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The Stigma of Migraine Packs a Punch

Social stigma still exists for some medical disorders and compounds the challenges health problems create.  For migraineurs, the stigma is high. In fact, researchers say, individuals who experience chronic migraine report lower quality of life and more social stigma—stereotyping, discrimination and loss of status—than those with episodic migraine or epilepsy, a disease that, unfortunately, has traditionally carried considerable stigma.

In the largest study to examine this issue and the first of its kind in the United States, researchers enrolled 62 subjects with epilepsy and 123 patients with chronic migraine (migraine 14 or more days per month) and another 123 patients with episodic migraine (migraine 14 days a month or less). Participants completed a battery of questionnaires to measure the extent of their disability and the stigma they experienced. William B. Young, MD, at Thomas Jefferson University in Pittsburgh, led the study.

Out of the three groups, those with chronic migraine reported the least ability to work and the need for the most bed rest during the day. They also reported the highest amount of stigma compared to the other two groups. When disability was removed from the equation and all factors were considered, individuals with chronic migraine reported levels of stigma similar to that of epilepsy, while those with episodic migraine reported less.

Dr. Young notes the level of disability associated with chronic migraine is important—and something that many individuals without migraine do not understand.

“I don’t think people realize that it is not unusual for people with migraine to have severe headaches every day—to be so disabled that they are unable to work,” Dr. Young said. “This is what causes the stigma—the fact that people with severe migraine may not be able to work.”

He noted that in his clinic, 25% of migraine patients cannot work because of their illness and that among chronic migraineurs, severe depression and suicidal thoughts are common. Stigmatizing individuals with the disorder makes the situation worse, taking a toll on relationships, work lives and emotional well-being.

“When people treat my patients as if they are to blame because they have a severe, debilitating disease, they are contributing to the problem and making life harder for them,” he said.

Stigma and the devaluation it brings can also arise internally and profoundly affect how the individuals view themselves, the authors note. When this occurs, the stigma can be just as damaging as the stigma projected from others.

Calling social repercussions of migraine a public health problem, Dr. Young suggests that a variety of steps be taken to reduce migraine’s stigma, including education, policy changes and counseling and empowerment programs.

The study appeared online in the journal PLOS One last month.

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