How to Make a Migraine Game Plan If You Have a Demanding Job

Samantha M., a 36-year-old marketing specialist living in Indianapolis, first started to experience migraine symptoms around age 26 when she had a full-time office job. When an attack was coming on, her brain felt foggy, the right side of her head pulsated, and her ears turned red—then the headache hit. She hadn’t yet nailed down a medication routine, and the pain was sometimes so debilitating it would prevent her from doing her job. “There were many times I’d wake up in the morning and be unable to make it to work that day,” Samantha tells SELF.

Samantha’s story isn’t all that rare. Migraine, a neurological disorder known to cause intense headaches, is the third most common disease in the world, and is estimated to affect over 37 million Americans.¹ The condition can interfere with your ability to concentrate and communicate and leave you feeling run down, nauseated, and irritable. 

A migraine attack, which typically causes a severe, throbbing headache and oftentimes other symptoms like vomiting, sensitivity to light and sound, and visual disturbances called aura, can knock you off your feet—in fact, about a third of people with migraine say the condition has negatively affected their career by impacting their productivity, for example, or forcing them to take more sick days.² At the same time, only half of people with migraine feel like their colleagues actually understand and accept what’s going on, underscoring a very strong stigma mislabeling people with migraine as sensitive, lazy, or weak.^3,4

As a result, many people push themselves to power through when they get a migraine at work, no matter how bad their symptoms are (a concept called presenteeism), Carol Barch, a nurse practitioner with the Stanford Headache Clinic, tells SELF.⁵ When you do this, your productivity drops off and your work tends to suffer—then things can really start to spiral, says Barch. Presenteeism can lead to more headaches, poorer mental health, and more sick days, creating a vicious cycle for people who live with migraine.⁶

Migraine isn’t, and shouldn’t be, a career death sentence. There are steps you can take to advocate for your health needs and minimize the impact migraine has on your work.

Maintain a solid routine full of healthy habits.

First and foremost, you need to take good care of yourself, says Barch, which, with migraine, is all about maintaining routine and consistency. In people with migraine, the brain is very sensitive to changes, so you want to keep your lifestyle as stable and predictable as possible.⁷

Get high-quality sleep, eat nutritious meals, enjoy a form of movement regularly, stay hydrated, and manage your stress levels as best as you can, says Steven Baskin, PhD, the codirector of behavioral medicine services at the New England Institute for Neurology and Headache and an attending psychologist at Greenwich Hospital of Yale–New Haven Health. Sudden changes in diet or sleep—or other regular habits—can spontaneously trigger a migraine in some people. “A migraine brain can’t handle all of that—it just gets overloaded,” says Barch.