Should I tell my employer I have migraine? A calm decision guide

Ms TMA (name changed to protect the person’s privacy) had just started a new job. It was a fresh start. New desk. New people. New systems. New chance to prove herself. On the outside, she looked ready. Inside, one question kept coming back. Should I tell them I live with migraine?

This was not about a small headache. Ms TMA had migraine attacks that had changed her working life. They had affected her confidence, performance, income, and ability to stay in her last role.

Why migraine at work can feel hard to discuss

In her old workplace, she had learned a painful lesson. Pain was not safe to talk about. One day, another worker went home with a headache. Ms TMA was nearby when her manager and a few people laughed, "Going home for a headache?" The words sounded casual. To Ms TMA, they felt heavy.

She knew what that "headache" might really mean. She knew what it was like to sit under bright lights while her head pulsed. She knew what it was like to smile in a meeting while her brain felt slow and foggy. She said nothing. Not because she agreed. She stayed quiet because silence felt safer.

When her own migraine attacks came, she pushed through. She worked in pain. She tried to look fine. Her work suffered. Some days, she took time off before anyone could see her struggle. Sometimes one day off became two. Sometimes it became three. After a while, the pressure became too much. The attacks became more frequent. The fear grew. The silence became heavy. She left the job.

Now she was in a new role. She wanted this time to be different. She wanted to stay, grow, and do good work. At the same time, she felt afraid. If she told her employer, would they judge her? If she said nothing, would she be left with no support?

This is the real problem many people face when they live with migraine at work. The question is not only, "Should I tell my employer?" The deeper question is, "How do I protect my health, my dignity, and my career?"

Migraine is not just a headache

Migraine is often misunderstood. Many people hear the word migraine and think it means a bad headache. That is wrong. Migraine is a neurological condition. It can cause strong head pain, sickness, light sensitivity, sound sensitivity, dizziness, tiredness, brain fog, and problems with speaking or thinking clearly.

Some people can look well and still be in pain. Some people can answer an email while fighting symptoms no one else can see. This is why migraine at work can feel lonely.

Do you have to tell your employer about migraine?

In many cases, you do not have to tell your employer that you have migraine. Your health is private. You have the right to keep personal information to yourself.

Yet telling someone may help if migraine is affecting your work. The Migraine Trust says it can be important to inform your employer about migraine, especially if you need support or reasonable adjustments. Employers usually need to know about a health problem before they can make changes to help you at work.

In the UK, migraine may count as a disability if it has a serious and long-term effect on normal day-to-day life. This depends on how migraine affects you. ACAS explains that reasonable adjustments are changes an employer makes to reduce disadvantage linked to a disability.

This does not mean you need to tell everyone everything. You can share enough to get support without feeling exposed.

When telling your employer may help

It may help to tell your employer if migraine causes repeated sickness absence. It may help if bright lights, screens, noise, meetings, shift work, travel, or a heavy workload make your symptoms worse. It may also help if your manager has started to question your reliability.

Many people wait until they are exhausted before they ask for help. That can make the conversation harder. A calm conversation early on can stop people from guessing. It can help your employer understand that you are managing a real health condition and you want to work well.

Selective disclosure can be wise. This means you choose who to tell, what to say, and how much detail to share. Some workplaces are kind and helpful. Some are not. Wisdom matters. You may choose to speak to your line manager, HR, occupational health, a union representative, or a trusted senior person. The right choice depends on your workplace.

It can be helpful to talk about the effect of migraine on your work, not every medical detail. You could say, "I live with migraine. It can affect my vision, concentration, and ability to work under bright lighting during an attack. I am managing it, and I would like to discuss simple changes that could help me work more consistently." This is clear, calm and professional.

You do not need to explain every symptom. You do not need to describe every time you cried in a dark room or felt your brain had packed a bag and left the building.

How to talk about migraine at work

Before you speak to your employer, prepare. Think about what migraine affects at work. This may include screens, lighting, noise, travel, meetings, start times, concentration, and recovery after attacks.

Think about what changes may help. The National Migraine Centre says workplace support may include breaks, anti-glare screens, better lighting, and time off for medical appointments. Some people may also need flexible working, quieter spaces, working from home, or adjusted start times.

A simple way to start the conversation is this: "I live with migraine. It has started to affect parts of my work. I am committed to doing my role well. I would like us to discuss practical changes that may help me stay consistent and productive."

This keeps the focus on solutions. It also helps you speak from strength, not shame. One useful rule is this: share enough for support, not so much that you feel exposed.

You might say any of the following:

• "Bright light can make my symptoms worse."
• "During an attack, my concentration can be affected."
• "I would like us to agree on a plan so I can manage this responsibly."

It is also wise to keep a written record. The Migraine Trust workplace guidance recommends keeping written records of reasonable adjustment requests. This can help if you need to review the plan later.

What if you are afraid they will judge you?

Fear of judgement is real. Many people with migraine have been dismissed or doubted. They have heard comments that made them feel weak, dramatic, or unreliable.

Still, it is worth asking what silence is costing you. Silence may feel safe at first. Over time, it can leave you unsupported. It can also allow others to misunderstand what is happening.

Ms TMA learned this. Her silence helped her survive a difficult workplace. It did not help her build a healthy working life. In coaching, she began to see that disclosure did not have to mean telling everyone everything. It could mean telling the right person enough.

So, should you tell your employer you have migraine? The answer is maybe. Do it with care, preparation and with self-respect. You do not have to overshare. You do not have to hide either. Your aim is to build a working life that supports your health and protects your dignity.

Migraine may affect your work. It does not have to erase your professional identity. Need help planning a migraine-at-work conversation? Book a coaching call.

References

The Migraine Trust. Getting support for migraine at work [Internet]. London: The Migraine Trust; [cited 2026 May 5]. Available from: https://migrainetrust.org/live-with-migraine/migraineandwork/getting-support-for-migraine-at-work/

Advisory, Conciliation and Arbitration Service. Reasonable adjustments [Internet]. London: Acas; [cited 2026 May 5]. Available from: https://www.acas.org.uk/reasonable-adjustments

National Migraine Centre. Migraine at work [Internet]. London: National Migraine Centre; [cited 2026 May 5]. Available from: https://www.nationalmigrainecentre.org.uk/understanding-migraine/factsheets-and-resources/migraine-at-work/

The Migraine Trust. Workplace toolkit 2025: migraine at work [Internet]. London: The Migraine Trust; 2025 [cited 2026 May 5]. Available from: https://migrainetrust.org/live-with-migraine/migraineandwork/getting-support-for-migraine-at-work/1631749830-tmt-workplace-toolkit-2025-online-aw/