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Workplace Woes and

Workplace Woes and ‘The Talk’

I feel as though I am always walking a fine line of employed and not-so-employed when it comes to balancing my work life and my migraines. Along with other illnesses such as chronic anxiety and depression, migraine can take a pretty intrusive role in my life and can make keeping a job really difficult. One too many sick days, one too many requests for accommodation and I could very easily be seen as unreliable and out of a job. For that reason, I often find myself pushing through intense symptoms while on the clock, and loading up on multiple jobs (I currently have three jobs that I physically report to) as a safety net. That often ends up manifesting as me overworking myself (sometimes multiple shifts per day, seven days a week) in order to keep all of my employment, while having the assurance that if I lose one job from being ‘too sick’, I will have something to fall back on. I feel as though I am a hard and diligent worker, and I always try my best, but often I have to leave work or call out because I can not function to the standard required by my workplace.

Anticipating loss

While it can be difficult to find financial security when dealing with migraine, there are options available to those who experience chronic pain, such as workplace accommodation, sick leave, and disability insurance. Many migraineurs struggle to get diagnoses, however, and those that do can struggle to get approved for insurance.

For those of us who are not able to take advantage of sick leave or insurance, we may find ourselves in a constant loop of seeking and losing employment. If we do find employment, we may feel anxious and constantly anticipate losing work because of our disability. This has been especially pertinent for me lately because I am often having to leave work because of  other chronic illnesses  along with migraines. This affects me sometimes multiple times a week.  I anticipate each week will be the week of ‘too much asking’ and constantly feel anxious about my performance and job security.

The talk

‘The Talk’, the one where performance and commitment is discussed in the workplace, is never fun. It has happened to me a number of times and each time it feels truly awful. I am never surprised, but I always feel exasperated because I always feel like I am doing as much as I can.

Isn’t it enough that I am trying my best?

I try to hide my pain and push through often to avoid ‘The Talk’, but it seems to follow me at many of the places I go. Between feeling guilty for asking coworkers to constantly cover shifts or relieve me, and pushing through pain to get through as many shifts as I can each week, working is as confusing as it is draining sometimes, and migraine and anxiety tend only add to that confusion.

It can be really uncomfortable living on the edge, waiting for ‘The Talk’ to happen or hoping it doesn’t or hoping that it does but that there is understanding and compassion. One affirmation I give myself is repeating that I am valuable despite what my illnesses say, even at work. It can be hard to believe that in the moment or when things are particularly difficult, but it is true.

Have you lost or struggled to gain employment because of chronic pain? How do you navigate ‘The Talk?’ Let’s discuss in the comments!

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.


  • AnnMagee
    10 months ago

    I hav been battling migraines for years and my boss for the past 6-1/2 years doesn’t believe in them. I am luckily part of a union that has helped me with FMLA but I am leery of calling in sick with a migraine because my boss is horrible to me. This past two weeks I have had only two days with no migraine and that is unusual for me.
    I usually just work through but the past couple days have exhausted me. One of the supervisors is understanding but I still have to deal with the big boss. I have no accommodation from her and I have asked for something that helps but I get nothing. I will be contacting my doctor again and get her to send a letter to my boss about accommodation for me.

  • atrnovac
    10 months ago

    I got really lucky I work for a health insurance company. My employer is great when they found out I have chronic migraine they had hr email fmla paper My work sees it as a disability and my managers alway ask if I do get a migraine at work if I’m ok or need to go home and if I’m ok to drive. It’s not all sunshine I have tried for other positions and I carry the qualifications to do the job but I think I get passed over because I do miss days for my migraines.

  • Allyson.Ellis moderator
    10 months ago

    I’m so glad you have an understanding work environment, atrnovac. Feeling supported can make such a difference! I hear how discouraging it feels though, to be passed over for promotions due to migraine. The positive of having colleagues who are compassionate toward this illness does not dampen the sting of rejection. Thank you for sharing your experience. Wishing you a gentle day. ~Allyson ( team)

  • tammay
    11 months ago

    It’s so sad to me that migraine is not viewed as a neurological condition by so many employers and that even when people meet all the requirements for accommodations, they are met with resistance. That just shouldn’t be happening (but I know the reality is that it does, many, many times).

    While I have never had The Talk, I have definitely had issues with having to push through migraines many times. This was especially true when I was working as a college instructor. My schedule was full and I had to stand in front of a class many times (under excruciating florescent lights) with a heavy-duty migraine. Luckily, at that time, I didn’t have some of the other symptoms that I have now (like nausea).

    The “solution” (if you can call it that) for me was to move to working from home jobs. These were far from idea, as they payed very very low and offered no benefits whatsoever (no healthy, sick leave, disability, etc). But at least they let me choose my own schedule and as an independent contractor for most teaching EFL students or online courses, I could cancel lessons without having The Talk. I was lucky in that I think most of the companies that employed me recognized that I was a hard worker and honored that so I never got fired (though I left on my own accord many times).

    But I could never fully support myself with those jobs, not even multiple jobs so I had to borrow a lot from my parents :-(.

    Hopefully as time goes by, migraine will become more respected as a neurological disease and employers will be more flexible in accommodating those with migraine.


  • Allyson.Ellis moderator
    10 months ago

    Tam, thank you for sharing your experience of working with migraine. The lack of understanding and compassion surrounding migraine in the workplace is so frustrating and discouraging. I’m glad you have found ways of working that are more manageable for you, though I hear the strain it has created from the poor pay and lack of benefits. We all hope that greater awareness and education will lead to more accommodating work environments in time! Wishing you a gentle day. ~Allyson ( team)

  • knause
    2 years ago

    I just received The Talk, I’m very scared to loose my job in IT Support. I’ve been employed for the same company for the last 7 years and it was never a question before, until a new HR manager came. I’m 51 and suffer from Migraine since I was 12. I have about 3 migraines with Aura a month and missing work about once a month for one day, only staying home when migraine becomes unbearable. Usually waking up with a full migraine not beeing able to take medication while still having the Aura.
    I’m really sorry to hear, that so many of us facing this and that there is so much missunderstanding regarding what migraine is and what it involves suffering from it. Do you thing a migraine awareness campaine would make a change? Looking forward to your comments.

  • horsewhisperer1
    2 years ago

    I worked as a Psychiatric Nurse for 28 years (the last 6 years as a clinician in a community mental health team. The same year I received my 25 year pin for unbroken service within the health region, I also received “the talk” from Human Resources. This meeting was humiliating and embarrassing. Rather then recognizing that I had a neurological disorder (i.e. migraine) it was strongly advised that I “retire.”
    Letters from my G.P. and neurologist requesting work accommodation for migraine disorder were met with resistance and seemingly obtuse responses.
    The worst bullying came from the nurses I worked with, who minimized my migraines, apparently envious of the thought of me getting a shorter work week via accommodation. My manager feared grievances from other team members who thought I was getting special treatment through an accommodation proposal. My manager subsequently revoked the proposed work accommodation (which would have meant a shorter work week).

    I retired just before my 56th birthday. Years of bullying, and attempts to educate colleagues that migraine was “not just a headache” eventually took its toll on my health. My migraines worsened and I realized continuing to work just wasn’t worth. I loved my job and had worked hard to maintain high standards of care for my clients. I received a letter of praise from my manager who also had a neurological disorder and understood my circumstances.

    Since retiring my migraines have improved. I still experience stigma with regard to my migraines, but nothing like I experienced from other nurses. Imagine! How ignorant!
    You’d think they’d know better!

  • ati7of
    11 months ago

    Working in the medical field one would think they would have been more accommodating, especially because you had been there forever. What happened to “self care” that the mental health professionals preach about?

  • Nancy Harris Bonk moderator
    2 years ago

    Hi horsewhisperer1,

    I’m so very sorry you had to deal with workplace bullying for all those years. You would think of all places, migraine stigma wouldn’t exist in healthcare system, such a shame.

    On the bright side, it’s good to hear you’ve seen an improvement in migraine frequency and severity – YAY!!

    Thank you for sharing!
    Nancy Harris Bonk, Moderator/Patient Advocate

  • LeilaniRL
    2 years ago

    Hello all:

    Thank you for your help so far but I need more help I’m afraid and I don’t know where to turn to.

    My work is trying to accommodate me and my conditions but I’m afraid that hey don’t understand the severity of my situation.

    My work says that I need to be present in my office. “Not being present creates a barrier to… collaboration and and therefore impacts the workflow and productivity.” Yes, I understand this but when I talk one on one with people, sometimes something happens:

    The person’s face that I’m looking at kind of zooms in towards me and then all sounds are muffled and I can hear a slight ringing in one or two ears. Then, my right arm and right fingers tingle and within two hours I have a migraine at work or wherever I’m at.

    I know that they want me there in person, but it’s hard on me. Currently I have the ability to share computer screens and teleconference with everyone at work.

    I need to be able to:
    – Run away when I have a migraine. I usually have diarrhea or excessive bowel movements and I’m in the bathroom for more than 20 minutes and I’m usually crying.
    – I need to be able to fully recline in fetal position to sleep the migraine away.
    – I need to be in complete silence and barometric pressure to be steady
    – I can’t have conversations or movement good big around me. It drives me insane and I get irritable and BOOM migraine.

    Is there any advice you can give me or is there someone to help my work to understand? What’s my next point of action?

  • Nancy Harris Bonk moderator
    2 years ago

    Hi LeilaniRL,

    I’m sorry you are dealing with this. Have you had an opportunity to speak with your employer about workplace accommodations? I would imagine some of the things you mentioned may be accommodated, while others probably not. Let me share our information on workplace accommodations I hope help;

    Nancy Harris Bonk, Moderator/Patient Advocate

  • Alex B
    2 years ago

    As a person who suffers from Migraine with aura I sympathize with your situation – however – I don’t see how having 3 jobs can be good as that just increases the change that you get a migraine at work. That’s 3 different places you end up missing work from. That’s 3 times the stress and most often high stress is what causes migraines.

    I’m pretty sure it’s federal law they cant fire you if you are diagnosed by doctor. Although migraines are definitely in the ‘purgatory realm’ as far ‘disability’ is concerned, I’m almost positive that under work laws you can’t get fired.

    Even if that’s not the case you shouldn’t be working 3 jobs. Two at most. Personally I believe migrainers should receive some kind of disability check, perhaps half of real disability. People with migraines should really only be working part time.

  • Kyky Knight moderator author
    2 years ago

    Hi Alex B!

    Thank you so much for your thoughtful response! It sure has been tricky navigating Migraine while trying to report to many workplaces, and it became very overwhelming for me personally. I certainly agree with the sentiment expressed that the chance for stress building is heightened, and I think I would be inclined to follow that advice in the future! It is sure important to make sure we are taking care of ourselves and I find myself pushing through and neglecting that at times. The reminder is always awesome to have!

    You are also right about the ‘purgatory realm’ so to speak of migraine. While there are protections for those living with chronic migraine such as accommodations (here is some information on workplace accommodations I thought you might be interested in checking out: , it can be very difficult to qualify for disability and can be a very difficult journey (one of our advocates discusses that experience here: Tricky stuff for sure, though I certainly wish that it were easier for many living with migraine to balance the pain of migraine with work.

    Thank you for being a part of the conversation, and take care!

  • abbey1997
    2 years ago

    Although I have never lost a job due to this, I’m once again in a situation where my migraines are out of control so it becomes a fear. In the past I’ve gone on intermittent FMLA, which I may have to look into again. I wanted to throw that out there for people that have that option because I didn’t know I had it until someone told me. Good luck everyone.

  • Kyky Knight moderator author
    2 years ago


    I empathize with the feeling of having migraines that are out of control, as well as with fearing that they will jeopardize work. I am sorry to hear that is your experience. Thank you so much for your well wishes to members for the community! I wish good luck to you too. I learned so much about seeking out help for migraine from being told by others that I had options, and you are so right, it can make a world of difference! Sending well wishes your way. Take care.

  • Scarby
    2 years ago

    I just had “the talk” on Monday. My job is extremely stressful, especially during the winter as I work for a propane gas company. This past winter was exceptionally busy, plus we were short handed in the office. I also had to put my father in a nursing home the previous year. I lost him in January. I had taken on more responsibility at work due to a coworker dealing with a disability. I was on a new medication which worked great…for 3 months. At least it got me through the worst. However, like all treatments before, it quit working and the migraines came back with a vengeance! I read all the comments about gaining respect from your coworkers. For the most part I have that. One has suffered in the past, but hers are more manageable now. One is very sweet, but she is determined that there must be a cure out there. And one, well, one just doesn’t believe in migraines, or chemical sensitivity, or depression….

    On a funny side note, I was going to have “the talk” with my boss that very day. I realized I could not continue working full-time and being 100%. He was planning to offer to fire me so I could get unemployment even though he didn’t want to fire me. Instead, we worked out a part time arrangement. We shall see how it goes. Today I have a migraine, but one I could have worked through. Just happy I didn’t need to.

  • Kyky Knight moderator author
    2 years ago


    Wow, so glad to hear that over time you have developed understanding relationships with some of your co-workers! Especially your boss, I hope the new part-time situation goes splendidly and am sending many well wishes your way! I totally relate to getting things under control only for them to become chaotic again, and with taking on way too much responsibility, and I know how whirlwind-y that can feel. I am also glad you didn’t have to work through a migraine, at least for a day. Take care.

  • pennych
    2 years ago

    I totally understand your situation as I am going though the same issues myself. i have lost a job due to migraines and am searching for more work at home employment. I find that employers do not understand what migraines are and how it is different from a regular headache. The fact that our health condition is not visible ( like a broken leg, cough, cold, MS, diabetes) makes it harder to have people understand. With that said I am on the search to make migraine episodes less frequent with healthier eating ( whole foods, vegetable , fruits, nuts, healthy fats like avocado and olive oil and ditch the processed foods anything in packages with ingreadients we can even pronounce). This way of eating keeps blood sugar stable. Blood sugar highs and low are not good for migraines. I stumbled upon a great website called and she has eliminated 21 health conditions, one of which are migraines. As she mentions migraines are a symptom of inflammation in the body and the best way to start to eliminate the inflammation is buy cutting out gluten, dairy and sugar. Then it’s on to eating lots of dark leafy greens and all the good stuff, produce that is organic, decreasing our consumption of toxins that we out in our body and on our body ( unsafe, chemical cosmetics )

  • Dee
    2 years ago

    I haven’t lost a job due to migraine but yes, had “The Talk” . This does depend on your migraine frequency (chronic or episodic) and I know that mine alternate between twice to once per week depending on my stress levels, how well I’m sleeping/eating and the season (cold, rainy weather definitely increases my frequency). But then, how long each migraine lasts for is another story. I can’t cope beyond day 1.

    The trick for me has been to provide an outstanding performance at work when I’m well. If you are getting through a lot of work when you’re well, and you maybe go to work one day of the week when you are not so well and not achieve as much, then the other days make up for that. Take advantage of the days you are well to become a valuable, indispensable employee. And never finish a days work with loose ends. You don’t know if you will have a migraine the next day, so you will want a clean slate each day.

    The other thing I’ve learned is to not use migraine as an excuse every time. The stigma of having migraine and being “unfit for work” unfortunately exists for us and when I was being truthful about my disease, my employer requested a letter from my doctor advising them on how I was being managed and whether this was going to be an ongoing thing. My very understanding doctor wrote back letting them know that the migraines were being managed with medication and that this should reduce my migraine frequency and sick days. Since then, I rarely take a sick day reporting in that it is due to migraine. I use some other illness as a reason instead.

    Rarely will I take a sick day for a 1 day migraine. For the migraine that is there when I wake up, my doctor has recommended that I take pain medication as well as an anti-nausea med. Caffeine also really helps if I’m at work with a migraine. It helps my concentration, fatigue and the pain (but no more than two cups taken hours apart). Now it’s the migraine that rolls on for 2-3 days that’s difficult because by day two, it becomes exhausting. And these are the migraines that I reserve my sick days for. It’s funny how dealing with migraine makes you so much stronger to other illnesses. I can go to work with a flu, cold or ear infection and cope up okay, but day 2 of a migraine and it starts to become impossible.

    You can take comfort in the fact that if you talk with your colleagues, you will discover that everyone has some health condition that holds them back too. We are no different except that it is migraine for us most of the time. You are valuable. Make migraine work to your advantage instead of against you.

  • CatefromPhilly
    2 years ago

    Funny, we have all worked out the same basic survival plan. I’ve been at the same job for most of my life, heard so many comments on my performance, or lack there of, basically due to my honesty because I had letters from my physicians, and it wasn’t until I took a path similar to yours that my career took off, my reviews were excellant, and I started earning serious respect. I even received more consideration for my migraine “issues.” How about that?!?!

  • Toby51
    2 years ago

    I tried very hard to keep my sick time to a minimum. After missing a couple of days in a week (in addition to struggling to cope with migraine at work), I’d still hope that the next week I’d have fewer migraines and could double my productivity to catch up. My workplace had an “Attendance Awareness Program”, to which I was assigned each time I surpassed a target attendance percentage (= regular “Talks”), regardless of me providing the required doctor’s notes to support the absences. In this program I received a letter from human resources, which included the phrase “If you continue to fail in your obligation to attend work, further actions will be taken”. There’s no compassion and understanding behind that kind of wording. And it implied that I had the ability to control my condition and was choosing not to. Truthfully, though, after years of struggling to have my employer accommodate my disability, I began to question the ethics of holding onto a full-time job that I could only attend part-time and became increasingly aware of the negative impact that my chronic absences had on my co-workers and clients. My job involved serving vulnerable people and working as part of a multi-disciplinary team and I wasn’t keeping up. Further, the frequent migraines reduced my mental sharpness and my memory. Even when I was at work, I was often (but not always) under-functioning. I kept hoping that the latest treatment trial would be the answer so I had no plans of resigning (but constantly feared being fired). Ultimately, my doctor put me on a sick leave and I went for more testing and specialist consultations. After a few weeks I tried to return to work, but nothing had improved in the frequency of migraines and my employer was even less sympathetic. My return to work lasted 3 weeks part-time and I had to go back on sick leave. I’ve been on a long term disability pension (for which I’m very grateful) for the past four years and I still haven’t found a treatment that works well enough for me to return to work. It is so frustrating and I miss my career. I would need an employer to accommodate an erratic, unpredictable attendance and level of cognitive functioning. Even if this was possible, I can’t actually do my job under those accommodations. My chronic absences and falling behind before going off work showed me that it couldn’t be done. I don’t want to be on disability and still hope for a treatment that works for me. In the meantime, the only boss that could tolerate my chronic migraine is me. I’ve thought a great deal about ways I can be self-employed but haven’t seen a way yet. I keep hoping for better days ahead and I focus on gratitude.

  • pwrnapper
    2 years ago

    Yes trying to maintain a decent job is very difficult with migraines. Personally I get Cluster Headaches which can be totally disabling. I’m glad I work in an office job but do attend meetings and have face to face customer consultations periodically, glad it is not a full time activity. I’m very fortunately that my boss cuts me some slack when the monster arrives and accommodates my needs. There is a peaceful area with a couch at work and I keep 2 neck pillows ( at work and home, 1 in the freezer when cold is needed and the other 1 for putting in the microwave when heat is needed. I also have injection os DHE with me at all times and O2 tanks delivered to the office. All of these items are necessary to quickly abort the monster and become human again. I really appreciate the 12 years on this job and an understanding boss.

  • elleimacricco
    2 years ago

    Pwrnapper, how do o2 tanks help your migraine and how do you get them?

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