly, when I get them, I go home because “working” through one is absurd and I get zero work done. I’ve always been direct and unapologetic about them, and haven’t had anyone be suspicious (I’m lucky, I know!)

    • Anonymous :

      +1. Long time migraine sufferer here, I can’t tell you how many times in my professional life I’ve encountered coworkers who get 3+ migraines a month but have never seen a neuro, don’t know what triptans are. Medical decisions are personal choices of course, but so much unnecessary suffering!

      • Agree! I wish I had gone years earlier.

      • Anonymous :

        +1. As the co-worker who has to cover for you and occasionally gets migraines, too, please see a doctor. Do NOT tell me to just track your p*r**d so I can plan ahead because you don’t believe in doctors. No. Just not doing it.

      • Senior Attorney :

        Yep. Within just a couple of weeks of the first appointment, my neuro had me on a cocktail of beta blockers and topamax that has reduced my migraines from multiple times a week to just a tie or two a year.

    • Yes. So much this. I can’t believe it took me so long to see a neurologist. I’ve had migraines as long as I can remember and it wasn’t until I started tracking them 4-5 years ago that I saw how much they were impacting my life. Triptans were such a game changer and they allow me to stay at work if I need to.

      I’m home with a migraine today because I’m pretty sure it was triggered by lack of sleep and dehydration, so resting should keep it from getting worse. Typically I stay at the office and take pain pills if I am really busy or have court or appointments. I try to limit the time I take off work for my migraines, but my office is very understanding. Plus I’m super pale and look terrible when I’m in pain, so no one thinks I’m making it up.

    • Mineallmine :

      I have to get a referral to see a neurologist, and my GP refuses because he thinks I’m exaggerating when I say it’s debilitating. I went from having a migraine a couple of times of year to nearly every day, I think due to some medication I was on. It took me a year to finally get him to switch me off those meds, and now 6 months later I still get them at least every couple of weeks for a couple of days. God I want to switch doctors but I have almost no choice here, none of the other practices in my catchment are accepting new patients. 800 MG doses of ibuprofen sometimes takes the edge off enough that I can move around, but it’s ripping up my stomach and sometimes I can’t drive or read thanks to the vision distortion. Sorry I’m just venting. Someone below mentioned praying for death, which really resonated.

      • That’s horrifying. I’m so sorry. Would it help if you tracked your migraines and could show it to your GP? I know several people who use Migraine Buddy. I used iHeadache, which seems less user friendly, but worked fine.

      • Anonymous :

        OMG thats awful! I am so sorry to hear that. It sounds like you don’t even have triptans yet and if you have them nearly everyday you need preventatives STAT! Meds like Topamax, noratriptaline, etc.

  3. Anonymous :

    Migraines are a protected disability under the ADA, and your workplace may be required to make reasonable accommodations for you (including letting you come in late, letting you work from home, etc.). Definitely know your rights and if your manager (or anyone else) gives you a hard time about your migraines, let them know you want to have an interactive conversation. Signed, a management-side employment lawyer with migraines.

    • But it is not reasonable to self-diagnose your migraines, not get appropriate medication/behavioral treatment, and miss work frequently and ask for accommodation without seeing a doctor. I have seen this several times.

      Don’t self-diagnose. See the appropriate doctor.

    • Anonymous :

      Yes, migraines may qualify as a disability, however, HR will ask for documentation from a licensed health care provider, so PLEASE, go see that neuro, because a note from urgent care or someone who just writes what you say will.not.cut.it. You don’t need to give the details to your manager. You do need to have a plan for How Your Essential Functions Will Get Done. If you cannot function at a “meets expectations”, even if it is barely that – use leave.

  4. Anonymous :

    +1 Excedrine Migrane and Coffee. I always keep a triptan at my desk or in my purse (currently Zomig is my favorite, so easy to use). I also find eating something with protein, fat, and carbs helps ALOT, which is difficult because my nausea makes me not want to eat. My go-to is a McDonald’s breakfast sandwich, yay for them serving them all day. This may be less obvious but always help me: a shower before work (I shower at night, but if I have a migraine, shower in the morning helps). ALSO, if you can, install F.lux onto your desktop. The ability to minimize blue light during a migraine helps tremendously!

    • And blue blockers sunglasses can be great.

      • Anonymous :

        My mother has Prevencia lenses on her everyday glasses and they’ve cut her migraines from once a fortnight to twice a year.

    • Rebecca in Dallas :

      I take Excedrin Migraine (I also have a prescription that is a similar aspirin + caffeine combo, just a little stronger) plus iced tea. For some reason hot coffee doesn’t sit well on my stomach if I’m feeling nauseous already, but ice cold tea tastes great! I read somewhere that giving yourself a brain freeze helps with headaches, so maybe that has something to do with it.

      And yes, a hot shower with tea tree/mint shampoo or body wash helps soooo much!

  5. For those who use sumatriptan/Imitrex, I can’t recommend the shots enough. I still use the pills for the vast majority of my migraines, but the shots are incredible for fast-onset migraines (or waking up with one). They literally work in less than five minutes. I have had both the needle-less (Sumavel DosePro) and the needle ones (a generic). They have honestly changed my life.

    • Anonymous :

      Completely agree, they are amazing. Unfortunately for me, I discovered I have a phobia of giving myself shots, even the needle-less ones. Not sure what the problem is, I know it’s illogical and I’m totally above it mentally. So I use the nasal sprays instead, which are pretty good, but nothing works quite like the shots. For those of you that are not babies about giving yourselves shots like me, please try them! and they’re cheap!

    • Triangle Pose :

      Yes! I used to use sumatriptan back when my migraines were truly excrutiating and the waiting was still hard to bear. The needle-less Sumavel DosePro is awesome. With yoga and changing my diet I have been able to stave them off and have them less than once a year now but I”m so glad that Sumavel DosePro is there.

      • Not sure if this has been mentioned, but the Imitrex nasal spray is also awesome. Maybe not as fast acting as the shot, but better than a pill for sure.

      • I don’t know if you are still reading this or not, but what diet changes did you make? I’ve noticed that reducing sugar and dairy really helps me, but it’s not perfect.

  6. Too many migraines :

    For those on triptans, how often do you take them? I have an rx for 10 pills at a time that I can only refill once a month. Lately I’ve been getting migraines noticeably more often and am running out of pills before it’s time to refill. Is there something else I should ask my doctor for? (Yes, I realize this question is better aimed at my actual doctor, but I’m curious about others’ experiences.)

    • Anonymous :

      You’re really not supposed to take a triptan more than 2x per week because it can trigger rebound migraines. That’s why the typical insurance limitation is around 9 pills per month (though my crappy insurance only gives me 4). If you’re needing them more often than that, you definitely need to go back to your neurologist. There are daily preventatives they can try that are supposed to reduce the number of migraines you get, so you use your triptan less often. It may be that you just have them bad enough that you needed that preventative on top of the triptan, it could be that you’re not taking them early enough for it to be effective so you take another the next day even though it’s still the “same” migraine, it could be that you’ve triggered the rebound effect, or something else.

    • Go to your doctor. You shouldn’t need to use triptans that often. There may (will) something more effective available for you.

    • The reason the pills range from 9-11, as far as I know (I get 9), is this risk for rebound migraines with overuse. When I was first getting mine under control, I was always running out of pills. It took a while to learn my triggers and things like that to prevent as many as I could on my own, then use the pills to supplement. I read 1-2-3 Heal Your Headache which helped me identify my triggers (lack of sleep, too much bright light – I’m religious about sunglasses now, red wine/alcohol, menstrual cycle, barometric pressure changes).

      Are your pills 100 mg? I have also split mine occasionally when I know a half pill can stop a migraine from getting bad.

    • Anonymous :

      Yup – go to your doctor, and hopefully a neuro. It’s probably time for a preventative (like beta-blockers) that can help you get less frequent migraines. You are also probably getting rebound headaches.

      • Too many migraines :

        Rebound headaches! I didn’t know that was a thing! I’m going to call my doctor now. Thanks, all.

    • Anonymous :

      See your neurologist about taking a preventative medication. There is no reason you should be taking triptans that frequently. You may need to try a few different preventatives to find one that really works, but once you do, your migraines should be much more under control.

    • This happened to me and I ended up trying the Heal Your Headache diet. It’s a book that talks about getting out of the cycle of rebound headaches and identifying your triggers.

      The diet was tough, but after the first month I went down to about one migraine a month. I’d always dismissed food triggers, but I feel so much better now and am testing foods to add back in. Anyway, keep it in mind if you don’t want to take preventative medicine.

    • Agree with all the posters who say check in with your neurologist. Time for a preventative medication to take daily, or to change the one you are on now.

      Also – the rebound phenomenon is real, but there is a subset of severe migraineurs that need to take tryptans more frequently. This is a treatment of last resort, after failing many, many other preventative meds and alternatives to tryptans. In fact, my Mom was on a tryptan daily (after having had migraines for 50+ years), and was seeing one of the most famous headache experts in the country who managed this. It worked for her, and made her functional and she never took a day off work. She was a high powered director in Big Law. Crazy…

      The limitations insurance companies have on medications are two fold…. you shouldn’t need more than that number a month because if you do, your treatment is likely failing and you need to see a doctor for re-assessment. But of course, they insurance companies are trying to save $$ too by limiting you. My Mom used to have scripts for multiple different tryptans as a result, and she would rotate them. They were all prescribed by her neurologists. She always had the shots at home for the worst ones.

      Getting a good neurologist, that specializes in migraines is essential. The vast majority of folks with migraine never see a headache neurologist, unfortunately.

      In my extended family, many folks have migraines (all inherited on my mother’s side). Interesting to me, only 2 guys have had migraines – all the rest are women. And both of the guys went to the ER when they had their most severe headaches and had extensive work-ups, including spinal taps, CT scans, even MRI for one. None of the woman have ever gone to the ER.

      This anecdata actually tells me a lot about how women respond to pain…. and perhaps, how doctors respond to women’s complaints of pain.

    • Renee Miller :

      Possibly not the best medical advice, but I told my doctor that the 50 mg pills helped, but wore off a bit later. So she upped the prescription to 100mg, which I just break in half. I get 9 pills a month per insurance rules. I don’t end up using them all, but having the extra really helps with my anxiety over running out (which has happened and was brutal!).
      A game changer that helped make the migraines less frequent is taking a daily herbal supplement called Mig-Relief. Highly recommended!

  7. Drink 32-64oz of gatorade or pedialyte (not powerade, it doesn’t work for migraines). Just chug. Definitely hydrate but the electrolytes really help in addition to triptans + nSAID + caffeine.

    • Anonymous :

      It’s been a while since I did my testing to see which triptan was best for me, so things might’ve changed, but I recall that NSAIDs + triptan was a HUGE no. The only exception was Amerge (naratriptan) and even that can only be combined with Aleve.

      • My neurologists have told me that naproxen works as a booster for triptans and makes it more powerful so you’re less likely to have to take as many triptans. If I have a bad migraine starting, I always take sumatriptan and aleve.

  8. I had botox injected into my jaw when my doctor noticed my jaw muscles were unusually large as a result of stress-grinding my teeth. They have significantly helped with reducing the number of migraines I get and I can always tell when it’s time for another shot because the headaches start creeping back.

    I believe if you have are diagnosed/have a history of headaches and are referred by your family doctor it is covered by your insurance

    • Anonymous :

      Yes! My sister had been going to a headache clinic for years and was able to get her insurance to cover botox for her horrible migraines. They have been a life changer in addition to the imitrex shots someone mentioned above. Bottom line – get to a doctor. My sister was getting a migraine about 20 times a month and she could barely function. It’s gotten much, much better but it took going to the headache clinic for a few years before the medication/botox was properly balanced.

    • Anonymous :

      +1, I’ve been getting botox for migraines for a year, it is LIFE CHANGING. It was a huge process getting it approved. I’ve tried every triptan on the market, and just about ever preventative too. I currently take a cocktail of noratryptaline, topamax, and a betablocker, all in low doses. I went from daily chronic migraines (before preventative meds) to 1-2 migraines a week (after preventatives) to 1 migraine a month.

      • THIS. Botox is a lifechanging treatment for me. I actually laughed at the “take excedrin migraine” advice above, because that doesn’t even begin to touch my bad migraines. Botox, botox, botox. I would 100% pay for it completely out of pocket if I had to, it’s that much of a gamechanger.

    • I’m in the process of trying to get my insurance to approve botox now. This will vary depending on your insurance, but many will only cover it if you have chronic migraine (> 15 days per month) and have tried at least two classes of preventative drugs for a significant amount of time with no benefit or major side effects. It’s sort of infuriating that it takes a good six months of hoop jumping before insurance will pay, especially since it supposedly takes another six months or so to really see the benefits… and I have “good” insurance. I’ve been in constant pain for more than a decade, so it’s not like it’s going to go away on its own.

      • Anonymous :

        Good luck, Anon! I hope you get Botox soon and that it works for you as well as it did for me!

      • Look into the Botox savings card plan from Allergan/Actavis…I know it’s recently changed, but it may help you cover it, even if insurance doesn’t.

  9. Been getting migraines since I was 16, just like my mom (who suffered as a single working mother in the ’70s before decent meds, go her!). I’m on topomax as part of a preventative med regimen, but that only lessens the severity & frequency. I still get migraines 1-2x a month & maybe every 6 weeks is one severe enough to not work at all. But usually it’s a morning migraine, so I can tap out a quick text or slack message to my coworkers at whatever hour I feel it starting, medicate, roll over, pray for death / sleep the rest of it off, & then work from home starting around noon.

    Moral of the story: work with a doctor for prevention, learn your own patterns, & forewarn your coworkers. It’s all in how you manage the migraine beast.

  10. Anonymous :

    I have to go home if I get them – visual disturbances are my major issue and I just can’t work through them. Prevention is key for me – moderate caffeine (none or too much triggers), good hydration, sleep (ha!) and watching my potassium. I need to eat a banana and drink coconut water whenever I work out the slighest bit. Even a mild yoga class means I need coconut water. I’m super sensitive to dips in my electrolytes but potassium in particular. Not an instant migraine but definitely can trigger especially if I’m premenstrual.

  11. Squiggles :

    I have a script for Migranol (something you shoot up your nose when you are starting to get your aura). I leave a bottle in my desk and have one at home (I used to carry one with me but no longer) and will take that ASAP. Between that, coffee and Advil migraine, I am generally good.

    If I am at home, I will just go to bed as well.

    But I know my triggers and try to avoid them as much as I can.

  12. I used to get headache’s, but Dad told me they were NOT migrane’s, as they do NOT run in our family. But mom says they could be b/c her Grandfather had migranes. Grandma Trudy agreed, but I don’t have the headache’s any more, so that is a good thing, ever since I became a partner, I feel better! YAY!!!!!

  13. I was at the office when I experienced a migraine *with aura* for the first time. It completely freaked me out. I dropped everything and immediately went to my eye doctor’s office because I thought it was a vision problem. I was reading a brief at the time, and there was no way I could have continued with that vision impairment. So, the eye doctor asked me, do you have a headache right now, and I said yes, now that you mention it, I have an awful one. 2+2=migraine with aura. I took a triptan pill which I always carry with me. I’ve had migraines since then, but no others with aura (yet).

  14. I have created a “migraine” first aid kit. It has advil, some bekool migraine soft sheets, earplugs and sunglasses. In my case, it also has a 5 hour energy, which I have found to help (probably because of the B12/Caffeine combination). I had a conversation with my HR manager to provide me with a key to the “privacy room” that is used by our nursing mothers. This allows me a quiet space where I can sit for a few minutes and close my eyes.

  15. Has anyone noticed their brain feels “fuzzy” after taking topomax? I had to stop taking it as a daily preventative med due to this side effect.

Leave a Reply to anon Cancel reply

Your email address will not be published.

Thank you for commenting. On the off chance that your comment goes to moderation, note that a moderation message will only appear if you enter an email address. If you have any questions please check out our commenting policy.

This site uses Akismet to reduce spam. Learn how your comment data is processed.