For many, the return to routines each fall also marks the return of pressure—pressure to perform, show up, and push through. But for people living with migraine, those daily expectations are often complicated by something less visible but just as real: stigma.

At the American Migraine Foundation, we hear it all the time. Stories of being dismissed in a healthcare setting. Misunderstood at work. Judged by family or friends who don’t realize how debilitating migraine can be. Stigma surrounds life with migraine in ways that are subtle and overt—and it makes an already complex disease even harder to manage.

But here’s the truth: stigma is learned. And together, we can unlearn it.

What Stigma Really Looks Like

According to licensed psychologist and clinical professor Dr. Dawn Buse, stigma occurs when someone is discredited, devalued, or judged negatively for a specific condition—especially one others can’t easily see. Migraine is a perfect example of this: a serious neurological disease that is still widely misunderstood.

Watch Dr. Dawn Buse break this down in this MHAM Live: “Dismissed and Misunderstood”

Dr. Buse explains that stigma shows up in two main ways:

  • External stigma, like being doubted by a healthcare professional or denied workplace accommodations.
  • Internalized stigma, where people begin to blame themselves, feel guilt or shame, or question whether their experiences are valid.

This internalized stigma doesn’t happen in a vacuum. It often stems from years of not being believed or taken seriously. As Dr. Buse shared, “A third of people we surveyed said they felt dismissed or discredited by their healthcare provider.”

And that stigma doesn’t stop in the doctor’s office.

Stigma at Work: The Invisible Battle

Many people living with migraine show up to work and get the job done—but at a cost. They might skip lunch to power through a migraine attack. Miss out on promotions or key meetings. Or work extra hours to keep up. And often, their effort goes unseen.

Hear more from board-certified neurologist and headache specialist Dr. Olivia Begasse de Dhaem in this MHAM Live: “Stigma and the Workplace”

As Dr. Begasse de Dhaem explains, “Most migraine-related productivity loss comes from presenteeism—people working during an attack but functioning at only 50%.” Employers may not see that toll, especially if the job gets done.

The result? People may hide their diagnosis, decline career opportunities, or avoid asking for help. All of which can reinforce harmful stigmas—and lead to burnout.

Language Matters—More Than You Think

Stigma thrives in silence and misunderstanding. But the words we choose can disrupt both.

That’s why AMF is intentional about using accurate, respectful language when talking about migraine. We refer to it as a disease, not a condition. We say migraine, not migraines. And we talk about people living with migraine—not migraineurs or people suffering from migraine.

Why does this matter? Because language shapes perception. And perception shapes care.

How to Advocate for Yourself

Dr. Buse and Dr. Begasse de Dhaem both shared practical ways people living with migraine can advocate for better care and workplace support:

  • Come prepared with a headache diary
  • Share how migraine impacts your daily life
  • Know your rights under the ADA
  • Ask for accommodations
  • Bring a loved one to appointments for support

Feeling stuck in conversations with your healthcare provider or HR? Both experts offer specific wording and tips in their MHAM Live sessions, which you can revisit anytime.

 Looking for more tools to speak up and take action? Download these free guides:

Changing the Conversation Starts with Us

The good news? We’re already making progress. Over the last decade, treatment options have expanded, public awareness is growing, and more healthcare professionals are engaging with migraine science than ever before.

Still, the work continues.

If you’re living with migraine and feel invisible, unheard, or unsupported, know that you’re not alone—and you’re not imagining it. Stigma is real. But so is your strength. When we speak out together, we help shift the narrative for everyone.

Let’s keep working toward a future where migraine is met with understanding, not judgment. A future where people living with it get the care and compassion they deserve.

Need a place to start? Join our Move Against Migraine Facebook group, a supportive space where thousands of people share resources, validation, and hope every day.

And if you’re looking for more ways to take care of yourself or others, explore our full library of AMF Patient Guides—all free to download, easy to share, and made to support you every step of the way.