Using Migraine as an Excuse

If you’re like me, you may have experienced a migraine attack that left you unable to stand, unable to drink water without throwing up – an attack that has left you writhing on the floor.  If you are half as sick as this, there’s little doubt that a migraine attack is a VERY good reason to not go to work.

But today we’re not talking about someone with migraine, but someone who doesn’t have migraine at all – but they still use the “I have a migraine” excuse.

The reality is that most of the migraine patients I know will push themselves to go to work if they can, to go to that family picnic even though they’re not feeling well, to do some housework even if they have to stop and lie down every few minutes.

So although there may be migraineurs out there who “use” the condition to regularly skip work when they could reasonably go, I haven’t come across any.

So would someone without a migraine attack actually use it as an excuse?  Sadly, it happens.

In fact, Troy Patterson, freelance writer and regular writer for Slate.com and Spin Magazine actually recommends the “migraine excuse” to avoid embarrassing conversations.  A woman asks,“When experiencing extreme, debilitating cramps or other symptoms from menses, is it better to make up a white lie or speak the truth as to why I need to work from home?”

Mr. Patterson’s answer includes this advice:

If I were you, however, I’d avoid the subject.  Who benefits by bringing it up?  How does it harm anyone to shade over the truth here?  I think it’s OK to shroud the red tent with a white lie.

If you don’t get severe cramps every month, then you might try piggybacking on whatever bug has recently gone around the office.  Otherwise, I suggest, at the risk of overkill, concocting a migraine headache.  Migraines can last for hours or for days; they’re famously disruptive to work schedules and social calendars.  Also, it seems somehow permissible to use a migraine as an excuse because—well, I hear they’re awful, but—they’re not contagious and they don’t generally snowball into anything fatal, right?  There’s no special worry about the mortality of the migraineur.  Further, some back-on-the-envelope cultural analysis suggests some mystery and glamour to the ailment.  It’s a serious person’s malady, with a Didion tinge of thoughtful drama.

Mr. Patterson isn’t the only one to recommend “concocting a migraine headache” to avoid embarrassment.  It’s been recommended as a way to keep your boyfriend from visiting, an excuse for avoiding sex (the classic), and a sneaky way to get drugs from your doctor to get high.

I shouldn’t have to tell you that faking a migraine hurts everyone who is really experiencing debilitating migraine attacks.  But then again, maybe I do.

There are a number of things in Mr. Patterson’s answer that concern me…

• Is this kind of lying morally right in the first place?  Mr. Patterson seems to think so.
• “they don’t generally snowball into anything fatal” – thankfully, they usually don’t, but they sometimes do.  Migraine has been related to heart disease, stroke, depression, and suicide.  For more, read Are Migraines Dangerous?
• “Mystery and glamour”?  On the one hand, I would be happy if that was the case.  The reality is, there’s still a lot of stigma when it comes to migraine.  Check out Those with Migraine still Stigmatized
• “It’s a serious person’s malady, with a Didion tinge of thoughtful drama.”  Joan Didion is an American author and journalist who wrote an essay entitled “In Bed”, vividly describing her experiences with migraine.  She also talked about the then-common belief in a “migraine personality” – “ambitious, inward, intolerant of error, rather rigidly organized, perfectionist”.  But it’s impossible to pigeon-hole every migraineur as this kind of person.  Unfortunately, the idea that obsessive people tend to get migraine has added to the stigma more than to the science.

Perhaps we need to answer Mr. Patterson’s question – “How does it harm anyone to shade over the truth here?”

Saying you have a migraine headache when you don’t is very harmful, not only to the person lying but to migraine patients around the world.  Why?

1. When some people lie, those telling the truth are more likely to be doubted and not taken seriously.  When someone has a horribly painful debilitating migraine attack, do they really need the added pressure of having to “convince” someone that it’s real?
2. It cheapens the reality of migraine, which is actually quite serious and can lead to all kinds of physical problems, not to mention the emotional and social impact.
3. It promotes the impression that migraine is something just to be “lived with”, when in reality migraine patients need to be getting proper treatment.
4. Instead of adding “glamour” and “mystery” to the concept of migraine, it adds to the stigma, which means that patients are not getting the help and treatment they need.
5. It has the potential to erode trust between employer and employee, or between any two people when one person is not being truthful.

Not to mention that the idea of “thoughtful drama” minimizes the destruction that migraine can wreak on a person’s life.  Not to mention the seriousness of menstrual migraine.

And we haven’t talked about the legal issues related to getting prescription migraine drugs on a pretense.  First, a trained doctor does have good tools to diagnose you beyond just “taking your word for it”.  Second, even if someone did get away with it, all this leads to is unnecessary restrictions on drugs.  Migraine patients may not be able to get the treatment they need when they need it, because doctors are being over-cautious that they’re coming in for a drug-fix.

We don’t want to be insensitive to women who struggle with whether or not to share about personal health issues in situations like this.  Many places have laws that protect women from having to get specific about their health issues.  But there is no excuse for an employer who feels he (or even she) must push for information when it isn’t either sensitive or necessary.

But if there is that little trust between employer and employee, will lying really help?

The bottom line for our purposes.  Does lying about migraine hurt anyone?  You better believe it.  Let’s permanently retire the “migraine” excuse for anyone who isn’t actually in the throws of a real attack.  A little honesty may make a big difference for millions who are suffering with migraine.

Thanks to Kerrie Smyres for sharing Troy Patterson’s article.  Don’t miss her comments in Use Migraine as an Excuse, Recommends Advice Columnist  You can comment on Mr. Patterson’s article by clicking the comment icon at the top or bottom.