How to manage a migraine while working from home

Migraine is a debilitating neurological disease, ranking consistently among the top 10 leading causes of years lived with disability, worldwide. The main symptom of migraine is an enduring headache, along with symptoms such as severe pain on one side of the head or throbbing pain, sensitivity to light and sound, and nausea. Despite being a very common headache disorder that affects roughly 15 percent of the adult population worldwide, it remains inadequately understood and most neglected.

In Delhi, approximately 25 percent of the population suffers from migraines, every year.

While migraine is an invisible condition, it can severely impact individuals across personal, professional, and social domains, thus affecting the overall quality of life and productivity. Work-from-home, or the 'new normal,' has drastically impacted the lives of people suffering from migraines -- from an inability to concentrate at work to missed workdays. It has become even more urgent to ensure that individuals have the understanding and tools to effectively manage migraines.

Dr. Debashish Chowdhury, Professor, and Head of Neurology, G B Pant Institute of Post Graduate Medical Education and Research (GIPMER) and Incharge, Headache Clinic, GIPMER, New Delhi said, "There is a lack of understanding amongst people about the severity of migraines. In a study we recently conducted, about 50 to 60 percent of migraineurs were undiagnosed, despite recurrent headaches. Because migraine falls on a spectrum, ranging from infrequent or mild attacks to recurrent ones, many pass it off as �merely a headache'. With busy work-from-home schedules, paired with the fear of contracting COVID-19 infection and difficulty in accessing in-person care, people are avoiding seeking medical help for the condition, instead attributing symptoms to associated comorbidities, such as stress or depression."

He continued, "Financial worries due to job loss or salary cuts also contribute to aggravated migraine attacks, which is more noticeable recently. The effects of migraine on one's quality of life also reportedly worsened, particularly for many migraineurs working as essential healthcare workers at this time.

Symptom neglect and failure to treat the condition can lead to migraines becoming chronic. A fundamental need is to recognize migraine as a serious condition with severe disability and adopt a holistic treatment approach. Early detection can be a key enabler of a smoother patient journey and an improved quality of life."

Migraines can begin at any age but tend to peak during one's prime productive years. Moreover, women are three times more likely to be affected than men, with prevalence peaking between the ages of 25 and 55 years.

Long hours of working from home, along with longer screen times, disrupted sleep schedules and irregular eating habits can increase stress levels. For migraineurs, such changes can become migraine triggers, exacerbating their condition. Identifying personal triggers can help individuals manage their migraines better.

Working from home can be hard, but a daily routine that optimizes your physical and mental health can help keep your migraine at bay. Eating healthy meals at appropriate times or consuming small, frequent meals throughout the day is associated with less frequent migraine headaches. Taking breaks from work at regular intervals can help you eat right and reduce eye strain owing to excessive screen use. Making modifications to your lifestyle, including smoking cessation and reduced alcohol consumption, and maintaining optimal sleeping habits, and exercising regularly can be key to manage migraines. These also benefit migraine prevention and treatment.

It is important to consult a medical specialist when you are experiencing severe headaches that disrupt your daily routine. A lot of migraineurs hesitate to seek medical help. This could be due to several reasons -- lack of understanding of migraine severity, lack of time due to hectic work-from-home schedules, or recently, due to a reduction in in-person clinic consultations owing to the fear of Covid-19 infection. However, consulting a neurologist, even via teleconsultations, is a necessary step to diagnose your condition and understand the available options for acute and chronic management of migraine, including preventive treatment. With evidence-based information on effects across migraine intensity reduction, quality of life, and ease of use, neurologists can guide you on the most suitable treatment option to prevent or reduce your migraine episodes.

It is a good idea to maintain a diary (or download a migraine tracker app), to record the time and severity of your migraine attacks, symptoms, daily diet, exercise routines, and medications and side effects. This can help identify triggers and patterns. It can also prompt meaningful conversations with your doctor, contributing to a more holistic treatment plan, personalized to suit your work schedule.

Living with migraines can make one feel helpless, distressed, and misunderstood. But talking to your friends and family will help them understand your condition better. Having an open conversation about your migraine with your employer is a good idea, particularly to work out a schedule, with specific routine adjustments to mitigate triggers. This can help you be productive and healthy while working from home. Employers can also take the initiative -- arranging wellness programs for employees to raise awareness about migraines and how to effectively manage them at work and enhance productivity.

Migraine attacks can be challenging. Changes to your daily routine and active communication about your condition with your employer, after consulting a neurologist, can help you better manage migraines as you work from home.

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