Migraine in the Workplace: Understanding, Supporting and Thriving

Introduction

Understanding the impact of migraine

Migraine isn’t just about physical pain: it’s a complex neurological condition that profoundly affects emotional well-being, self-confidence, and daily functioning. Its unpredictable nature can lead to feelings of guilt, isolation, and fatigue, while the constant effort to avoid triggers can take a significant mental toll. (3, 5) Supporting people with migraine means recognising not only the pain, but also the lasting emotional stress and complex, ongoing demands it places on mental health.

Many individuals living with migraine are ordinary people making extraordinary efforts to lead a fulfilling life. They are resilient, considerate, and constantly adapting—navigating each day with a level of strength that often goes unseen. From managing complex treatment plans to balancing work, family, and social responsibilities around the unpredictability of their condition, their perseverance is remarkable.

Why migraine is a workplace health issue

Beyond intense pain, migraine attacks often bring symptoms like difficulty thinking, visual disturbances, nausea, and sensitivity to light, noise, and smells, making it far more than just a routine headache. It can significantly impair quality of life and work productivity. Absenteeism (sick days from work) and “presenteeism” (when people work despite symptoms, often underperforming) drive substantial economic losses. Yet, simple workplace-based interventions can make a meaningful difference. (6)

Migraine can impact people at work in a number of ways, such as (2, 3):

• Reduced workforce participation. Many people are unable to work either due to disadvantages in job-seeking or disability.
• Absenteeism. People living with migraine often need to take more time off work than the average person.
• Presenteeism. ‘Presenteeism’,  or functional impairment, refers to when someone is at work but is less productive than usual due to illness.
• Limited career prospects. Many people feel they are less likely to receive promotions or bonuses due to their migraine.

Prevalence among working-age Australians

4.9 million Australians have migraine, and it is highly prevalent among working-age Australians. While broad population estimates suggest that around 20% of people overall experience migraine (and most of them are in the working-age group), more conservative modeling indicates around 8–9% may be actively affected in that age range. (7) Either way, this underscores that migraine is a significant health issue for Australian workers and the economy alike.

According to the 2025 Migraine in Australian Women project which surveyed 1,207 women aged 18 years old and over, 8 in 10 women reported work as the most significant area of their life impacted by migraine, on a par with their physical health. (3) 

The Impact of Migraine on Work

Symptoms that affect job performance

Migraine symptoms can extend far beyond head pain, affecting thinking, mood, energy levels, and even basic bodily functions. During an episode, people may experience sensitivity to light, sound, or smells, dizziness, nausea, brain fog or difficulty concentrating—sometimes even before the pain begins and long after it ends. Because each phase of a migraine can bring its own set of symptoms, the impact is rarely limited to a few hours of headache. Instead, an episode may stretch over several days, disrupting work, daily routines, and overall wellbeing.

Many people continue working through the early and late phases of an episode only stepping away during the peak of the pain. In fact, studies show that around 90% of people cannot function normally during a migraine episode, yet many still feel compelled to appear “fine” to avoid stigma or in fear of job-related repercussions. (9)

The unpredictability of episodes

Migraine doesn’t follow a schedule. One moment an employee may feel fine, and the next, they are managing disabling symptoms that make it impossible to continue. This unpredictability can make it difficult to reliably attend meetings, meet deadlines, or maintain consistent productivity, leading to added stress in the workplace. Many people push through migraine symptoms out of fear of stigma or job repercussions, while others carry guilt or frustration when an attack forces them to step back.  (9) 

Over time, the lack of predictability can limit career opportunities, affect confidence at work, and reduce overall wellbeing.
Beyond the workplace, this same unpredictability also disrupts social life, family responsibilities, and the ability to plan for the future—impacting a person’s sense of freedom and quality of life.(3)

Presenteeism, absenteeism, and reduced productivity

In 2018, migraine was estimated to cost Australia $16.3 billion in lost productivity. Around $4.1 billion (25%) was linked to chronic migraine and $12.2 billion (75%) to episodic migraine. On average, this equates to $11,132 per person with chronic migraine each year, and $2,707 per person with episodic migraine. (2)
The impact is significant and felt across many areas of working life:

• Overall cost (each year)
  • $4.1 billion (25%) is linked to chronic migraine. On average, this equates to $11,132 per person with chronic migraine 
  • $12.2 billion (75%) to episodic migraine equating to $2,707 per person with episodic migraine
• Employment participation
  • People with chronic migraine are 19% less likely to be in paid work
  • People with episodic migraine are 2.8% less likely to be in paid work
• Absenteeism
  • Chronic migraine: 5.2 days missed per year
  • Episodic migraine: 2.8 days missed per year
• Presenteeism (reduced productivity at work)
  • Chronic migraine: 6.8% reduction in work capacity
  • Episodic migraine: 2.2% reduction in work capacity

Most migraine-related productivity loss at work is due to presenteeism or functional impairment—people being present at their jobs but less productive and efficient because of migraine symptoms—rather than absenteeism. 89% of migraine-related productivity loss is due to presenteeism. For all the fears and reasons already outlined, people turn up and are present at work, but they’re not as productive as they normally would be because of all the symptoms of the disease. (6)

Presenteeism can ultimately have a greater cost to productivity than occasional, necessary absences. Yet due to widespread misconceptions, only 42% of employees feel comfortable telling their supervisor the real reason they’re taking time off for a migraine. Just 22% of employers consider migraine a valid reason for absence (4), highlighting a serious disconnect between the reality of the condition and the understanding in many workplaces.

These costs fall most heavily on people in their working years, when migraine is most common, underscoring the value of supportive, migraine-friendly workplaces. (2)

Adopting and implementing migraine-friendly strategies and interventions in the workplace that support people with migraine improve their health and in turn improve their participation and productivity at work is not only compassionate and the right thing to do, it also makes good business sense, as highlighted by this article by the Harvard Business Review (6): 

• Educational or awareness programs about migraine have been shown to increase productivity by 29–36%.
• In a real-world case, a company offering telemedicine consultations with headache-trained nurses achieved an impressive return on investment of over 490%.
• Another documented example: three companies implemented a migraine education initiative (involving informational packets and newsletters) and reported:
  • 25% fewer absentee days
  • 32% fewer days affected by reduced productivity (presenteeism)
  • An overall 15% drop in total costs.

Navigating Disclosure and Destigmatizing Migraine

The challenge of invisible illness

Migraine is a highly stigmatized disease, often misunderstood, in part because it’s invisible, there are no outward signs of the pain, nausea, cognitive fog, or sensory overload someone may be experiencing. This invisibility can lead to unfair assumptions that the condition is exaggerated, not serious, or simply “just a headache.”

Unfortunately, the lack of understanding of what migraine is – that it’s more than just a headache – and how it can manifest with symptoms and comorbid conditions like anxiety, depression or stress, coupled with the existing stigma around mental health, can further exacerbate the stigma.

“I think I would have gotten access to resources that would have been helpful if migraine hadn’t been so highly stigmatised. It probably would have been more acceptable for me to say I had a hangover and throw up than to say I had migraine”.

Migraine in Australian Women project focus group participant quote (3)

Due to the persistent stigma people may fear being judged for missing work, perceived as unreliable, or even accused of using migraine as an excuse which makes them less likely to reach out for help or disclose their condition to their workplace. (9)

This stigma alongside the burden of the condition itself takes an emotional and financial toll on people living with migraine, including sometimes the loss of livelihoods. (10) The stigma surrounding migraine can often add to the feelings of isolation and frustration, especially when the condition is seen as less serious than it truly is. (3)

Research with over 60,000 people shows that migraine stigma, reported by nearly one in three, can reduce quality of life and increase disability, sometimes even more than episode frequency. How society treats people with migraine can be as impactful as how often it occurs. (5)

Reframing Disability: The Social Model 

Traditionally, disability has been viewed through the “medical model,” which focuses on someone’s health condition as the source of their limitations. But this doesn’t tell the full story.

The social model of disability takes a different view: it’s often the environment, not the person, that creates barriers. For people with migraine, this could mean:

• Bright or flickering lights that trigger symptoms
• Noisy open-plan offices without quiet spaces
• Rigid work hours that don’t allow recovery time
• Attitudes that dismiss migraine as “just a headache”

These barriers are not caused by migraine itself, but by workplaces not designed with migraine in mind. The good news is that many of these barriers can be removed. With simple adjustments (like flexible hours, quieter workspaces, or awareness training) employees with migraine can fully participate and thrive. (6)

Reducing stigma through awareness 

Migraine is one of the most common and disabling health conditions worldwide, especially in working-age people. In fact, it is (1):

• The second leading cause of disability in people aged 15–49
• A top three cause of disability for young women
• Responsible for billions in lost productivity and healthcare costs in Australia each year

These statistics reflect more than “headaches.” Migraine can significantly reduce quality of life, affecting a person’s ability to work, study, parent, or even plan daily activities.

For employers, understanding this impact is essential. When colleagues and managers recognise migraine as a serious neurological condition, not just an occasional inconvenience, it reduces stigma and creates a culture of support.

Disclosure at Work: A Personal Choice

Deciding whether to disclose a health condition like migraine at work is deeply personal. Some people feel comfortable being open about their needs, while others may be concerned about being judged or treated differently, or workplace discrimination.

There’s no one-size-fits-all approach. You don’t have to share personal medical details, but knowing your rights and how to advocate for reasonable adjustments can make a difference. Framing migraine as a legitimate neurological condition, one that ranks among the top causes of disability globally, can also help build understanding.

Some workplaces have a reasonable adjustments policy, and sometimes even a reasonable adjustments passport which employees can fill out, choosing how much or how little of their condition to disclose, whilst seeking workplace adjustments that will support them. (11)

Thriving at Work with Migraine: Adjustments and Strategies

Common workplace triggers

For many people with migraine, the modern workplace can present a range of challenges that significantly impact their ability to manage their condition. Common environmental triggers (12), such as bright or flickering lights, strong scents, loud noises, poor posture or poor ventilation, can make office settings difficult or even unsafe during or between migraine episodes.

Reasonable accommodations and legal protections

In Australia, people with migraine are protected by federal and state anti-discrimination laws, including the Disability Discrimination Act 1992. This means it is unlawful to treat someone unfairly because of their condition. Employers are required to make reasonable adjustments, such as flexible hours, quiet spaces, or modified workloads, to support employees with migraine to stay healthy and productive. For those living with severe or chronic migraine, additional support may be available through the National Disability Insurance Scheme (NDIS).

Unfortunately, many people still face stigma or discrimination at work, and some report losing their jobs or feeling unable to speak up about their condition. Rigid policies around attendance and absence can also unintentionally disadvantage people with frequent migraine, especially when the condition is unpredictable. Research shows that people with migraine are far more likely to “push through” and appear well than to misuse sick leave. (3, 4, 8)

Conversations with HR or managers

Deciding whether to talk about migraine with your manager or HR is a personal choice. The Australian Women and Migraine Survey found that while 62% of women experience migraine at work, less than half (48%) feel comfortable raising it with their manager. (8) Many people worry about stigma or being treated differently. At the same time, if your employer isn’t aware, it can be harder for them to provide the adjustments you may need.

If you’re considering having this conversation, think about how migraine affects your work, the relationship you have with your manager, and what you hope to achieve. Planning ahead can help. For example, you might:

• Bring a letter from your doctor explaining the impact of migraine or outlining your management plan.
• Prepare examples of adjustments that would make your work more manageable.  E.g. requesting flexible time to rest and recover during an acute attack and the ability to make up for the lost hours once you have recovered.
  
• Highlight the value you bring to the team—supporting migraine health is supporting overall brain health and productivity.

Some people find it useful to share information from a migraine diary or tracking app. This can show the difference between days you were fully unwell versus days you managed to keep working despite symptoms. One community member demonstrated to their employer that although they had only taken around one sick day each month, they had actually worked through many more days with symptoms. You can see the full example in the downloadable resources below.

Sharing this type of data can help employers understand the true impact of migraine and reduce misunderstandings

Self-management and preparation

People with migraine have different ways of making their workplaces more migraine friendly, regardless of disclosing to their employers or not (13): 

• • Anti-glare accessories. Blue light glasses or anti-glare computer shields can reduce eye strain from looking at a computer.
  • Regular breaks. Take short breaks throughout the day if possible. Even a few minutes away from your desk can help reduce neck and eye strain.
  • Access to water. Keep a water bottle on your desk to reduce the risk of dehydration (which can be a migraine or headache trigger).
  • Ergonomic desk set up. Check that your chair, desk and monitor are set up in a way that minimises tension in your neck and shoulders. 
  • Lighting changes. This might involve swapping out fluorescent lights for warmer or more natural light bulbs. Alternatively, ask to move desks to be near natural light or away from harsh lights. 
  • Noise reduction. Noise-cancelling headphones, lowering the volume on the office radio, or establishing quiet spaces can help with noise-related migraine triggers.
  • Fragrance-free workplace. This is harder to manage individually, but you can ask your manager to consider implementing a fragrance-free workplace policy (or fragrance-free areas).
  • Migraine toolkit. Ensuring you have access to acute medication and your migraine toolkit to support your migraine management if an episode is triggered whilst at work.

Some of these changes can be implemented by yourself while others may require a conversation with your employer. This could also be a helpful stepping stone towards a broader conversation about migraine at work.

For Employers: Creating a Migraine-Friendly Culture

Awareness, flexibility, and compassion

Supportive colleagues and employers can play a vital role: a co-worker reminding us to take medication at the first sign of symptoms, or a manager encouraging us to take a break when needed, can make it easier to prioritise health without guilt or self-judgment. These small acts of care can offer immense relief.

These moments of understanding help reduce the psychological toll of migraine. They remind people living with the condition that they don’t have to face it alone, and that their wellbeing matters.

Practical steps for teams and managers

Whilst migraine affects individual people the most, the ripple effects can be felt by teams and bosses in the form of increased workloads, heightened demands and team tensions. Reducing the broader impact and increasing team well-being should be everyone’s business.

There are a myriad of proven ways which can help improve a person with migraine’s well-being and therefore have wider positive effects on workplaces (6):

Reduce Stigma

• Acknowledge migraine as a serious health issue – Treat it with the same importance as other chronic conditions to reduce stigma and encourage open conversations.
  Why: Migraine carries a heavy physical, emotional, and psychological burden, and stigma only makes it worse.
• Promote awareness and training – Equip managers and teams with knowledge about migraine, its symptoms, and its impact on all aspects of a person’s life, including work performance.
  Why: Greater understanding from colleagues and leaders reduces stigma and improves mental health for those affected.

Support Well-being

• Create a trigger-friendly workplace – Reduce bright lighting, strong smells, or noise where possible. Allow access to water and for quiet spaces when needed. Make ergonomic adjustments to work environments like chair changes or screen filters.
  Why: Minimising triggers helps employees stay engaged at work without worsening their symptoms.
• Encourage self-care – Support employees by normalising self-care and healthy habits like taking breaks, staying hydrated, and using medication when needed.
  Why: During an attack, brain fog can make it harder to think clearly—reminders and understanding go a long way.

Improve Quality of Life

• Offer flexibility – Flexible work arrangements, such as remote options or adjusted schedules, can help employees manage symptoms without sacrificing productivity or their own well-being.
  Why: Controlling their environment helps reduce triggers and prevent migraine episodes.
• Support access to care – Encourage employees to visit their doctor to discuss a migraine management plan. If possible, provide health benefits that cover migraine treatments, preventive care, and mental health support.
  Why: Migraine is common yet under-diagnosed and under-treated; reducing barriers to care helps employees manage it more effectively.
  
• Encourage self-management tools – Share resources like migraine diaries, tracking apps, or wellness programs that help employees monitor and manage their condition.
  Why: While migraine has no cure, tracking and management can improve control and quality of life.

Benefits of inclusive policies

Many reasonable adjustments that help people with migraine are not unique to migraine, they’re part of a broader inclusive approach already used to support employees with:

• Sensory sensitivities
• Mental health conditions
• Chronic pain
• Neurological diversity

Implementing these not only reduces migraine triggers but also creates a healthier, more accommodating workplace for many people.

The Value People with Migraine Bring

Serena Williams, Ian Thorpe, Whoopi Goldberg and Elle Macpherson are all people with extraordinary careers who also live with migraine (14) – and who wouldn’t want them in their teams?

People with migraine have often cultivated a unique set of desirable skills and can bring:

• Strong planning, agility and time-management skills from navigating unpredictable symptoms
• Emotional intelligence, self-awareness, and resilience under pressure
• Creative problem-solving, resourcefulness and adaptability in complex situations
• Clear, assertive communication developed through self-advocacy
• Deep empathy and understanding for others living with invisible challenges

These qualities make people with migraine valuable colleagues, thoughtful leaders, and supportive friends.

Conclusion

Supporting people with migraine benefits everyone

When people with migraine are supported to care for their health, they are better able to live fuller lives, both inside and outside of work and the benefits extend far beyond the individual. Healthier, more engaged employees create stronger, more productive teams. A supportive workplace doesn’t just reduce barriers: it allows people to feel valued, included, and able to contribute in ways that are meaningful to them. Simple changes such as flexible hours, access to quiet spaces, or understanding policies can make a profound difference, creating a safe environment for people to be their whole selves, feel confident in their abilities and helping people remain in the workforce and thrive.

Recognising migraine as a serious neurological condition is an important step in breaking down stigma. While disclosure is always a personal choice, knowing that compassion and practical support are available can ease the isolation many people experience.

Building healthier, more productive workplaces

Migraine is an invisible condition that can affect every part of life, from careers and education to relationships and daily functioning. Despite being the leading cause of disability for people under 50, it is often misunderstood and underestimated. Too many people face stigma, disbelief, and isolation when what they most need is understanding and compassion.

Stigma adds a heavy burden to life with migraine. Many people fear being judged as unreliable or using their condition as an excuse, which makes them less likely to seek help or disclose at work. This not only affects emotional wellbeing but can also impact livelihoods. When migraine is dismissed as “just a headache,” the isolation and frustration deepen, showing that how society responds can be just as important as the condition itself.

By fostering awareness, compassion, flexibility, and understanding,  employers and colleagues can play a vital role in helping people with migraine feel seen and supported rather than stigmatised.

Employers can play a central role in changing this by:

• Providing education: Raising awareness helps reduce stigma and improve understanding across the workplace.
• Offering tools and support: Encouraging self-management strategies, access to care, and practical resources empowers employees to take control of their migraine.
• Adapting the workplace: Modest adjustments, like flexible schedules, reduced exposure to triggers, and supportive policies, can help prevent migraine from becoming a barrier to participation.
• Contact us: Migraine & Headache Australia runs a workplace awareness and educational activities for employers across Australia. Services range from ‘lunch and learn’ seminars, webinars and even a dedicated short eCourse for employees, managers and HR to better support staff who live with migraine.
  

By taking these steps, workplaces become more inclusive, not only for people with migraine, but for anyone managing an ongoing health condition. Healthier, supported people are better able to share their skills, creativity, and resilience. This not only improves individual wellbeing but also strengthens teams and workplaces. In this way, supporting people with migraine leads to a positive cycle, where healthier individuals contribute more meaningfully, and workplaces become more inclusive, compassionate, and productive for everyone.

Further Resources and Information

If you would like to learn more about migraine and resources which may support your migraine management, you may find the following useful:

• Migraine – a comprehensive article about migraine symptoms, causes, treatments, and more.
• Migraine Symptoms – a comprehensive article about the phases of a migraine episode and the myriad of symptoms that come with it
• Understanding and Managing the Psychological Impact– article exploring the less visible impacts of living with migraine, offers practical, evidence-informed strategies to help people living with migraine not just cope, but live well
• Strategies to Help Prevent the Progression from Episodic to Chronic Migraine – article exploring the factors that play a role in migraine chronification and strategies for prevention.
• Returning to Work with Migraine – article discussing the impact of migraine at work and how to prepare to return after the holidays

Discussing migraine at work can be daunting but besides this article, there are other resources which may help guide and prepare you for this conversation:

• Migraine at Work – Discussion Guide https://migraineatwork.org/wp-content/uploads/2022/01/Discussion-Guide.pdf 
• Migraine at Work – Accommodations for Migraine in the Workplace https://migraineatwork.org/articles_migraine/accommodations-for-migraine-in-the-workplace/
• The Migraine Trust – Information to support you in managing your migraine at work https://migrainetrust.org/wp-content/uploads/2025/07/1631749830-TMT-Workplace-Toolkit-2025-Online-AW.pdf
• The Migraine Trust – Managing your migraine at work checklist https://migrainetrust.org/wp-content/uploads/2025/07/1631749830-TMT-Workplace-Checklist-2025-Interactive-AW.pdf
• The Migraine Trust – Migraine information for workplaces https://migrainetrust.org/wp-content/uploads/2025/07/Workplace-factsheet.pdf
• Migraine tracking apps: Migraine Buddy, N1-Headache
• The Traffic Light of Headache diary-keeping method – https://americanheadachesociety.org/news/the-traffic-light-of-headache
• The Social Model of Disability – https://afdo.org.au/social-model-of-disability/

Share this article – and the below resources – with someone you think could benefit from it

Downloadable Resources

Migraine & Headache Australia Workplace Adjustments Passport
MHA Workplace Adjustments Passport

Community member Migraine Tracking App Example
Migraine Absence Tracking Days

Migraine & Headache Australia Migraine Management Plan
MHA Migraine Management Plan

References 

1. 1. Steiner TJ, Husøy A, Stovner LJ. GBD2021: headache disorders and global lost health – a focus on children, and a view forward. J Headache Pain. 2024 Jun 3;25(1):91. doi: 10.1186/s10194-024-01795-2.
   2. Deloitte Access Economics, 2018, Migraine in Australia White Paper. Accessed 2025 from: https://www2.deloitte.com/au/en/pages/economics/articles/migraine-australia-whitepaper.html. 
   3. Qualitative data summarised from the findings of a national research project undertaken in 2025 by Migraine & Headache Australia in partnership with the Jean Hailes for Women’s Health Foundation about the experience of Australian women living with migraine. https://www.jeanhailes.org.au/uploads/15_Research/NWHS25_report_migraine.pdf 
   4. Shapiro, Robert.: “What’s Holding Us Back From Getting the Care We Need?”. Migraine World Summit, 2019. Accessed 2025 from: https://migraineworldsummit.com/talk/whats-holding-us-back-from-getting-the-care-we-need/ 
   5. Seng EK, Muenzel EJ, Shapiro RE, Buse DC, Reed ML, Zagar AJ, Ashina S, Hutchinson S, Nicholson RA, Lipton RB. Development of the Migraine-Related Stigma (MiRS) Questionnaire: Results of the OVERCOME (US) Study. Headache. 2025 Feb;65(2):269-279. doi: 10.1111/head.14886.
   6. Harvard Business Review, Migraines are a serious problem, employers can help. 2021. Accessed 2025 from: https://hbr.org/2021/02/migraines-are-a-serious-problem-employers-can-help?utm_source=chatgpt.com 
   7. Tu, Susan et al. “The Health and Productivity Burden of Migraines in Australia.” Headache vol. 60,10 (2020): 2291-2303. doi:10.1111/head.13969
   8. Migraine and Headache Australia, Returning to work with migraine article. Accessed 2025 from: https://headacheaustralia.org.au/returning-to-work-with-migraine/ 
   9. Begasse de Dhaem Olivia, “How to Manage Migraine Stigma at Work”. Migraine World Summit, 2024. Accessed 2025 from: https://migraineworldsummit.com/talk/how-to-manage-migraine-stigma-at-work/
   10. Music Rob, “Advocacy, Access & Migraine at Work”. Migraine World Summit, 2024. Accessed 2025 from: https://migraineworldsummit.com/talk/advocacy-access-migraine-at-work/ 
   11. The Australian Public Service Commission, Reasonable Adjustment Passport Guide. Accessed 2025 from: https://www.apsc.gov.au/about-us/working-commission/what-we-offer/diversity-policy/reasonable-adjustment-passport-guide 
   12. The Migraine Trust, 2021, Migraine attack triggers. Accessed 2025 from: https://migrainetrust.org/live-with-migraine/self-management/common-triggers/
   13. Begasse de Dhaem O & Sakai F, 2022, Migraine in the workplace. DOI: 10.1016/j.ensci.2022.100408
   14. Migraine Pal, “Famous People with Migraine”. 2017. Accessed 2025 from: https://migrainepal.com/famous-with-migraine/