How does migraines affect you at work?

Migraines at work

Strong pounding pain, nausea, vomiting, sensitivity to light and noise are typical side effects of a migraine attack. These become even more unbearable when colleagues and superiors in the workplace lack understanding and those affected have to fight against prejudice, stigmatization and discrimination.

An attack is often preceded by an aura, which is linked to visual and speech disorders, numbness or other neurological perception disorders. Working with such symptoms in a concentrated manner is therefore impossible. What migraineurs can do without in this state is a guilty conscience and the fear of negative consequences.

facts and figures

Most of the around 18 million people affected by migraines are gainfully employed - I would like to briefly outline what that means for the German economy.

According to the BARMER doctor report, migraines are among the top 20 reasons for incapacity for work and sick leave. About 900,000 people suffer from migraines every day. With 220 working days per year, that's an incredible number of lost working days per year. Due to migraines, there are around 143 million lost work times annually. The costs that arise from this amount to around 15 billion euros per year. If you add medical and drug treatment and care, the total annual cost of migraines is around 16 billion euros.

The loss of added value due to illness in general amounts to approximately 225 billion euros annually. The 16 billion euros for lost work due to migraines make up around 7 percent of the total costs. Quite a penny ...

Migraines at work

Migraine triggers are many. There are also countless triggers and stimuli lurking in the office, which rain down on us at the workplace. Be it an old flickering screen, bright neon light, stuffy air in open-plan offices, loud conversations between colleagues, a telephone that rings continuously, stress, or a colleague's acrid perfume.

“Another problem is that I have an office job where I sit in front of the PC 40 hours a week and I just can't stand it when I have a migraine. Every flicker and light in general is unbearable. "

A common cause of headaches in everyday working life is an incorrect posture at the desk and the associated tension in the shoulder and neck area. In most cases, your own workplace is not ergonomically tailored to the employee. This constant tension activates pain receptors, which can trigger headaches.

However, it is important to distinguish between tension headaches and migraines. Tension headaches that are triggered by tense neck and shoulder muscles can be prevented by stretching and loosening the hardened muscles, applying heat and cold and using a workstation that is individually tailored to the user. It can also be very helpful to open your office windows, let in fresh air, and drink plenty of water. If none of this helps, you can also use light to medium-strength non-prescription drugs such as acetylsalicylic acid (aspirin), paracetamol or ibuprofen.

"Take a pain pill!"

However, anyone who is overwhelmed by a migraine attack at work is usually no longer able to continue working. Migraine attacks are more than ’just headaches and greatly impair the concentration of those affected.

“The problem with that is that I can't drag myself to work with a migraine, as most people think or say. You can still go to work or do something with a headache, which is almost impossible with a migraine. "

If a migraine attack is imminent, it is no longer possible to continue working at full capacity. A migraine attack means decreased concentration, an increased error rate and slowed down work processes. If neurological deficits such as perception disorders in the form of an aura also occur, this harbors considerable risks, depending on the activity. Anyone who suffers from visual disturbances, numbness or paralysis during the aura cannot continue working on a machine or in traffic, for example. Difficulties in concentrating or finding words are also problematic when working with other people or maintaining customer contact.

Because of their sensitivity to noise, light and smells, those affected need a quiet and dark room in which they can withdraw.

"Here in the office I have the opportunity to retreat to a couch, but if I notice the tablet doesn't work after a short time, I call in sick and drive home."

Then I have to go to bed, roll the blind down, make a few noises and smells, otherwise the nausea will get worse. Then I always hope that I can sleep, then at least I don't feel the pain. Most of the time it works.

In acute cases, specific anti-migraine drugs such as triptans can be taken. Triptans block the release of neurotransmitters, which can lead to local neurogenic inflammation in the blood vessels in the brain. In addition, triptans normalize the increased nerve activity in various brain centers and constrict dilated vessels. Triptans have the advantage over other painkillers that they work in a targeted and selective manner at the switching points in the brain that are involved in a migraine attack.

However, if you want to drive home from work with a migraine, you should note that the ability to drive may be impaired when taking (strong) painkillers and that the general ability to react and concentrate in severe pain also decreases. In order not to endanger yourself or others and to avoid an increased risk of accidents, it is better to use public transport or a taxi.

Sick leave

Migraines do not necessarily have to lead to a long absence from work, as a regular daily routine and individually well-adjusted drug or non-drug treatment can alleviate or prevent an acute attack. Strategies for reducing stress play a special role here. In addition to a more conscious and balanced everyday life, regular relaxation procedures (progressive muscle relaxation according to Jacobson, breathing therapy, autogenic training) are recommended. In addition to relaxing the muscles, these also cause a breakdown of stress hormones and a regeneration of the body's own pain defense systems.

Numerous studies show that the regular use of such relaxation techniques can significantly reduce the number of attacks in the long term. In addition, shoulder and neck tension are improved and high blood pressure is reduced.

“These methods are aimed at reducing the willingness to have seizures. For M-sense migraine, we have made proven relaxation exercises such as progressive muscle relaxation according to Jacobson, autogenic training and breathing meditation available on the go. "

However, migraines can severely restrict the ability to perform and act - and, depending on the severity, even endanger professional existence, namely when those affected suffer from chronic migraines. This is the case if headaches or migraines have occurred for 15 or more days for at least three consecutive months. If this is the case and you are declared unable to work due to the chronic illness, a disability can be recognized under certain circumstances at the pension office and a disability pension can be applied for.

In most cases a migraine attack lasts around 24 hours and you are ready to work again after one to a maximum of three days. If a sick note is required for the missed working hours, a family doctor can issue the corresponding proof if the migraine has been previously diagnosed by a neurologist. The person concerned can therefore have his family doctor certify that he is unable to work for the duration of the migraine attack.

In order to be able to give the doctor precise information about the frequency, severity and duration of the migraine attacks, those affected should keep a headache diary.

Dealing with colleagues and employers

If a migraine attack is brewing, you have to make the difficult decision: stay or go home? Staying means torture. Staying means enduring an extremely exhausting ordeal.

I tried to go to work with migraines, also to avoid absenteeism, and when it didn't work at all, I stayed at home. But I often handle it in such a way that I still torture myself to work and at least try, but then usually go again in the morning so that you can at least see that I had good intentions and that I also tried it. I don't know whether it will be appreciated. I don't think so

“Most of the time I would wake up in the morning with a migraine, and each time I would struggle with whether I went to work or not. When I left, I always came later and could only stay 2 to 3 hours at most and then had to go home again. "

But for some, going home or staying home is even worse because they fear they will make a bad impression on colleagues and superiors or because they are afraid of being misunderstood. Many migraineurs fight against misunderstanding, prejudice and stigmatization on a daily basis.

»There were often the slogans“ Shouldn't get in line ”,“ It can't be that bad ”,“ You're never so sick that you can't work ”and much more."

»This constant lack of understanding or the casual, ridiculous remarks /“ jokes ”about my migraines got me to the point that I no longer felt comfortable there. Even when I was feeling great, I didn't like going to work anymore. "

“In the first department where I was, it was mostly my colleagues who didn't show any understanding. They were probably always afraid that they would have to do my work when I'm not there. In each of the other two departments, it was the superiors. Often I've been made to feel that it's up to me that I'm not doing something right. "

In total, there are well over 200 different types of headache. Around 758 million people worldwide suffer from migraines and around a third of the German population has tension headaches at least once a month. Headaches should therefore also be an issue in business and work life. Communication, openness and more information create clarity and promote understanding and empathy.

“In my experience, my boss thought for a long time that I was using my migraines as an excuse. Fortunately, however, he also knows that I am a reliable employee who is conscientious and who also makes things difficult when she is sick. In other words, he has understood a little more in recent years that I then suffer a lot and says nothing more about it. "

»You should tell your colleagues and employers right from the start that you have migraines and just deal with them openly. It should then quickly become clear that migraines are not an excuse, but a burden for those affected. "

“What would I probably do differently? Absolute openness, even if you don't get the job. And do a job that is really fun. "

»I have often sent my boss reports about migraines, in which I find myself very much, and so that he understands it a little better. Did it help? Yes something. "

For outsiders who do not know the trigger, frequency and strength of your migraine attacks, it is very difficult to classify and correctly assess the intensity of the pain and the external circumstances. Communication is key here. Since migraines are unfortunately still very often not taken seriously and many colleagues and employers lack understanding, it can help to clarify important questions about fluctuations in performance and failures in an open conversation, to dispel prejudices and to look for solutions together.

»My employers at my former job were often very irritated when I had to call in sick because of a migraine. It was always very uncomfortable for me to cancel because I already knew that nobody would care how I was doing. It was always just about the failure and finding a replacement as quickly as possible. "

»After I was back, I often heard and found out that people were ridiculing the subject of migraines behind my back and saying,“ Yes, I also often have headaches… ”"

»Unfortunately, I almost never met understanding, e.g. when I turned down the blind in my office. Then they complained about why it was so dark in the secretariat. After I was massively bullied there, I changed departments. "

Three rules of conduct for dealing with migraine sufferers

Rule number 1: Migraine attacks are not a severe headache. Migraines are migraines, and those who are not affected by it should not make comparisons. Sentences like "Oh, I know that - I also sometimes have a headache. Just take an Ibu! "Should be avoided as a matter of urgency. What you can really do without during an attack is a lack of understanding on the part of fellow human beings and the resulting feeling of having to justify the severe pain and explain the difference to normal headaches.

Rule number 2: People with migraines often cannot tell that they are suffering from an attack. Premature conclusions that the colleague does not want to work, would rather celebrate sick, and use the migraines as an excuse, do not help anyone and reinforce the bad conscience of those affected, which they already have.

Rule number 3: Don't give advice: more drinking, more sport, less stress, healthier diet - when it comes to the alleged misconduct of others, many people quickly come across with “well-intentioned” advice and tips. Factors such as stress and lifestyle are not the cause of migraines, just triggers that can trigger an attack.

→ So it would be better if you advise your colleagues to go home and take a rest instead of tormenting yourself through the day. Show ’understanding and compassion and, if necessary, confirm to the supervisor that it is not possible for your colleagues to continue working.