A migraine can really be a pain -- and not just for those who experience the headaches. In many cases, employers, relatives and friends dismiss migraine sufferers as malingerers who are unreliable or lazy because they need frequent breaks from responsibilities to recuperate.
It's a stigma, and it's very real, say Long Island neurologists.
"They're stigmatized just like people with seizures and fibromyalgia," or chronic fatigue syndrome, said Dr. Gopal Kishore, associate chief of neurology at St. Joseph Hospital in Bethpage. "They are told: 'You just have a headache. Why don't you take a Tylenol and come to work?' "
The reality, however, is that migraine headaches can be severely painful and disabling, often requiring people to take time away from their obligations.
More than 10 percent of the population experiences migraines, he said, although most don't seek medical care. "It's a severe, painful headache that is often preceded or accompanied by sensory warning signs such as flashes of light, blind spots, tingling in the arms and legs," he explained. "Other symptoms include facial numbness, blurry vision, nausea, vomiting and increased sensitivity to light and sound."
Scientists think the brain's chemistry may be a factor in the development of migraines. And there are a variety of potential triggers, including stress, certain foods and medications.
But regardless of the cause, people who experience a migraine -- which can last hours or days -- typically want to flee to a quiet and dark room.
Dr. Michael Sauter, chief medical officer at St. Charles Hospital in Port Jefferson, said he's treated several people whose bosses wanted to fire them because they seemed to be unreliable.
"Employers do form opinions based on how frequently migraines occur," he said. "They want people to be productive at work. If someone's constantly calling in sick, they get doubtful about whether they should continue working there."
What to do? The neurologists recommend that anyone with migraines:
Seek professional help quickly if you have a severe headache. "Don't wait for the headache to get worse," Kishore said. "When headaches are at their peaks, [some} patients need to go to the emergency room for intravenous pain medication and further testing, which may include brain scans." This will help rule out even more serious conditions, such as a stroke, that can cause symptoms similar to those of a severe migraine.
Keep track of when migraines occur in order to understand -- and avoid -- the triggers that cause them.
Be aware that migraines can make people especially vulnerable to depression, which can contribute to perceptions that they're lazy or unreliable. "For years, we believed that the only reason migraine sufferers were depressed was because they had bad headaches," Kishore said. "Today, we know much more about the brain chemistry and genetic differences that make migraine sufferers more susceptible to depression."
Talk to a doctor about treatments. Drugs are available to relieve acute headaches and to prevent them from happening in the first place. "The biggest thing we have nowadays is Botox, a headache treatment that works very well in certain patients," Sauter said.
For people troubled by migraines who are worried about stigma at work, Sauter suggested that they ask their doctor to write a note to their boss explaining their condition.
But, he said, many people are able to find relief from migraines and avoid poor perceptions in the first place through proper medical care.