How Do You Decide Whether to Work or Not?

One of our patient advocates recently published an article detailing her struggle with deciding whether or not to go into work when a migraine hits. She especially highlighted the struggle of making the work decision when a migraine isn’t the most brutal, and could be pushed through, but really may not be the best idea for your long-term recovery. We asked you, in the community how you feel about determining whether or not to go into work, especially on days when the call could go either way.

Feeling guilty for not fulfilling responsibilities

I feel guilty all of the time like that and watch the clock. Missed work yesterday and was sick as a dog, and trudged into work this morning hung-over from all my meds and the pain from the day before”

“Wow this describes my battle a few times a week. That guilt of thinking that you are almost well enough to be at work vs the fear and guilt that going into work would mean you are unwell tomorrow as well. I find it very hard to make a decision”

“I’m a teacher and unfortunately when I miss a day, it affects all the staff. This of course makes me feel guilty so I push though as much as I can. Today, I made it through the whole day with a mild migraine because I felt too guilty asking to leave. I know I desperately need to sleep and take care of myself, but the guilt of taking a sick day is almost worse”

The confusion and complexity of making the call

“Like others here, this has happened to me so many times. Especially as I get aura migraines without pain. It makes it very hard to know whether I’m well enough to work—sometimes it’s obvious, especially on the first day of the migraine. But by day 2 or 3, once my stomach has settled, I often think I’m fine until I try to drive or concentrate on work. Then I’ll realize I’m slurring slightly or just forgetting words, which is really embarrassing when I’m on the phone to a client!”

“Lately mine have gotten to the point where they will hit me suddenly. One day I had a migraine and I tried to stick it out as long as possible when I should have just stayed home. I was driving home and I didn’t even have time to pull over before throwing up everywhere. It’s scary”

“This is the worst—trying to make this decision. As my migraines became more chronic, I faced this decision constantly. Should I go in, or hope I feel better tomorrow? Should I tough it out the rest of the day, or head home now in hopes I can keep it from ruining the rest of the work week? It’s so very difficult to know the best approach…which can be different every time anyway”

Words of advice to others

“I say, just do what you’re capable of that day. If you can, go into work, but I think it would be a bad idea to be in front of customers, suggest you work in the back office for the day. Keeping to yourself, quiet if you can, just getting on with stuff in your own time, might be an easier way to get back to work than rushing back to the frontline”

“I think we just have to think of ourselves in the moment and try and forget about the workload and deadlines—however, I haven’t figured out how to do that yet!”

“Never push through, take care of you properly first, and then only if you are 75% better from the migraine, try and go in”

“Stay home definitely, and value yourself by resting. We are so much more than what we do. I had to learn this lesson and always found it so tricky as a nurse to call in sick, knowing full well that if I went in I ran the risk of making mistakes, lapses concentration, ineffectiveness, etc.”

Please continue to share with us how you manage the decision of whether or not to work, and any words of advice you have for our fellow community members!


View Comments (22)
  • litoria76
    1 year ago

    I started getting migraines on a chronic daily basis about 3 years ago. I had them previous to that but was protected by FMLA, although I had so many bad migraines that I would run out of the allotted hours. Well, due to the severity of my migraines (I can’t even open my right eye during them due to the sensation of knitting needles being jammed in my eye socket) it was suggested that i go on short-term disability because I was about to be fired due to attendance. So I did that and the migraines continued despite trying just about every possible remedy but failing each time. The STD ran out, long-term disability denied me, then my employer fired me. I can’t even get up the energy to shower more than once a weed due to being so drained by the migraines, nausea, light sensitivity, and now type 2 diabetes. I’m afraid to leave the house because if I didn’t wake up with the migraine, it’s highly likely headlights, sun glare, tail lights, or flourescent lights will set one off… I have been unemployed for the past 2.5 years and am waiting on a hearing for SSDI.

  • BrownT
    2 years ago

    I worked for 25 years with chronic migraines. In the last 10 of those years, I did not have a day off from the pain. However, the mornings tended to be better than later in the day. I found if I could keep busy and concentrate on work I could ignore the pain up to a five. Then I would play mind games with myself for as many hours as I could to keep at work. I also took my rescue Meds and pain medication to help. Most days that would get me to 2:00 p.m.. Because I would start work early, I made the arrangement that I could go home at 4:00 p.m. On normal office days. The last few hours were a battle that weighed how much sleep I had been getting with my stamina for pain and suffering and the demands of my work. I was in control of when I could work on my responsibilities. So heavy mental work was completed first thing, meetings and staff work reviews happened later morning, and I left light mental work like emails and reading/reviews until after 2:00.
    If I was wasted at 2:00, I would talk to my boss who was somewhat understanding and usually could go home for more serious meds and ice packs, dark rooms and sleeps to reset my brain. Going home early relied on my ability to be highly productive during my good hours and exceeding my boss’s expectations. This was key.
    The other days I would get next to no sleep from paying the price of working and not getting my migraine under control before needing to go back to work. Those days were a weighing of how good the rescue meds were doing against whether I could sleep for a few hours and go in at noon. Too often, I needed to go into work with a severe migraine and do the best I could. This was the pain and suffering that wore me down and often required a weekend of struggle to get my head under control. It was not a life I would wish on anyone.
    The last years I had a new boss who was more time oriented than productivity oriented. This boss wanted me at work during business hours and did not allow me to go home early on bad days. After years of fine tuning a system that worked for me and previous bosses, I was surprised how unproductive I became by having no flexibility for those two hours and being able to go in early and leave early. Ironically, I was put in this new position because of my exceptional productivity and expertise in the subject area. However, I could no longer deliver. I rarely got two hours of sleep because my head would hurt too much. My after work headaches became even more severe and took longer to break. It reach a point were I was not sleeping and had a severe headache most of the time. This inflexible schedule wore me down until I was burnt out. My doctor required I go on sick leave. My new boss wrote a letter to my HR file that basically destroyed my reputation.
    I was forced to retire early and took about four years to once again get the strength to cope with my chronic pain so that I could just have a shadow of my life back. I still cannot do what I once did and my social life and home life never really recovered. My spouse is understanding, but misses the person she knew.
    My earlier work life did show me that with a little consideration and flexibility I could have a life that included work. I was blessed to grow up in a home where my mother suffered from episodal migraines and she spent much of her life in a dark room. I also had a grandfather (dad’s dad) that had headaches. In hindsight, he drank heavily and was dangerously grumpy because of what could only been migraines. Tragically, he died from an adverse reaction to a pain medication he took in desperation.
    I wanted more for my life – and was blessed with some normality even while suffering with overwhelming pain and suffering. Without having achieved my dreams, could I have lived with the chronic pain? It was critical for me to have something else to live for.

  • PhillyGirl
    2 years ago

    I work at a job where I am scheduled with clients all day, every day. If I call out, everyone else has to scramble to reschedule all of the clients. Sometimes there is no one to cover for me. As a result, I cannot really stay home. I have been in situations where I have to read my computer through an aura, where thinking felt like waaay too much work, where I have had to ask my co-workers to have a conversation in another room.

    I have migraines approximately 3 times per week. My decision is either to not work or to deal with it. Nobody really understands how hard I have to try to have a real career. I never leave home without my rescue medicines, and my staff is used to seeing me with an ice bag on my head. They think I am a little crazy, but that’s okay with me–I am a little crazy!

    One think that I do wish I had would be more quiet–open plan offices are hell for people with migraines.

  • GSDmom
    2 years ago

    I work as a cashier so with sharp splitting head pain, money mistakes could be detrimental all around never mind the lack of customer service skills. Add to that the depression and exhaustion of the dragging-down tiredness of the pain as it wants to nail us to the floor and shut our senses down.

    Then there’s the guilt trip, loss of wages, threat of job loss and all those other goodies stacked on top (nuts, whipped cream and cherries much?).

    So what can we do. Try our Maxalt, rizatriptans, what have you, rescue meds that are all tailored for each one of us to try to drive the pain away again. Then the miasma of the “migraine hangover” is ours to dredge through the doldrums afterwards with the fear of that “bounceback migraine” lingering.

    And then you hope you can go to work tomorrow. And then you hope (this is in my case) your coworkers don’t cause any flack about you being out and increase the stress trigger because they don’t really care about nor understand the migraine disease (even though one of them suffers like I do as badly).

    It’s debilitating.

  • Julie Fetchak
    2 years ago

    I also work at a high school (as a guidance secretary) so if I miss due to a migraine, my work pile is still there waiting on me when I return. I’ve had 3 migraines this week. The last one, I had to get a big bag of ice and lay down in the clinic after taking Zomig. I can’t think when I have them and feel like an ice pick is straight through my eye and have nausea and vertigo. I work 40 minutes from work…so if I wake up with one, I usually call in, but if I’m there and get one, I usually stay. I also pick up my son on the way home. There are so many ‘non-believers’ out there that have never had a migraine. When your boss fits that catagory it’s a very hard decision to go in or not. I’ve even texted him pictures to ‘prove’ myself. These are hard to live with, I’ll tell ya that.

  • cindyd
    2 years ago

    Struggle with this daily. I have FMLA and have good bosses at work but Friday had my annual performance evaluation and my boss told me I had a great attitude and did a really good job but it is “the days you miss but you have FMLA so you are okay.” Wow that hurt. I looked at him and told him, “I can’t help it.” For the next 20 minutes I worked with a lump in my throat and felt like crying. I did nothing to cause this. I inherited this. I told my husband that if I were sitting in a wheelchair they wouldn’t say a word to me. The old adage about sticks and stones isn’t true. It hurts.

  • Inoexactlywhatumean
    2 years ago

    I am so grateful to find out it’s not just me. I feel so alone facing this problem. I’ll psych myself up: okay this one isn’t too bad, I can work through it. I have to save the sick leave for the times when I can’t even lift my head. But I am always worried that the migraine that I underestimate will turn into one of those which make me pray for death.

  • intime
    2 years ago

    I am currently get disability through Social Security for my migraines. There are certain attorneys that specialize in disability cases but they do take a percentage of your settlement. In my case it took a couple of years so they got a sizable amount. You get paid out on when you initially filed. Your lump sum will not be fully taxable depending on your situation.
    The deciding factor I believe was my chiropractor with my family doctor & neurologist. So all ways get as many professionals that you see to document your migraines to the attorneys, you never know what will make the difference.
    I know everybody is talking about not working but you can work up to a certain amount each month & still get govt. disabilty. For me I went from management to a less stressful job in my sector. It hasn’t been easy to work still with the migraines but my days are shorter & I’ve cut my hours to half what I did work. For me financially I had to have something to supplement the disability to make it. I still feel like half a person at work when a migraine hits but I do the best I can & that’s all we can do in living with this debilitating disease called migraines.

  • litoria76
    1 year ago

    I’ve been denied twice for SSDI & my appeal was also denied. I’m waiting for SSDI to schedule a hearing with my disability lawyer. It’s encouraging to see other people being approved.

  • DonnaFA moderator
    2 years ago

    Hi intime, thanks so much for sharing your story, your experience, and tips with social security. It’s a topic of interest with many of many members.

    I’m so glad to hear that you were able to get your benefits and lessen the time and stress expended on your job. We’re glad you’re here! -All Best, Donna ( team)

  • 2 years ago

    I struggled with the guilt of not covering my workload and the knowledge that if I did work, I’d pay for it later with more pain for years. What changed my life was my Mothers death. My life fell apart. I thought it was the loss of my mother only. Thankfully I had a great doctor who saw I was physically overwhelmed by 2-5 migraines a week and my Mothers death was a wake up call to change my life, my priorities.

  • mfhcounselor
    2 years ago

    I lost my most recent job largely due to chronic migraine. I worked in a “hospital setting” as a clinician working with individual with emergent or chronic substance abuse and/or mental health concerns. As such little time off was given were expected to be at work; period. Sometimes I would push through but I looked high from the after or on going effects of the meds. You guys know; slurred speech, inability to form sentences, walking in a fog with terrible memory, etc. I honedtly should even haven to work; i think it was dangerous. The clients started to complain. So I decided to stay home but that meant the clinic was potentially understaffed. My boss ran numbers and discovered I had 85% productivity and that was not good enough. I asked about part time hours but ended up getting fired anyway. I felt like a failure. The job was high stress but I was good at it…oh well.

  • 2 years ago

    I lost my job also. Thank God I had a loving husband, good health insurance and a lawyer who worked for free. I’m on disability now. Migraines are not gone, of course, but under more control. I wish you the best.

  • mfhcounselor
    2 years ago

    Sorry for the spelling and grammar..i’m in a haze right now…

  • Tamara
    2 years ago

    Being a sales rep gives me a bit more flexibility in my days than most which I greatly appreciate. Most of the time I feel crappy in the morning with the warning signs of the coming storm I try and relax for an extra hour (which tends to turn into a kitty purr and snuggle session), if I still feel very groggy or worse after this I tend to give in until at least after lunch and will jus try for a emails/phone calls. But there are the days I feel much better with the tiny bit extra sleep and can then go do a work day.

    I am only working 4-6 hours though so that is a “full day”.

    I also have the option throughout the day, any symptoms of migraines coming I go sit in my car and settle for 16-20 minutes … still there – meds and nap (fuzzy blanket in car), no significant improvement – time to go home fast!

    I also have came home early, got meds to work well for a couple hours of sleep and gone back out for one more visit. But I also have got stuck at the side of the road praying for death because I didn’t get home in time.

  • Jojiieme
    2 years ago

    Feeling for you, knowing how that feels…
    I hope this week, and the immediate pre-/ post- holidays season is reasonably calm for you.

  • Jojiieme
    2 years ago

    Trying to make the decision now. If I can get to the networking Breakfast, I can last the distance (2 hours). But I got 3 hours sleep, for the last 3 nights each, we’re in a storm now, in a heatwave and the migraines are ever-present (like the neighbours’ cigarette smoke).
    Our air con is broken, landlord won’t repair… So staying home is like living in an oven.
    Yesterday a staff member told me to stop thinking about my ‘headache’, change my attitude and it would go away (!!!) Luckily our Manager was present and backed me up.
    I need to make the effort this morning… I’ll shower, dress, get my partner to drive… It’s like a fireworks extravaganza inside my head and my balance is off, but I have to do this.

  • Jojiieme
    2 years ago

    Lasted just long enough; didn’t sound too incoherent. Managed to get a couple of urgent errands done on way home.
    It’s now steamy, hot, glary, and inside me my head feels it’s trapped like a walnut inside a nutcracker. My legs feel wet pasta cut from a pasta machine: I can’t work out to tell them to move. Partner’s assembling a new fan while I type.
    No abortives will work for me, apart from cool and sleep… I’ll imagine you in the northern hemisphere in the wintery cool 😉 …

  • DonnaFA moderator
    2 years ago

    Hi JOJ, Oh goodness, I’m so sorry! I hate that feeling like bands are shrinking around your skull.

    Yes, cool is integral. It’s cool outside, but the sudden temperature difference going inside from out is jarring. We keep our house about 66. If we have guests, they keep their coats on, lol. I’ll wish you some unseasonably cool weather! -Warmly (Cooly?), Donna ( team)

  • DonnaFA moderator
    2 years ago

    Hi JOJ, wow, thank goodness for your boss and your extraordinary self-control! I hope you get some sleep and some relief very soon. It’s good to see you again! -All Best, Donna ( team)

  • Rebecca moderator
    2 years ago

    I can really relate to this – sometimes I worry that others won’t take me seriously when I have a migraine and can’t work – especially if I’ve “soldiered on through” before. It’s hard to explain that sometimes my migraines are debilitating while other times I can function at a basic level if really needed. The thing is, what I consider a “painful” is very different from the non-migraine sufferer. Headaches that I can push through would put a “normal” person in bed for days. It’s very subjective.
    Also, I know that if I can “push through” it will be at the expense of something else – either it will take me longer to get better or some other aspect of my life/work will suffer.

  • LilMamma
    2 years ago

    Hi all! I have been out of work since the end of January when my boss sent me home because of my instability getting around. I have used up my FMLA, had no short term disability and am now trying to get long term disability approved but it’s not looking good. I am dealing with a migraine for 120 days now. I am working with my GP & Neurologist, have been to the ER, a hospital stay, on a number of medications, through vestibular therapy for osolopisia, all with no luck. It’s all very frustrating, upsetting and alienating. I am starting to lose hope. I am in touch with my employer who keeps asking for my return date. I just wish I could give one.

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