Taking on Migraine Stigma

Migraine stigma can affect quality-of-life and mental health

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With its headaches, nausea, and cascade of other symptoms, migraine is particularly difficult to deal with because of its sometimes unpredictable nature. It can strike at any time. However, what’s often under-discussed when it comes to this disease is the stigma surrounding it: that people with migraine may be viewed as attention-seeking, or that their attacks are “just a headache.” As a result, migraineurs experience differential treatment from friends, loved ones, and coworkers.

The consequences of this stigma shouldn’t be underestimated; if very real issues or symptoms are seen as illegitimate, there’s social and emotional fallout. This stigma adds to the burden of migraine, making already difficult situations worse.

Migraine & Stigma

While migraine was long under-appreciated—and came to be associated with dishonest, lower-class women looking to avoid social responsibility in the mid-19th century —it’s common and impactful enough to have warranted serious investigation and general reappraisal. Despite growth and research in understanding, though, misunderstanding of the condition has persisted.

Approximately 12% of people have migraines.

Because the primary symptoms of migraine aren’t visible—you can’t see someone else’s headache or light-sensitivity, or feel their nausea or other symptoms—it ends up being up to those who have migraines to speak up and report their condition when attacks arise. This is especially the case with chronic migraine (in which migraineurs experience 15 or more attacks a month); coworkers, friends, family, even medical professionals may minimize or even doubt claims of attacks.

Medically, these kinds of attitudes are defined as stigma; the migraineur is discredited and treated differentially based on their condition. Stigmatization leads to different or unfair treatment in workspaces or at home, and, in some cases, in hospitals or emergency rooms. This isn’t just an individual, personal issue; it’s been found to be pervasive, severely impacting the quality-of-life and health outcomes of those with migraines. Not only that, this stigma can become internalized, leading to further problems.

Impacts

According to one study published in the medical journal, PLoS One, levels of stigmatization among chronic migraineurs are equal to those who have epilepsy and can be even greater for those with episodic migraines. In the same way that migraine attacks can cloud practically every aspect of life, the impact of migraine stigma is multifaceted and indiscriminate. Researchers have noted impacts at work, at home, and in the hospital.

Migraine Stigma at Home

Tragically, this stigmatization can begin at home. According to a wide-ranging study of over 13,000 households with a member who has migraines, 24.4% of people with episodic migraines and 43.9% of people with chronic migraines reported their spouses not believing them when they reported attacks. In turn, 14% of the former’s spouses, alongside 22.1% of the latter’s, reported disbelieving their migraineur spouses. Adding to the cavalcade of effects that migraine can have in family life, this leads to increased stress at home and can impact mental health.

Migraine Stigma at Work

One of the most commonly seen effects of migraine—as well as the stigma surrounding it—is an impact on socioeconomic status; not only do medical costs for these patients tend to be higher, but the disease can impact job prospects. Several studies noted that migraine’s perceived effect on work—that is the absenteeism, reduced hours, or other impacts on productivity—is the primary reason for stigmatization.

Not only may migraineurs be seen as a “drag” on the company, but the severity of the condition has also been found to be underestimated. As any migraineur can tell you, the intensity of symptoms can make a work environment impossible, yet only 22% of managers in one study found migraine to be “serious enough” to warrant time off of work; this is less than the amount for depression. Many who have the condition tend to hide it, worrying that they’ll be seen as needing extra consideration at the workplace.

Migraine Stigma & Medical Care

Even more distressing is the fact that migraine stigma can even impact medical care received. It seems doctors are not immune to the problem. The fact is that not only are most migraineurs not diagnosed—patients, themselves, minimize their own condition and may avoid it—but 31% of neurologists, according to one study, were either skeptical of or didn’t agree that migraine was an actual disease. Furthermore, a significant portion of doctors view their migraine patients as drug and attention-seeking.

What arises from all of this is that significant portions of migraineurs feel medical professionals aren’t taking them seriously. This leads to a lack of trust in doctors, which, in turn, means less trust in both their diagnosis and treatment. It can be a highly problematic situation.

Internalizing Migraine Stigma

What gets even more galling with migraine stigma is the way it can become internalized. Basically, the migraineur starts to believe that they deserve differential treatment from others and may actually start doubting their own condition. For instance, people with migraines start to believe their condition affects productivity at work or ability to be good parents, spouses, or romantic partners.

Notably, researchers found that measurements of quality-of-life were influenced by those of self-stigma surrounding migraine; the internalization of negative attitudes surrounding this disease affect the outlook and health of the person with migraine. Likely, this contributes to the overall higher rate of mental health problems in this population. On both an individual level as well as within society at large, de-stigmatization of and education about migraine would be beneficial.

Coping With Migraine Stigma

So what can migraineurs do to combat the internal and external stigmatization associated with their condition? Here are some quick tips:

  • Find Good Medical Help: If you have migraines, make sure you’re working with a good specialist whom you can trust and who can provide dedicated treatment. Don’t be afraid to ask questions or seek out second opinions.
  • Seek Counseling: In the absence of a cure, coping with migraine is a multi-faceted effort, and this should also be the case for taking on stigmas associated with the condition. Consider seeking out counseling—either individual, family, or group—to talk about how this disease is affecting you.
  • Communication: At home, you should be open and communicative with your partner, and (strategically) with any children in explaining what migraine is and how it affects you. At work you may want to be more sparing about this information—it’s often best not to be too open about it because of the risk of stigma—but it’s a good idea to let management and HR professionals know.
  • Educate Yourself and Others: When it comes to migraine, your best weapon against stigmatization is education. If you have migraines, or if a loved one does, you’re best off learning as much as you can about this difficult condition. The more informed you are, the better you’ll be able to take on misunderstanding and biases surrounding migraine.

A Word From Verywell

No matter if it’s an episodic or chronic case, migraine can be incredibly difficult to deal with. At the end of the day, while there are many highly effective treatment approaches, there is no cure for this difficult condition, and aspects of it are not completely understood. That said, the means to manage it are accessible, and, with the help of understanding family and friends—as well as dedicated caregivers—migraine doesn’t have to be a burden. So long as you’re proactive, you will get the better of this condition.

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Article Sources

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  1. Young W. The stigma of migraine: Stigma leads to loss of status and diminished quality of life. Pract Neurol. 2018:23-6. 


  2. Parikh S, Young W. Migraine: Stigma in Society. Curr Pain Headache Rep. 2019;23(1). doi: 10.1007/s11916-019-0743-7


  3. Young W, Park J, Tian I, Kempner J. The stigma of migraine. PLoS ONE. 2013;8(1):e54074. doi: 10.1371/journal.pone.0054074


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