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Please Don’t Use Migraine as an Excuse

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, going to work, or doing chores. To us, it’s an all-too-real hell that we’d never lie about.

In fact, migraineurs frequently push themselves relentlessly despite being in terrible pain, fatigued, and nauseated (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’re loathe to let migraine win.

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 cause an attack to occur.

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.

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 worldwide1. During an attack, 90% of migraineurs cannot function normally2. In fact, a migraine attack is as disabling as quadriplegia or active psychosis, according to the World Health Organization3. 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.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

  1. Steiner, TJ et al. “Migraine: The Seventh Disabler.” The Journal of Headache and Pain 2013, 14:1.
  2. American Migraine Prevalence and Prevention Study Fact Sheet. National Headache Foundation.
  3. Harwood RH et al. Bull World Health Org 2004;82:251–8.<


  • Cindi
    6 years ago

    RIGHT ON Kerrie, as usual! I’ve been working through the pain for over a decade at this same job, and finally I stopped. I realized that no one else was taking care of me, and I needed to do it myself. Yes, I’ve upset co-workers (although they understand, it’s still frustrating for them and I get that) and had some sad pay checks from missing so many days of those “monster” migraines due to changes in weather mostly. I think this has helped me control my anxiety level, which helps overall. My chronic migraines are not getting better with age, they are getting worse. So, changes are coming in my life, and the first big step for me was staying home and caring for myself when I know there is work that others are having to carry when I’m not there. I’m over the guilt finally. It is what it is.

  • chericoe
    6 years ago

    Hi Kerrie, I also agree with what you have written so well. I have suffered since I was 13, but really not diagnosed till I was 19 with chronic migraine. I started popping aspirin by the handful when I was 13 to carry on through a day, but it started to affect my stomach. At 19 I tried Excedrin, but it gave me tachycardia. I have kept a journal, stayed away from what I thought were trigger foods, tried to keep away from lights and noises that affect me, had my wisdom teeth pulled, had a hysterectomy, stopped chewing gum, taken Inderal, and numerous other meds that I can’t even remember through the years to prevent migraines. I also have tried most of the triptans. I raised two children, but spent many days in bed and missed a lot of time with them because of my migraines. It really puts a guilt trip on you. I also missed a lot of professional (sorry, in the middle of a migraine and can’t think of the word I want to use.) My family has been supportive, but when I do try to attend functions I am not myself and it really is not fair to them. Many days were spent in bed while the rest of the family went to parties, camping, etc. My work and school history suffered tremendously because of my migraines and people look at you differently. One time I was working the evening shift, got off at midnight and had a migraine. I had a 45 minute drive home and was desperate to get home. Needless to say I was pulled over. I explained to the police that I had a migraine, he stated that he understood cause he had them too, so he only gave me a warning. That was the only person I have ever met that said he understood. I will always remember him and that was about 15 years ago. Thank you for sharing your story.

  • Cecile
    6 years ago

    I try to remember that there will always be those people who don’t require my energy: those who don’t understand, or who won’t understand, or who are negative. When a migraine hits, these are the people I erase from my worry list.

    Since migraineurs look “normal,” ultimately, the only people who realize how abnormal our lives are, are our close friends and family. The migraineurs I know strive to live quiet lives as normally as possible. But, in the process, migraine disease can erode relationships. I know from my own experience, that it’s impossible not to turn inward, and in doing so, I forget that I can’t do that without turning my back to others. As a result, I’ve had to make extra efforts to patch up relationships or maintain smooth ones. So, with migraine being the energy thief that it is, I try to guard the precious little there is for my loved ones.

    If I ever use migraine as an excuse with friends or family, those are the people who will understand. But in turn, I have to be mindful of the effect it has on them, too. I’ve had migraines since age 12 or 13 and I’m 61 now; that’s a lot of years for people to have to be sympathetic to me, no matter how much they might care for me. So, if it’s an excuse, it’s real and it’s as rare as possible.

  • Kerrie Smyres moderator author
    6 years ago


    By “excuse,” I mean pretending you have a migraine when you don’t. I don’t think of canceling because of a true migraine as an excuse, but a completely legitimate reason. If you actually have a migraine, you’re coping with life, not making excuses to get out of it!

    Relationships are definitely a struggle with migraine. It sounds like you have a very healthy attitude!


  • Veronica Ussery Perez
    6 years ago

    I guess I will be the dissenting opinion on this article. I have had migraines since I was 5 years old. A total of 37 years. Most of my life. I push myself through a migraine because I WANT TO LIVE!!!!!!!! I could lie in bed in pain or out doing something I like in pain. To me it is no different. There are those occasions when I have to cave and just rest. But 90 percent of the time I want to ENJOY MY LIFE so I press on. I don’t care what others think of me. I take that back. I care what my 9 year old and my husband think of me. The rest of the world just aren’t that important. I am not superstitious about migraine and I have no idea how another person lying about a migraine affects me what so ever? The article makes that statement but does not support it. I guess I have a different support system than the author or the ones that have commented because I have always been treated with the utmost respect when they find out I am hurting. That includes family, friends, and employers. They may not be able to sympathize, but they empathize. I have run into some that will make suggestions like don’t eat chocolate or eat better. For those I just lovingly attempt to educate them more about my condition. They are ignorant of the condition but not uncaring. I am sorry the rest of you have felt judgement from others. I give you permission to not let their opinions hurt you because they just don’t understand.

  • Kerrie Smyres moderator author
    6 years ago


    When people pretend to have migraine in order to get out of work or other commitments, it affects those who truly have migraine because it makes migraine look like it’s only a fake excuse, not a true or serious disease. This reaches into every area of life, from employment to school to relationships and even to health care. When others think we’re making up our illness, there are very real consequences, like getting fired from jobs, failing classes or not being able to graduate, becoming estranged from family, divorces, and inadequate care from doctors. This is far beyond an issue of caring what other people think.

    It sounds like you’re fortunate to have understanding people in your life. I am, too, but we are, sadly, in the minority.


  • undefeatedbella
    6 years ago

    Your words expressed what I find hard to even think clearly enough. Thank You. I also am going to give to my daughter who constantly thinks I just need to push through it or exercise more. maybe when she see’s this she will begin to understand, or maybe not but im tired of being treated as if I have just a “headache” or im not trying to think positive. It feels amazing to know others understand here.

  • Janet
    6 years ago

    Another article authored by you that brought me to tears. I’m going to print your article and send this through usps to my siblings who NEVER respond to any link or article I send about migraines.

    Mine, for some reason, in the last 6 months has intensified to an all time record for me as far as frequency ..intensity…and longevity. I think my body is rejecting all help that used to help. My husband is fed up…isn’t that rich?


  • BethBlue
    6 years ago

    Kerrie, that was beautiful. People who think they can take advantage of us because they presume we are “milking it” have absolutely no idea how much damage they are inflicting on all of us who suffer from migraines. At the outset, I thought people would grow to understand my illness after a period of time — instead, they have lost patience. At this point, I honestly don’t know where to turn.

  • GinaD
    6 years ago

    You are not being presumptuous. I am reading your post as I sit at home experiencing a major migraine attack, looking at the screen with one eye open, trying to determine if I can safely drive to the office to make this afternoon’s Christmas party. Bummed that I will probably have to miss it, that I have to give up yet another sick/vacation day, and especially that some co-workers will probably think I’m just flaking off. Migraine is definitely not an excuse.

  • Lisa Riley
    6 years ago

    I don’t think you’re being presumptuous. I think you’ve stated it exactly as it is. I’ll share this post. I appreciate the effort you made to put what I think into words. Thank you.

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