Managing your career despite migraines

Thriving despite the hardships

Many Migraine and chronic headache sufferers are aware how severe Migraine and headache disorders that demand total cessation of work can wreak havoc with doing one’s job. If one works in a situation that demands availability all the time when one is working – such as a retail position, a phone-operator/switchboard/call center job, or an assembly-line role — there is little one can do other than have a sympathetic or enlightened supervisor and coworkers.

However, other positions have somewhat more flexibility and an occasional headache will not necessarily be cause for someone to be in the crosshairs of management. Nevertheless, those with Migraines who are not in jeopardy of being fired may still find that their headaches are an obstacle to their career progression within their work organizations. This article describes some of the pitfalls that may arise for the Migraineur and some possible solutions to keep one’s career on track.

Fear of Not Measuring Up
One concern is the organizational culture of the organization in which the Migraineur works. Some organizations are very explicit in their sole focus on completing work and producing results, however that is accomplished. There is no penalty for working flexible hours, completing or doing work from home, as long as it gets done. Other organizations or industries, however, put a strong emphasis on always being visible at one’s desk and at putting in long (and extra) hours of work in the workplace — that is how employees are judged. For the Migraineur whose regularity may be challenged by a headache bout, or who must keep up a regular regimen of eating and sleeping, this can be both confining and anxiety provoking.

In addition, the Migraineur may be overly sensitive to perceptions of not working enough (because of time lost during headaches) and may compensate by feeling constantly pressured to work harder and do more — even if his or her work is comparable or better in both quality and quantity, to that of others. A nagging sense of not accomplishing enough can cause perpetual stress that can further aggravate headaches.

Hampered Socializing
Another concern for Migraine and headache sufferers is their inability to fully participate in the socializing and social networking that may be necessary to be accepted by coworkers, to forge relationships with potential clients and sponsors, and to be visible when employees are being considered for roles on projects, committees, for task forces. The failure to fully participate in social networking may be because:

The person doesn’t drink wine, beer, or liquor because they trigger his/her headaches. This may curtail fully participating in socializing, whether in bars, at holiday parties, or even at company barbecues.

The person may avoid bars and other venues characterized by many smokers and poor air quality because these may also trigger his/her headaches.

The person may have to excuse him/herself from late night partying because he/she has found that irregular sleep hours trigger headaches.

The person feels uncomfortable at the tail end of marathon meetings or long-distance travel because he/she has found that missing meals may also trigger his/her headaches. The person feels uncomfortable or is unable to excuse him/herself from a meeting to go eat, and their may be no privacy in the venue of the meeting.

A possible result of not being fully present at these extra-role activities, even if the person is a capable, hardworking, punctual, and productive worker, is that he or she is perceived as “not being a player”. This may be the actual perception of others, or it may only be self-critical analysis projected onto others, but the result is that the person feels that he is unfairly falling behind in his career. It can feel to such employees that they are viewed as frail or elderly — fine for current work, but not worth investing in with stretch assignments, mentoring, or the other types of training afforded to high-potential employees. The person then becomes in his or her own eyes a “double victim” — victimized by the anguish of the ailment and then punished again because he or she cannot fairly compete in the shadow world of social networking.

Migraineurs are not alone in this lament — women with small children, religiously conservative or observant employees, others with disabilities, and even the obese and unattractive all feel victimized by the inability to participate (and thereby compete) in some of the realms of the parallel social world. However, these are not illegal or discriminatory activities, and the focus needs to be on coping rather than holding onto victim status.

The person who feels compelled not to try to be promoted into a demanding or challenging position may find him/herself limiting his/her opportunities and being underemployed. Underemployment, the state of working at a job that is below one’s capabilities, is associated with frustration and discontent, reduced job satisfaction, reduced organizational commitment, increased job searching behavior. It also spills over into negative attitudes towards work and one’s career in general, including disillusionment, embarrassment, isolation from family and friends, marital tensions, and hampered decision-making ability.
What a Migraineur Can Do
No single solution will work for all Migraineurs as each person’s headache experience (in terms of frequency, duration and severity) and employment situation will be different. Here are some general ideas that may be helpful, depending on one’s situation.

Get a reality check. Get a realistic assessment of where you stand in the organization and don’t assume that you know how you are perceived. Ask friends or present/past supervisors if you are seen as a capable hardworking person. Ask if your headaches are seen as an impediment to your performance, as irrelevant (or unnoticed) or as evidence of your dedication and tenacity. You may be pleasantly surprised. Feeling more secure, you will be able to be more forthright when you are in pain and more relaxed about how your headaches are being interpreted. Even if you get some negative feedback about your performance, be careful not to attribute it to solely to Migraine factors unless it is warranted. Try not to exaggerate the degree to which Migraines hamper your performance or let it be an excuse for other areas of improvement. We all have room to grow from constructive criticism.

Hold off on self-evaluations. Don’t make self-evaluations during or right after a headache. A large body of research has demonstrated that people’s abilities and moods can vary significantly over the course of the day, and experts advise people not to make important decisions or self-evaluations during the down times of the day (which may differ for each person, such as “morning people” versus “night owls”). One can safely assume that when you have a headache and when you have taken Migraine medication, even if it alleviates the headache, that you will not be in the best of moods or most likely to make fair and non-pessimistic evaluations of your self (or others). These periods are not the time to assess if you measure up to other coworkers or to your supervisor’s expectations. Hold off on assessing the state of your career or the need for radical changes until your Migraine bout and the effects of the pain relievers have subsided.

Seek a better fit. Seek out jobs, professions and organizations that make output a priority and clock-punching a non-priority. Try to choose an occupation and a company that allow more use of flextime, of telecommuting, and of compensatory work (“comp time”) as long the work gets done. This will give you the benefit of not having to compete on a dimension — regularity of work attendance — that is not essential for the job and that needlessly makes you look bad in comparison to others.

Be informed. Get good medical help — make sure that you are getting the medication that is best for you in terms of effectiveness, side effects, and lack of rebound effects or habituation. Also determine your optimal mix of medication and other efforts (breathing, yoga, sleeping) that will help you short-circuit a Migraine and limit your lost time. Also determine the other efforts (such as acupuncture, chiropractic, or other nontraditional modalities) that work for you in conjunction with your medication. It can mean the difference between a two-hour and a two-day headache

Get support. Consider use of a short-term work/life coach to address career management issues to allow you to grow within your current job or in a more suitable one, despite suffering from Migraines.

Fred Mael is an organizational psychologist who does research and consulting in the areas of work and organizational performance, and does work-life and career coaching. He can be reached at This article was posted on the MAGNUM website in May 2003.