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These Are the Invisible Costs of Migraine That Your Friends May Not See

Real Talk

February 13, 2024

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Photography by Alexey Kuzma/Stocksy United

Photography by Alexey Kuzma/Stocksy United

by Clara Siegmund


Medically Reviewed by:

Susan W. Lee, DO


by Clara Siegmund


Medically Reviewed by:

Susan W. Lee, DO


Migraine goes well beyond the physical symptoms. It can affect your mental health, social and family life, and even your career and finances. It’s important to reach out for support to manage the impact.

Migraine is more than just attacks and headache days. Maybe you get dark circles under your eyes or your face looks pallid. Other people may be able to spot these visible symptoms of migraine.

But not all consequences of migraine are visible.

In addition to the physical symptoms that may be more familiar to your friends and loved ones, the other costs of migraine add up. These hidden hardships are unique to each person, appearing and feeling differently depending on your individual circumstances.

Even if something isn’t immediately obvious, it still exists. Just like the physical costs, these emotional, social, professional, and financial sacrifices of migraine can all take their toll.

Here are just some of the invisible costs of migraine that your friends and loved ones may not see.

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The emotional costs of migraine

Having a chronic health condition such as migraine can significantly affect your emotional and mental well-being.

Here are some of the ways these costs of migraine can appear.

Migraine is unpredictable

Migraine is unpredictable, even if you have a grasp on your triggers.

This means the shadow of migraine looms over daily activities, plans, vacations — you name it. You may feel great one day and be totally bowled over by a migraine episode the next.

For many people, this translates to living in constant fear, dreading the moment when migraine strikes at a bad time or the days when your symptoms are unbearable and you can hardly move.

It’s no surprise that dealing with daily unpredictability, unsteadiness, and dread is emotionally draining!

Migraine is an invisible illness

Migraine is an invisible illness, meaning symptoms don’t always show up in ways that others can see. With invisible illnesses, the burden of justifying sickness is unfairly placed on the person experiencing the illness.

If you have migraine, this can mean that you have to prove how unwell you feel, whether to friends, loved ones, work or school colleagues, or even healthcare professionals.

People may be generally sympathetic and understanding, but they may not always be willing to give you the time and space you need during a migraine episode. Co-workers, classmates, and even friends and family may think you exaggerate your pain to get out of responsibilities.

Whatever the case may be, it’s emotionally exhausting to constantly have to explain your illness, justify invisible symptoms such as headache and nausea, and try to keep your cool while responding to unsolicited and unhelpful advice like, “Have you tried taking an Advil?”

Even in medical settings, people with migraine may sometimes find themselves advocating for their needs with little to no success.

In a small 2019 study of 30 women with visible or invisible disabilities, one of whom had migraine, participants said they commonly had frustrating interactions with healthcare professionals who didn’t take their symptoms seriously. The researchers noted that this sometimes meant healthcare professionals didn’t believe the women’s reports of symptoms, and this resulted in delayed diagnosis.

According to another 2019 study, healthcare professionals may frequently misdiagnose migraine as something less medically significant.

When you have migraine, this can mean getting stuck with yet another emotional (and physical) burden: going from doctor to doctor until you find someone who acknowledges the validity of your experiences.

In the small 2019 study mentioned above, participants also said that others often discounted their disability because they looked healthy or young.

Whether you’re dealing with loved ones, acquaintances, or doctors, navigating the world with an invisible illness can take an enormous toll on your emotional and mental well-being.

Healthcare professionals may frequently misdiagnose migraine as something less medically significant.

Migraine has mental health comorbidities

On top of all that, migraine is often accompanied by other diagnosable mental health conditions, or comorbidities. A comorbidity is a coexisting health condition. Healthcare professionals use this term when a person has two or more health conditions at the same time.

Anxiety, depression, and bipolar disorder can all be comorbidities with migraine. People with migraine may even be at higher risk of developing certain mental health conditions, such as depression.

There are a couple of reasons for these comorbidities. For example, experiencing periods of lower quality of life due to chronic illness can trigger depressive episodes.

There may also be links between the physiological mechanisms behind migraine and mental health conditions, meaning that developing one may indicate that you’re more susceptible to developing the other.

Needless to say, experiencing migraine and mental health conditions together is a significant burden and has a steep emotional cost.

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The social costs of migraine

Migraine also comes with hardships related to your social life and family life. Here are some of the ways these invisible costs of migraine can show up.

Migraine makes it hard to keep up

Between balancing your health needs and keeping up with friends and loved ones, it’s easy to feel like you’re stretched too thin. No matter how much you value your relationships, tending to each one is hard when you’re not at your physical or emotional best.

You may find yourself forced to cancel plans when migraine hits in order to prioritize your physical and mental health. Or you may have a hard time saying yes to trips when you don’t know whether migraine will get in the way. Maybe you used up all your PTO (paid time off) to stay home on migraine days, so you always have to say no to 3-day weekends.

Whatever your case may be, migraine makes it difficult to be present. And that can make it hard to maintain relationships with the people in your life, whether friends, romantic partners, or family.

Migraine makes you miss things

Having migraine may mean missing out on significant events such as weddings, birthdays, and graduations.

Sometimes, it could be because a migraine episode hits and you have to skip the event at the last minute. Other times, triggers like loud noises or bright lights may force you to decline as soon as the invitation arrives.

Either way, odds are good that you were really looking forward to the event or would have loved to go if you could, and missing it due to migraine stings.

Migraine affects families

Migraine can also affect your family in ways that are totally out of your control.

During episodes, if you’re too unwell to do household tasks, you may need to lean on your partner for help with chores or parental responsibilities. On bad migraine days, you may be forced to miss events your children participate in, such as recitals or sports games.

Dealing with migraine as an individual already comes with emotional burdens. When partners and kids are also in the picture, migraine can add familial strain too.

The professional and financial costs of migraine

Migraine can also come with professional costs and, of course, financial costs. Here are some examples of what these hidden costs may look like.

Migraine hurts careers

Having migraine means there are days when you’re too sick to work, and this probably happens more frequently for you than it does for your colleagues.

People with migraine often have to miss work events and take more time off, using up sick days and PTO. You may even have to go on unpaid leave when you’re out of other options. This also makes it hard to take vacations, which can affect your emotional well-being as well as your social and family life.

Missing that much work may mean getting overlooked for special projects, new opportunities, and promotions, and this can potentially affect the career trajectories of people with migraine. Two people with the exact same skills and experience may be in very different positions if one has migraine and the other doesn’t.

Migraine is expensive

It’s expensive to be sick, and when you have a chronic health condition like migraine, it’s even more expensive.

Some financial costs of migraine are related to healthcare, including fees for:

  • prescription and over-the-counter medication
  • more frequent appointments with doctors and specialists, such as neurologists
  • trips to the emergency room or urgent care
  • various migraine therapies, including behavioral therapies such as cognitive behavioral therapy and biofeedback

Having more complex or intensive health needs can affect your insurance fees too. Having migraine may mean that you have a more costly insurance plan and need to pay more frequent copays.

Plus, migraine care isn’t always covered by insurance, so you may need to pay out of pocket for some care.

Then there are the other costs associated with migraine, including:

  • keeping your migraine rescue kit fully stocked
  • arming yourself with migraine supplies such as heating pads and homeopathic remedies
  • buying takeout when you can’t cook
  • getting groceries delivered when you can’t shop
  • paying for taxis when you can’t drive or take public transportation

People with migraine also risk losing income due to unpaid leave, work loss, or shift loss, which can make it harder to take on these financial costs.

All these fees can add up.

Using a national database of people with health insurance in the United States, the authors of a 2018 study compared people in similar demographics with and without migraine to determine the direct and indirect costs of migraine. They found that the annual financial cost of migraine was $8,924 in 2014 U.S. dollars.

According to inflation calculations from the United States Bureau of Labor Statistics, the equivalent annual cost of migraine in 2024 would be $11,703.

Of course, exact costs depend on lots of factors unique to each individual, so they are difficult to calculate. What’s certain is that having migraine is expensive.

The average estimated annual cost of migraine is $11,703 in 2024.

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The bottom line

If you have migraine, you know that it comes with much more than just physical symptoms.

Migraine affects every part of life, from emotional well-being to social and family life, career, and finances. While some of these costs may not be as evident to other people, they’re all significant when you have migraine.

It may feel overwhelming to face all the invisible costs of migraine, but it’s important to remember that you’re not alone. Friends, family, medical professionals, and others can help you shoulder the burden.

If you’re a loved one of a person with migraine and you’re wondering how to help, the best thing to do is ask. Stay open and kind and make your loved one with migraine feel safe coming to you for whatever they need.

Medically reviewed on February 13, 2024

8 Sources

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About the author

Clara Siegmund

Clara Siegmund is a writer, editor, and translator (French to English) from Brooklyn, New York. She has a BA in English and French Studies from Wesleyan University and an MA in Translation from the Sorbonne. She frequently writes for women’s health publications. She is passionate about literature, reproductive justice, and using language to make information accessible.

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