Dr. Elizabeth Leroux
Neurologist & Headache Specialist, Brunswick Medical Centre
Employers and employees can work together to find accommodations that help employees continue to work and be successful.
Susan Cape, a migraine patient living in Ontario, is always worried about when her next attack might hit.
“I never know when they’re going to come and I never know when they’re going to be out of control,” she says. “Sometimes, I get vertigo and it will go away after a couple of minutes and I might feel a bit off, but I can work through it. On other days, I might get nausea and then a blinding headache that lasts for two hours.”
Cape, who is a social service worker, experiences migraine symptoms almost every day and she worries about having to cancel on clients.
She’s not alone. According to Migraine Canada1, 12 percent of the world’s population2 has migraine and women are nearly three times more likely than men to be affected.3 Migraine is a neurological disease that can cause symptoms including fatigue, pain, nausea, , visual disturbances, numbness, and tingling.4 According to research, triggers of migraine may include lack of sleep, skipping meals, drinking alcohol, stress, eating certain foods, and hormonal changes, such as during menstruation.5 For people like Cape with chronic migraine, headache occur at least 15 days per month.6
Employers and employees with migraine need to establish a collaboration. There should be a culture of openness, understanding, and support.
Migraine sufferers push through at work due to stigma and fear of job loss
Migraine has a significant impact in the workplace. In one 2010 Canadian study,7 migraine ranked third for causing the greatest productivity loss nationally. But while people with migraine may need to take days off, they also go to work despite severe pain and symptoms.
Due to stigma and not wanting to lose their job, people with migraine push through, says Dr. Elizabeth Leroux, a neurologist and headache specialist at the Brunswick Medical Centre in Montreal. “They will show up in a very poor state and try to do their best. They try to hide it,” she says.
Dr. Leroux says that employers should learn about migraine and choose drug plans that cover migraine medications, including preventatives to support employees. Employers should also provide reasonable accommodations to enable employees to feel well and perform at their best. Some suggested accommodations include8:
- No-scent policy to avoid odour triggers
- Adaptation of lighting
- Optimization of the workstation for posture
- Coverage of allied health services, such as physiotherapy or occupational therapy
“A person with migraines shouldn’t be asked to provide a doctor’s note when they’re away. There has to be trust and recognition that people with migraine aren’t looking for free sick days,” says Dr. Leroux. “Employers and employees with migraine need to establish a collaboration. There should be a culture of openness, understanding, and support.”
Surround yourself with supportive people
Cape started getting chronic migraine about a year into her career, before she opened her own practice. “I faced employers and supervisors not understanding what was going on. They thought it was just a headache and not a big deal,” she says. “I asked several times for accommodations and I was met with a lot of resistance and it made things very difficult for me.”
Cape says that there’s a need for less stigma and more support in the workplace. She notes that it also helps to surround yourself with supportive people and to reach out to other migraine sufferers through groups on social media and in person. She finds that waking up at the same time each day, getting enough sleep, eating at regular intervals, and practising mindfulness and yoga help her to prevent and manage her migraines.
“I have a successful career. Eight years ago, I was not the same person. I didn’t have adequate support or people in my work life who understood migraine,” Cape says. “We need to challenge dominant perceptions around migraine and let people know that this is a real neurological condition. If we’re taken seriously and supported, we can do our jobs, enjoy our careers, and be successful.”
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1Migraine Canada. What employers should know about migraine. Retrieved from https://migrainecanada.org/posts/the-migraine-tree/branches/social-life/what-should-your-employer-know-about-migraine/. Accessed November 2021.
2A. Marco, R. Pescador, O. De Jesus. (2021). Migraine Headache. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK560787/
3R B Lipton, W F Stewart, S Diamond, M L Diamond, M Reed (2001). Prevalence and burden of migraine in the United States: data from the American Migraine Study II, 41(7):646-57. https://pubmed.ncbi.nlm.nih.gov/11554952/
4Cleveland Clinic. Migraine headaches. Retrieved from https://my.clevelandclinic.org/health/diseases/5005-migraine-headaches. Accessed November 2021.
5A. Marco, R. Pescador, O. De Jesus. (2021). Migraine Headache. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK560787/
6Migraine Canada. You are not alone. Retrieved from https://migrainecanada.org/you-are-not-alone/. Accessed November 2021.
7Zhang W, McLeod CB, Koehoorn M. (2016).
The relationship between chronic conditions and absenteeism and associated costs in Canada, Scandinavian Journal of Work, Environment and Health, 42(5):413-422 https://migrainecanada.org/wp-content/uploads/2019/12/Zhang_disability_Canada.pdf
8Migraine Canada. What employers should know about migraine. Retrieved from https://migrainecanada.org/posts/the-migraine-tree/branches/social-life/what-should-your-employer-know-about-migraine/. Accessed November 2021.