When the boom gives you a headache

Thanks to the economic boom, nearly everyone is working

Thanks to the economic boom, nearly everyone is working. But are we working too hard? And are we suffering from a host of stress-related illnesses which are being neglected in a blur of long hours and busy lives?

Taboos are re-emerging - sometimes after a sustained period of openness - about such conditions as depression and migraine. Today is the start of Migraine Action Week. This year's theme - Working with Migraine - presents one bleak example of how we are coping with our relatively new-found wealth and busy lifestyles.

"Migraine continues to be undertreated and under-diagnosed, affecting 12 per cent of the population," says Dr Eddie O'Sullivan, a Cork-based GP who is a medical adviser to the Migraine Association of Ireland. This percentage translates into approximately 200,000 people in the workplace.

How many colleagues do you know who will openly admit to suffering from migraine? The reality is that people are afraid to talk about anything that could impede their productivity. Yet poor lighting, overheated offices, flickering computer monitors, fume-filled factory floors and incessant building work on yet another development next to your workplace are becoming the new triggers for migraine.

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In a recent UK survey of more than 1,500 migraine sufferers, 52 per cent described their work environment as migraine-inducing. "With the increase in the number of people employed, more people are bringing their migraine to work.

A lot of patients experience migraine at work and the stress of long, hard hours can contribute to the prevalence of attacks as well," says Dr O'Sullivan. The changed nature of work - which now often involves concentrated periods of time in front of computer screens - is a contributing factor.

"Many people will not tell work colleagues that they suffer from migraine because the perception is that they will not be reliable and this might impede promotional possibilities," says Audrey Craven, co-founder of the Irish Migraine Association. A 35-year-old engineer, who has suffered from migraine since he was eight years old, explains: "The way migraine has affected me most is that it has made me feel like I'm not dependable. If I arrange a meeting in advance, at the back of my mind I just hope that I will be able to make it.

"If I get an attack in work, I'll go home if I don't have to meet someone. I'll make up the time at another stage. I am in a job where my work is evaluated at the end of the year rather than clocking in and out," he continues.

Ann Fahey, a secretary and a sufferer of migraine for more than 40 years, is not optimistic about the openness to migraine in the workplace. "There is not enough awareness of migraine in the workplace and this has an effect on employees who suffer from migraine," she says. "If I get a migraine, I feel I have to soldier on with it on my own. It's a very introverted experience. When you get a migraine, you are consumed with your own pain and, once that passes, your reality changes. Nobody understands the illness apart from those who have it," she says.

"I can have an attack anything from once a week to once a month. Fortunately, I have an understanding manager." Current estimates are that migraine sufferers miss between three and four days a year due to migraine. However, some sufferers miss one to two days per month. Migraine is a neurological condition caused by altered levels of the brain chemical, serotonin. It is characterised by a headache on one side of the head.

Other symptoms include a feeling of nausea, vomiting and light and sound intolerance. In 20 per cent of cases, sufferers have a premonition before the onset of pain. This is experienced as zigzag lines, flashing lights or blurring vision. There is a three to one ratio of female to male sufferers and hormonal fluctuations during the menstrual cycle can act as a trigger for a migraine attack in women.

The under-diagnosis stems partly from sufferers' lack of willingness to define their headache as migraine. "For many years, I assumed other people felt the same way as I did when they had a headache. And, I was amazed how strong people were - just getting on with it," says one migraine sufferer. "Now that I know that I don't have a similar headache to other people, it's okay to say I can't function. It's okay to stop trying to struggle on and accept it as an illness," he continues.

One of the main functions of Migraine Action Week is to encourage migraine suffers (known as migraineurs) to learn more about their condition and identify trigger factors (which include cheese, chocolate and red wine). The arrival of a new drug specifically designed for migraine - tripans - offers relief for many sufferers. And 58 per cent of respondents in the aforementioned survey claim they are able to work through a migraine attack with the aid of medication.

"Taking the medication early and going to lie in a darkened room is a key factor," says Audrey Craven. "If they do this, many migraineurs can return to their work station within a few hours," she adds.

Providing such a retreat zone for workers is one way in which employers can help. "We encourage people to learn to identify their own triggers and be their own detective to prevent attacks. We are also asking GPs to please listen to their patients and work with them to develop a good management programme tailored to each patient's individual needs. Migraine is as individual as a thumb print," says Craven.

In terms of the success of alternative/ complementary approaches to medication, the Migraine Association of Ireland has anecdotal evidence which suggests acupuncture and biofeedback work to relieve the symptoms. Complementary practitioners in the domains of homoeopathy, osteopathy, chiropractic and Western herbalism also claim some success in the treatment of migraine.

The Migraine Clinic, which operates on Fridays from 1.30 p.m. to 6 p.m. in Dublin's Beaumont Hospital hopes to embrace complementary medicine in its future treatment plans.

Migraine Action Week runs from today until Saturday. The Callsave number 1850 200 157 will be manned by two migraine nurses and members of the Migraine Association of Ireland throughout the week. Information units will be set up in the Wilton Shopping Centre, Cork City and Bloomfields Shopping Centre, Dun Laoghaire from Thursday to Saturday.

The Migraine Association of Ireland is hosting a seminar on the theme of Working with Migraine in the Royal Dublin Hotel on Sunday, September 24th from 2.30 p.m. - 5.30 p.m. £5 admission on the door. Tel: 01-8093342.