We’ve all been through job interviews — good ones, bad ones, and ones where we’ve left thinking, “Did I really say that?” Sometimes we land the job and sometimes we don’t. Either way, the process is stressful and hard.

Even though the interview process is a challenge, it doesn’t scare me. I feel confident that I can tackle the hard-hitting questions. I handle the first day of work the same way: I know it will be stressful, but I know I can do it.

However, each time I start a new job, nothing scares me more than figuring out how — or if — I will disclose my migraine attacks to my new colleagues.

I’ve desperately wished for a guidebook that could show me the best way to talk about my migraine attacks in my professional life — but I have yet to find it. Through years of experience, the one concrete thing I’m sure about is this: There is no right or wrong way to go about the “migraine discussion” at work.

The migraine discussion

Regardless of your occupation or your type of migraine, or your inner strength, working in pain is hard. For me, it can be hard to get out of bed in the morning when I know that I have an intense day of work ahead. It’s hard to remember all of the preventive measures I need to take throughout the day: Am I drinking enough water? Am I avoiding my triggers? Am I eating regularly? And it’s especially hard to focus when my migraine fog is at a high point.

When it comes to talking about your migraine attacks at work, there are only so many options, and the breakdown is a bit like a multiple-choice test. Here are the possibilities, along with the pros and cons, as I see them:

A. Complete honesty

This means being open and up front with everyone you work with.

Pros: You can be honest and unafraid that people will “find out.” If you need some type of help — such as finding a dark room or having the lights turned out above your desk — it won’t be a surprise to anyone on your team.

Cons: Other people may make assumptions about you. In my experience, when I’ve been completely open, my pain has been unintentionally viewed as a weakness, a flaw. I’ve felt like I’m seen differently in my colleague’s eyes.

B. Sharing some information

There are many different ways to give partial, but not full, information. For example, you might say, “I have migraines,” but not share how bad they are. That means leaving out details like, “I’m in constant pain and it never breaks.”

Pros: You can still hide your pain, for the most part. But, if an emergency happens, you won’t be unveiling a secret. For example, if you lose your vision and can’t see your computer screen, you can explain the situation and it shouldn’t come as a big shock.

Cons: It still feels like you’re hiding something.

C. Sharing only with managers

This option means that the people who supervise you directly will know a bit more about your pain — but it might make you nervous, since managers have decision-making power over your career.

Pros: Every manager handles this differently. In a situation where you’re unable to work, your manager may be more likely to believe that you’re actually sick, and less likely to question if you’re making it up. The fact that some people fake migraine attacks as an excuse to miss work makes life harder for those of us who have to live with this condition!

Cons: The potential downsides depend heavily on the specific manager. For example, one manager might come check on you in the hospital. Another manager might negatively change their opinion of you and your work.

D. Sharing only with friends

If you don’t feel comfortable sharing with your manager, it may be helpful to share with a friend in case of an emergency.

Pros: You can vent and talk through your migraine dilemmas with someone you trust. You may feel more comfortable asking for help, if needed.

Cons: They may see you and your work differently.

E. Complete secrecy

If you want to hide your migraine attacks, this can be a safe option until you feel comfortable sharing with your colleagues. For me, this is the easiest, most natural option.

Pros: You can hide your pain more easily. You’ll have fewer migraine conversations and, in turn, you may feel less judged for your illness.

Cons: At times, it helps to have co-workers know that you’re sick. For example, let’s say you have nausea from your migraine pain, but you need to give a presentation to a room of 40 people. In that instance, it might be helpful for your colleagues to know why you may need to leave the room suddenly, mid-presentation, and how they can assist if that happens.

If you were to ask me how I’ve answered this migraine question in my career, I would answer “F” for “All of the above.” In all of my work experiences, I’ve discovered that there’s no right way to go about starting, or not starting, the migraine conversation.

Much of the decision is based on the working environment, the people you work with, and the type of work you do, among other factors. How much you decide to share is ultimately up to you and what works best for your unique circumstances.

Why it’s a tough decision

If you’ve never faced persistent pain, right now you might be thinking: What’s so bad about disclosing migraine at work? My answer: Because it’s scary.

I’ve leaned toward complete secrecy because I’m afraid. It scares me that people will see me differently — whether intentionally or not — once they know that I’m in pain. I’m afraid that someone will give me a task, but feel uncertain about whether it will get done, or get done well, because I’m not at my best.

When I’m feeling tired, I don’t want my colleagues immediately to think, “She must be in pain.” I also don’t want it to be an unspoken point on my annual review: I worry that if my managers view my sickness as a weakness, they’ll assume others are picking up slack for me.

What it all funnels down to is that I don’t want anyone to assume that I’m anything other than competent and capable — qualities that I most value. This fear of being stigmatized is real for many people living with chronic illnesses, and migraine is no different. There are two sides to the stigma — people either view you as just a “sick” person, or conversely, think that you’re faking it. It’s the stigma that causes many people living with migraine to hide it in the first place.

If I’m honest with myself, another big part of this dilemma for me has nothing to do with the people I’ve worked with or their understanding of my pain. Many of my concerns revolve around the fear that migraine will win over my life.

My migraine attacks have stolen a lot from me: my freedom and my time (so much time). At one point, it felt like they stole my career. During that time, I had to leave my job because the pain had become too unbearable for me to get to the office each day and produce quality work.

It’s scary to accept that my migraine attacks had this power over me. I can’t think of another person or thing that has this level of control over me and, more importantly, my future.

The way forward

Looking back on the many nights that I stressed over how to handle my migraine attacks in a work setting, I wish that I’d had the insight I have now. There’s truly no right or wrong way to navigate the migraine discussion in your career.

Every migraine is different. Every boss is different. Every colleague is different. Every work scenario is different. Most importantly, I’m different. I’m glad that I’ve followed my instincts and handled each situation in a way that felt comfortable for me at that time.

I only wish that I hadn’t been so hard on myself. If I could give advice to the old me, I would say: “Your fear and anxiety are valid and understandable. This is an important decision. Do what feels best for you.”

The information presented is solely for educational purposes, not as specific advice for caregivers or the evaluation, management, or treatment of any condition.

The individual(s) who have written and created the content in and whose images appear in this article have been paid by Teva Pharmaceuticals for their contributions. This content represents the opinions of the contributor and does not necessarily reflect those of Teva Pharmaceuticals. Similarly, Teva Pharmaceuticals does not review, control, influence or endorse any content related to the contributor's websites or social media networks. This content is intended for informational and educational purposes and should not be considered medical advice or recommendations. Consult a qualified medical professional for diagnosis and before beginning or changing any treatment regimen. 

NPS-US-NP-00300 MAY 2018