One of the most difficult challenges people living with migraine have is accepting the idea of migraine as an invisible disability, and feeling confident enough in identifying themselves as disabled so they can then ask for reasonable accommodations. Unfortunately, many with migraine do the opposite, concealing their condition from their employers because they don’t want to lose their jobs.
Telling your employer
Whether to disclose your migraine to your employer is a tough call, and a very personal one. But, if you disclose your condition with the right supports and plans in place, it then gives you the protection of anti-discrimination law. And, your employer can’t help you if they don’t know.
To help the conversation, you can get your doctor to write a letter explaining your diagnosis. The letter should include what kind of migraine you have, what the symptoms are, and what accommodations you may require.
Read your employer’s sick leave, equity and diversity, and OH&S policies carefully. Know what your employer requires in terms of documentation for leave, the availability of flexible working arrangements or hours, and what is required of you to manage your absences.
Talk to your union, if you are a member, so they are aware of your condition and can help you inform your employer. A union rep may accompany you to a meeting, or they may help you prepare documents.
Then, when you’re ready, make an appointment with HR and your manager to discuss your migraine, and develop a workplace management plan. Be confident and clear that it should not affect your work if you can manage your migraine effectively.
‘Reasonable accomodations’ is a term used to describe alterations to work environments or schedules to allow for disability and serious illness. Think about the kinds of things you can change that would make it easier for you to manage your migraine at work. This may be things to avoid triggers, or to help you manage attacks.
For example: If there is a light over your desk that is too bright, or one in your eyeline that flickers, ask for the light to be turned off or removed, or move your desk position. If it is natural light, you can ask for a blind or curtain. If you are particularly triggered by smells, you can discuss a low-smell policy for the office (usually a request to fellow staff not to wear strong perfumes, or bring smelly lunch foods into the office). Or, if you are often affected by light or noise sensitivity, but any headache or other symptom is not significant enough to require you to go home, talk to your employer about using earplugs or wearing sunglasses at work so you can keep working.
There are things about your work station you can change, like asking for a glare filter for your computer monitor, or a document holder so you don’t have to look down. If your workplace is large enough, ask for an OH&S assessment so you can talk through what you need with a qualified officer, who can also inform you about other tools that may be available for you. Correct posture is also important to stop neck tension, which can be a trigger, so ensure your chair is supportive and properly set up.
If you want the ability to work flexibly, whether it is to work at home on bad days, or make up lost time on the weekends, think it through carefully and have a plan of how you will make it work (such as keeping a timesheet) before meeting with your employer. This will help give them confidence the work will be done. Time off for medical appointments, not requiring a medical certificate for migraine absences, or additional sick leave, are also things that can be negotiated.
Shorter, more frequent breaks (for example, three 20 minute breaks instead of a lunch hour) is a reasonable thing to ask for if that will help you. If there is a quiet room or similar (such as a room used by breast feeding mothers), ask for access to that room to rest for a short period if you need it.
IMPORTANT: Document everything. Keep a diary and your own notes of any discussions you have about your migraine management. Send an email after meetings thanking them for the meeting, and the dot points of what you have agreed on. Keep a file with any emails or other documentation about your migraine management so it is all together. If things go wrong, you will need the paper trail.
Have a support person in the workplace
A really simple suggestion that can make a big difference for managing migraine at work is to have a support person at work: a friend or someone you trust to help you if you need it. The ideal is someone who works on your team or perhaps at a desk near you - someone you regularly interact with throughout the work day, but it might be someone else at work who also lives with migraine and understands what you're dealing with.
A migraine buddy doesn't need to do anything except understand: know the signs that you aren't doing well, and perhaps be empowered to tell you when you need to go home if you have trouble making that call. If your kind of migraine attacks can cause you to lose consciousness or fall down and require an ambulance, it is really helpful to have someone on site who can give paramedics the basics of your condition. Your migraine support person should also know who to call to come and pick you up is you can't drive yourself home, and where you keep your medications in case you need help getting them.
Asking someone if they will do that for you can be confronting, but it doesn't need to be. Try just having a conversation about your condition with someone you know and trust. If they are supportive and interested, then let them know how they can help you.
Migraine Australia is currently developing resources to help both employers and employees create migraine friendly workplaces. Please check back soon.
The following links are to overseas resources, but may be helpful while we work on developing Australian ones.
The Migraine Trust – Help at Work https://www.migrainetrust.org/living-with-migraine/asking-for-support/help-at-work/
American Migraine Foundation – Migraine at work (requires registration) https://info.americanmigrainefoundation.com/migraine-at-work-download
Healthline – 9 Useful Hacks for Managing a Migraine Attack at Work https://www.healthline.com/health/migraine/hacks-for-migraine-at-work#1