Please Don't Use Migraine as an Excuse
Last updated: September 2023
Dear people without migraine,
Migraine, unfortunately, fits all the criteria for a foolproof excuse: Attacks are horrendous and debilitating, are invisible to untrained eyes, and usually only last a day or two. But migraine is not an excuse. Don't get me wrong – tons of people use it as one. It's just that those who do usually have never had a true migraine attack. People who actually have migraine and have lived through the misery of migraine attacks do not use it to get out of plans, go to work, or do chores. To us, it's an all-too-real hell that we'd never lie about.
Pushing through so we aren't stigmatized
In fact, migraineurs frequently push themselves relentlessly despite being in terrible pain, fatigued, and nauseous (or some other combination of the myriad migraine symptoms). Even when we can barely function, we go to work or PTA meetings or out with friends. Why? Because we don't want you to think we're making excuses or that we're fakers. We're well aware of the deep stigma attached to migraine and don't want it applied to us. We also don't want migraine to have so much control over our lives that it forces us to cancel plans. We loathe to let migraine win.
Superstitious about the next attack
We're also superstitious about migraine; lying about one tempts fate. That may sound absurd, but once you've had a full-blown migraine, you'll search desperately for ways to avoid getting another one. However, attacks are fickle and unpredictable. Because it’s so hard to track down triggers, migraineurs become suspicious of every possible culprit. Including that pretending you have one when you don't could actually trigger an attack.
Our experiences are real
The next time a migraineur friend cancels or coworker misses work, know that they’re trying their hardest to meet commitments, but sometimes it’s impossible. They may be literally unable to get out of bed, and driving would be as dangerous as if they'd drunk 12 martinis. For some people with migraine, this happens a few times a year. For others, it's nearly every day. We don't want to live this way, but sometimes we have no choice. Simply believing our experience is real is often the kindest thing you could do.
Migraine is disabling
Also, please think twice before using migraine as an excuse. Migraine is by far the most prevalent disabling neurological condition and is the seventh-highest cause of disability worldwide.1 During an attack, 90% of migraineurs cannot function normally.2 In fact, a migraine attack is as disabling as quadriplegia or active psychosis, according to the World Health Organization.3 Migraine is a serious illness that can devastate lives, not a convenient way to play hooky from work.
A migraineur who has to cancel plans far too often
P.S. Is it presumptuous of me to speak for all migraineurs? Probably, but I've encountered thousands of people with migraine in the last 10 years. We vary in many ways, though we're all fighting hard to keep migraine from controlling our lives and agree vehemently that faking migraine is abhorrent.
Are the family and friends you will be seeing this holiday season understanding about migraine?