migraine awareness month: how you can go “out of office” to support those with migraines
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many people work through migraines for fear of being stigmatized for taking time off to cope with the debilitating neurologic disease.
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living with migraine is a painful reality for close to five million canadians. many people see migraine as just a “bad headache” when it is, in fact, a genetic neurologic disease that ranges from mild, sporadic attacks to frequent severe and debilitating attacks.
the disease is often misunderstood and stigmatized because it is an invisible illness in the sense that, while people can be suffering greatly from its impact, it’s not as noticeable as other afflictions. it also doesn’t appear on brain imaging or show up in a blood test.
the challenges people with migraine face are especially amplified in the workplace because many will force themselves to power through their days even while experiencing an attack to avoid being chastised for missing work due to the illness.
a new national campaign dubbed “out of office for migraine awareness” was developed by pfizer canada in partnership with migraine canada and migraine quebec in the hopes of encouraging more employers to create supportive work environments and reduce stigma for those living with migraine.
wendy gerhart, executive director of migraine canada, sees firsthand how difficult it is for people living with migraine to convey how severe the disease is, partly because of a lack of understanding of what it entails and the intense pressure surrounding absenteeism in the workplace from employers.
“they’re (migraine) not respected and given the due diligence that it should be given as a neurological disease. i think people still do the whole eyeball rule and say, ‘that’s just a bad headache, get over it, take two motrin,’” said gerhart. “migraines really aren’t taken as seriously as they should be in the workplace.”
dr. heather pim, associate clinical professor of neurology at the university of montreal and the director of the headache clinic at the university of montreal hospital centre, works directly with people who have migraine in the hopes of helping those who continue to contend with the “neglected” disease.
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“migraine is associated with a high level of morbidity but not mortality, so it is not prioritized by medical professionals,” dr. pim said in an email to healthing. “i felt compelled to help this underserved population and to improve education and awareness of migraine.”
migraine is not simply a headache
migraine is a complex neurological disease that presents in various ways and with varying degrees of severity. it develops due to a complex brain reaction that drives the release of inflammatory neuropeptides, or chemical messengers, causing dilation of arteries within the brain.
people who live with migraine contend with the various symptoms of the disease, including:
- debilitating and pounding head pain
- nausea and/or vomiting
- sensitivity to light and sound
along with these symptoms, people with migraine may also experience an aura, which is a set of other symptoms and ill effects that develop as a precursor to the migraine. they can include:
- seeing flashing lights or a gleam of light
- blurred vision
- smelling a particular odour
- feeling as though a breeze is coming over them
- numbness
- weakness
- difficulty speaking
all these symptoms and precursor signs of a migraine attack can debilitate the person who is experiencing them.
“most people cannot function properly during a migraine attack. they have to withdraw from their surroundings into a dark, quiet area until the attack subsides,” said dr. pim.
how migraine affects canadians
migraines affect people between the ages of 20 and 50 more often than any other age group, with young women the most affected demographic. when migraine attacks occur during these years—the prime working years—the professional lives of those dealing with the disease can be hindered significantly.
“predominately, migraine will impact people during their young adult life, so when they’re at their peak working years and they’re trying to work to provide for their family,” said gerhart. “they’re trying to advance in their careers. in some cases, they’re trying to finish university so that they can do what they would love to do. it really does impact a lot of people in that prime time.”
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absenteeism in the workplace often places an invaluable label on people, even if they suffer from health disorders such as migraine. when skilled people are left to cope with migraine while trying to build their professional careers but need to take time off consistently because they physically and mentally cannot perform their job duties, it can lead to negative impacts that go much further than the time they’re experiencing symptoms.
“sometimes it may be hard for a family member, friend, co-worker, or employer to understand why someone has to leave a party or work if they ‘look fine.’ people living with migraine often feel that they have to defend themselves because people around them can’t appreciate that their brain does not function properly during an attack,” dr. pim said.
being on the defensive about a chronic disease and living with its symptoms can be challenging in and of itself, but even more so, it can lead to poorer mental health in the long term. as many as 25 per cent of people living with migraine also have depression and 50 per cent have anxiety, leading to an even lower quality of life.
“when migraine goes undiagnosed or improperly treated, rates of anxiety, depression, sleep disturbances as well as chronic fatigue increase and add to the disability of the migraine suffer,” said dr. pim.
the “unpredictable nature of a migraine attack” can also hinder a person’s ability to live their life, both personally and professionally. since no one can really schedule their migraine, planning activities or sticking to a set schedule is exceptionally challenging.
many young people even avoid getting a diagnosis of migraine simply due to a lack of understanding about what they’re going through or a lack of time and resources. this alone adds another layer of challenges for people living with the disease.
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“some young people, that are not necessarily prioritized to have a family doctor, will go undiagnosed and will suffer in silence and self-medicate with whatever they can get their hands on at the pharmacy. taking regular over-the-counter medications several times a week, such as tylenol, advil, motrin, etc. can even worsen the condition and lead to medication-overuse or rebound headaches which just complicates the situation and increases the level of disability,” said dr. pim.
establishing the out-of-office campaign to address stigma and spread awareness
pfizer, migraine canada, and migraine quebec developed the out-of-office campaign to showcase just how difficult it can be for people living with migraine to participate in their professional work when an attack occurs.
the campaign theme centres around migraine in the workplace because that is often the most significant challenge people with migraine face when dealing with symptoms.
“it (migraine) remains underdiagnosed and stigmatized in the workplace, which has a serious impact on the performance and well-being at work of those who suffer from it,” said dr. pim. “the goal of the campaign is to build a workplace that is more supportive of canadians affected by this debilitating disease.”
to ensure canadians are aware of precisely what goes into the daily life of someone with a migraine, the campaign calls for people to set their out-of-office alerts for four hours. that time was chosen because that is the minimum duration for a migraine attack.
during those four hours, people are called to put themselves in the proverbial shoes of those who live with migraines to better understand the challenges faced by those with migraine, such as being pulled away from their work, feeling anxious or ashamed that they have to take time off work, or not being able to climb the professional ladder due to migraine attacks that increase their time off work even if it doesn’t affect their performance.
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dr. elizabeth leroux, a neurologist and founder of migraine canada, sees the constant battle people living with migraine have to fight and the lack of current awareness and support from employers regarding this debilitating disease.
she said in a press release that “people with migraine often work through their debilitating episodes. raising awareness among employers and hr departments could lead to a cultural and structural change in canadian workplaces.”
“stigma and skepticism should be replaced by support, adapted environments, and access to medical care. this campaign marks a significant step forward in addressing an area of high unmet need.”
gerhart hopes that the campaign can act as a much-needed catalyst for change. “what we’re really trying to do is have the conversation, get people talking about it, get people asking questions,” she said.
dr. pim echoes the same sentiments as gerhart and dr. leroux. “ultimately, i hope employers, insurance companies and government officials better realize the impact this disease has on young members of our society and improve environmental and work conditions and access to health care and treatment for migraine sufferers,” dr. pim said.
changing the lives of migraine sufferers for the better
at the end of the day, people living with migraines deserve to have their disease recognized and destigmatized so that they can take suitable precautions and avoid added stress that can end up triggering episodes.
for that to happen, people must first understand that migraine is not just a headache. it is a neurological disease that can be highly disabling.
when people become aware of migraine, what it entails, and how canadians are affected, employers, colleagues, and social connections can all understand the disease better, which can foster a supportive collective that helps people with migraines feel safer to take time off when they experience an attack or use their time to seek out proper treatment.
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“i hope that by increasing awareness about migraine, not only in the workplace but in general, those living with undiagnosed headaches, that may be migraine, will be encouraged to consult a medical professional,” said dr. pim. “i also hope that people diagnosed and living with migraine will feel better understood and that people who may not have migraine but know someone who does will become more aware of the symptoms and impact of this disease so as to be more considerate and helpful to those living with migraine in their entourage.”
the out-of-office campaign runs from june 3 to june 7, 2024.
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