Migraines and Your Job

How to keep your career on track when you have migraines.

From the WebMD Archives

Getting migraine headaches is tough. Managing a migraine at work can be even trickier.

Can you keep migraines at bay while you're on the job? What can you do if one strikes during working hours? How much do you have to tell your boss about it, and could it hurt your career?

WebMD spoke with migraine and workplace experts about that. Here's their advice:

Headache Prevention on the Job

If a migraine strikes at work and is not treated and resolved quickly enough, there's a good chance it will hamper your ability to operate at full speed or in some cases, stay at work at all.

Migraines are often seen as a minor condition by people who don't get them. If your coworkers have never suffered a migraine, they might be clueless about what you're going through.

One of the best ways to address migraines at work is to avoid one, says Noah Rosen, MD, director of the Headache Center at the Cushing Neuroscience Institute at the North Shore-LIJ Health System in Manhasset, N.Y.

If you don't already know, it's worth figuring out what your most common migraine triggers are. Keeping a log of your headaches may help you get a better handle on what increases the chances of a migraine coming on, so you can take steps to reduce their frequency or avoid them.

When a Migraine Strikes at Work

Rosen says studies suggest that when a migraine strikes, taking medication as soon as the pain starts can help to prevent a headache from getting out of control. So be prepared.

"In general, I would recommend headache sufferers keep all of their non-sedating medications at work," Rosen says. This includes anti-inflammatory and migraine-specific medications.

If possible, retreat to a break room or a quiet space while you're waiting for the medication to start working.

Just keep the heavy stuff at home, Rosen advises. Narcotic pain relievers and some anti-nausea medications can be quite sedating. And any new medication should always be tried first at home, so you know how you react to it.

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10 Ways to Curb Headache Triggers at Work

Many jobs -- whether because of the nature of the responsibilities or the work environment itself -- can worsen headaches in someone with a migraine condition.

Minimizing the impact of work-based triggers may help keep migraines at bay. Here are tips:

  1. Drink more water. Dehydration is a common migraine trigger.
  2. Limit caffeine. It's dehydrating and acts as a diuretic. Plus, too much caffeine can be a trigger for some people.
  3. Avoid salty foods. You'll have to drink even more to make up for it.
  4. Call for back-up. In some jobs -- such as teaching or working in a call center -- it can be tough to take a bathroom break. In that case, you may need to involve your manager. "This is one circumstance where working with the administrator is important," Rosen says. Perhaps they can assign someone to cover for a few minutes.
  5. Don't let yourself get hungry. Hunger is a common headache trigger. It's easy to skip lunch or snacks when you're under pressure to get things done at work. But that's a mistake. "Be sure to get that lunch break and make sure you have additional snacks to eat," Rosen says. Avoid sugary snacks and instead opt for healthier fare, such as nuts, protein bars, and fruit.
  6. Dim triggers. Do the glare of computer screens, bright lights overhead, or your co-worker's perfume make your head pound? First try simple methods for minimizing their effects, says Curtis W. Reisinger, PhD, corporate director of the employee assistance program with the New York-based Physicians Resource Network. Put an anti-glare screen protector on your computer screen. Ask your supervisor if you can move to another cubicle if yours is right under direct, florescent lighting or where there are other triggers -- such as smells or loud noises.
  7. Check your set-up. If you have a desk job, the ergonomics of your desk matter. Something as simple as setting your computer screen at an appropriate level so you aren't looking up or down can help prevent headaches.
  8. Curb job stress. Stress is the most common trigger for migraines, Rosen says. So be mindful of stress-related triggers at work, and find ways to minimize them as much as possible. For instance, scheduling tasks one at a time throughout the day instead of trying to do everything at once often helps, Rosen says.
  9. Change the scene. Take a break. Make a short walk, or some other outing, part of your day. A quick manicure or shoulder massage at a local salon at lunch can help you relax. Can't leave the office? Simply stepping away from your desk for short periods may cut tension. "If you spend a significant amount of time at a computer station, spend 15 minutes every two hours away from the computer," Rosen suggests.
  10. Schedule downtime. When you're under stress, it's important to give yourself time to recover. "Take vacations when they're due," Reisinger says. "You're better off with mini-vacations than storing it all up."

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To Talk or Not to Talk

Generally, it's a good idea to keep your personal life separate from work life.

But if you've tried to quietly remove migraine triggers from work, and it's not working -- or if you find yourself having to leave the office frequently because migraine symptoms are interfering with your job performance, it may be time to let your boss and/or co-workers know about your migraines.

And keep in mind your upcoming job performance review. If migraines cause the quality of your work to suffer but your supervisor doesn't know about your condition, your performance evaluations can take a hit. "If you didn't ask for an accommodation before, that's the wrong time to ask for it," Reisinger says.

Ultimately, it's your decision to disclose, or not. If you do decide to discuss a medical condition at work, Reisinger says, the approach you take matters.

If it's obvious that you're dealing with something personal at work -- say you have to wear sunglasses indoors to reduce the effects of bright office lights -- it's important to avoid telling only some people around the office and not others. "If you tell only some people, it starts to look like you're playing favorites," Reisinger says.

And limit what you share. No one needs to hear about how often your migraines cause you to vomit, for example. "Keep it light, and don't try to get people to feel sorry for you," Reisinger says.

If you think your boss might not be sympathetic, you might want to ask your doctor for a note confirming your migraine condition and your work-based triggers.

"I've written letters for patients to request environmental changes [at work]," Rosen says. "I think privacy is important but if there are places where changes can be made to improve the situation they should be shared with administration," he says.

Many companies -- especially large employers -- have an occupational department or an Employee Assistance Program (EAP), where you can get professional help planning the best way to talk with your boss and co-workers about your migraines, and any special accommodations you may need in order to do your job.

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Your employer's Human Resources department is another place to turn for help if specialized programs aren't in place.

If your headaches frequently disrupt your work day, look for ways in which you can preserve a sense of fairness among your co-workers.

Avoid making excuses or falling into a pattern of asking others to complete your work. "Sooner or later it will breed resentment," Reisinger says. If possible, take work home to complete when you're feeling better or come in from time to time on the weekend to finish whatever was left undone during the week, he advises.

Know Your Rights

Migraines can be classified as a disability under the Americans with Disabilities Act, which makes it illegal for an employer to discriminate against you because of a disability. Whether or not you classify depends upon the degree to which your condition limits your ability to do your job.

"It's worthwhile that you know your rights to begin with because many times employers do not know what your rights are," Reisinger says.

That's why talking with your company's Human Resources department can be an important way of protecting yourself if your condition gets in the way of your work. You can also do your own research at resources such as The Job Accommodation Network (JAN), a service provided by the U.S. Department of Labor's Office of Disability Employment Policy offering guidance on workplace accommodations and disability employment issues.

If your condition is serious, Reisinger suggests going through the formal chain of command to discuss your condition and how to best manage workplace issues sooner rather than later.

WebMD Feature Reviewed by Brunilda Nazario, MD on April 16, 2012

Sources

SOURCES:

Job Accommodation Network: "Accommodation and Compliance Series: Employees With Migraine Headaches."

Noah Rosen, MD, director, Headache Center at the Cushing Neuroscience Institute at the North Shore-LIJ Health System, Manhasset, N.Y.

Curtis W. Reisinger, PhD, corporate director, Employee Assistance Program, Physicians Resource Network.

U.S. Department of Labor: "Disability Resources."

© 2012 WebMD, LLC. All rights reserved.

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