“My line of work is talking and supporting people during some of the worst moments of their lives,” says Bushra, a psychotherapist and owner of a Chicago-based private practice. “One of my worst fears surrounding my migraines is, ‘What if I have one during a session with a client?’”
For Bushra, and the 28 million women in the United States who deal with debilitating migraine, there’s never a good time for one to strike, but worse, it can show up during the day when you’re expected to bring your A-game to work. Whether they’re derailing meetings, work calls, or presentations — or making it impossible to sit in front of a computer at all — migraines can quietly upend productivity in ways coworkers and managers don’t always see.
“Many people experience sensitivity to light and sound, so typical workplace environments with bright or fluorescent lighting, computer monitors, or conversations can intensify symptoms,” says Danielle Wilhour, MD, a neurologist at UCHealth and an associate professor of neurology at the University of Colorado. “Migraines can cause significant fatigue and a need to rest in a dark, quiet space, which is not always possible in an office environment. The unpredictability of attacks can add stress or anxiety, further affecting productivity and performance.”
To shed light on the often invisible impact of this condition, we talked to three women on how they navigate their migraines that hit at the worst times during the work day — and some tips on how to communicate what’s going on in a professional setting.
“I now understand my migraine patterns.”
- Name: Saba
- Location: Dallas, TX
- Job: Supervisor of cardiovascular research
- Work setting: 5 days a week in an office with a 45-minute commute
In Texas, where sudden weather shifts are common, barometric pressure has become one of Saba’s biggest migraine triggers. One afternoon in Dallas, it hit before she even felt it coming — her colleague, a physician, noticed the change in her face first. Within minutes, the aura set in.
“I went into one of the labs, turned off all the lights, my colleague made me a strong cup of coffee, but soon I started seeing stars,” she recalls. “I couldn’t just stay at the office but I also couldn’t take my normal medicinal cocktail because I had to drive home, and didn’t want to feel disoriented. I remember trying to head home, but having to stop to throw up. I had such a long commute, but I had to stick to local roads with a vomit bag in one hand.”
Her work strategy: An open line of communication with work has helped Saba tremendously. “A lot of my migraines start in the middle of the night, so I usually will communicate early on if I’m coming in late or need to work from home that day.” She also built trust with her coworkers with how she organizes her work so a migraine won’t affect her expected responsibilities. “I try to stay ahead as best as I can, so when I do need that time off, I just know my deadlines are being met,” she says. “My colleagues always say, ‘Even if you miss something, we know that it’ll be done when it needs to be done.”
“I keep my clients in the loop.”
- Name: Bushra
- Location: Chicago, IL
- Job: Psychotherapist
- Work setting: Work from home
“Once I had a client come all the way from the suburbs to meet me in the city for our session. Within 10 minutes, I had an aura, and I knew what was coming next — a full on migraine.” Bushra recalls. “I had to end the session early, not charge her of course, and figure out a way to get home because there was no way I would be able to navigate public transportation with an aura.”
Her work strategy: Bushra says being as honest as she can is the best thing she can do in her line of work. “The way I handle things now, is I let clients know I get migraines, that they’re debilitating, and they may happen during our sessions together. I work from home now, so that has helped a lot to ease the pressure of trying to figure out ‘What happens next?’ for me.”
Her advice? Let colleagues know this may happen from time to time and drop off when you need to. “The migraine will get worse if you push yourself. Learn your limits — we all have them — and stick to that. Have an email apologizing to stakeholders ready to go and send.”
“I take screen breaks when I need to.”
- Name: Taylor
- Location: Chicago, IL
- Job: Senior talent discovery partner
- Work setting: Work from home
Taylor first started experiencing migraines when she was 16, and back then she turned to over-the-counter meds to help alleviate her symptoms. Now in her 30s she’s figured out how to manage them better with her prescription meds to stop them from progressing.
“When a migraine hits during work, I have to immediately take my meds to stop it from progressing,” she says. “I try to push through them and minimize screen time, but sometimes they can get so debilitating I have to take a break.” In her line of work, Taylor says she’s normally in front of a computer all day. “That in itself can be a trigger for me,” she says. “I try to take mini breaks and look away from the screen to help.”
Her work strategy: Taylor says communicating to her manager about her migraines has helped her cope with them during work. “I’m very lucky that they are supportive,” she says. “If I am in the middle of a migraine at work and my work day allows for it, they have even suggested I go try to lay down and stay off of my computer for a bit until I am feeling better.”
For others experiencing migraines, Taylor advises seeking a specialist. “They can get you on a medication that’s right for you. If you are at work and not able to leave I would suggest trying to get to a dark room and minimize screen time if possible.”
Doctors’ Notes
“Living with frequent migraines can be exhausting and isolating, but it’s important to advocate for yourself and to seek care that meets your needs,” says Wilhour. “Asking for support, accommodations, or updated treatment options is not a sign of weakness, but a step toward protecting your health and quality of life.”
Dr. Zarmina Mufti, a neurologist and headache specialist, agrees. “The goal with any migraine attack is to reduce sensory overload and calm the nervous system before symptoms escalate,” says Mufti, who’s also known to share evidence-based migraine education and patient advocacy content on social media.
Some helpful strategies:
- Give your eyes a break. “Screens and bright lighting often intensify pain,” says Wilhourn. Lowering screen brightness, using blue-light filters or light-filtering glasses (specifically FL-41 tinted glasses), and dimming overhead lights to reduce light sensitivity.
- Sit in a dark, quiet room for 10–20 minutes. “This can help settle symptoms, especially early in an attack,” says Mufti.
- Cold therapy. An ice cap or cold pack applied to the forehead or back of the neck which is something you can keep in the freezer and grab when needed.
- Ask your neurologist or doctor for a workplace accommodation letter. “This can be incredibly helpful in outlining reasonable accommodations — like flexible breaks, lighting adjustments, or screen modifications,” says Mufti.
When talking to your employer, Mufti also recommends focusing on how your symptoms affect function, rather than just the pain. “Many people emphasize pain, but migraine is a neurological condition that can impair vision, concentration, and screen tolerance, making everyday work tasks difficult.” she says. “Framing accommodations as tools that support productivity (and providing a medical accommodation letter if needed) can help employers better understand the condition and its impact.”
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