{"doi":"10.1111/head.14530","title":"Living in society, living with migraine: Editorial for the 2022 Members' Choice Award paper","abstract":"Imagine a society in which everyone had migraine. The lights in stores would be dimmer. Music in bars would be quieter, and no one would wear perfume. Everyone would take breaks throughout the workday. Workplaces would have quiet, dark retreats where employees could go to manage symptoms. If someone could not come to work or had to go home early, staffing would be available for easy and adequate coverage. And, if everyone had migraine, migraine stereotypes would lose their power. Everyone would know that migraine is not “just a headache,” that the cacophony of neurologic symptoms that comprise a migraine attack can be disabling. People with migraine would never be considered unreliable at work, or so quickly dismissed as exaggerating to avoid responsibilities, or need to assiduously hide that they were experiencing impairments from migraine at all. If everyone had migraine, then navigating life with migraine would just be navigating life. Migraine occurs in a social context.1 Unexpected attacks can be disabling events that pull individuals from their routines, interfere with the fulfillment of social roles and expectations, and disrupt social systems.2, 3 The pace of an assembly line is determined by the slowest worker, perhaps the one having a migraine attack. Migraine is a problem for all of us, whether or not we have the disease. And we have two options to respond to the societal problem of migraine: interconnectedness and accommodation, or stigma and blame. The social interconnectedness that amplifies the impact of migraine also provides opportunities to reconceptualize the problem in a manner that may benefit everyone in society. Everyone stands to gain from better migraine management if that speeds our social assembly line. Employers would have more engaged and productive workers.4, 5 The government would oversee a more productive economy. The health system would benefit from lower emergency care utilization for a chronic disease. Families would be more engaged, and partners and parents would be more fulfilled. And individuals with migraine would have reduced symptoms and disability. On the other hand, migraine stigma discredits and isolates people with migraine in an effort to diminish their disruption to societal status quo.6, 7 A particularly stigmatizing migraine stereotype is that people with migraine are responsible for their illness. If we continue to blame individuals with migraine for their illness, it absolves us of responsibility for accommodating their illness. This strategy may provide short-term relief from psychological discomfort for stigmatizers,6 but in the long term is detrimental to people with migraine and society as a whole. Our paper8 joins other recent studies in demonstrating the negative impact that migraine stigma has on people with migraine. In our study, we found that people with migraine recruited from neurology offices in the New York City area (n = 121) reported stigma at levels similar to patients with epilepsy.8 The experience of stigma was strongly and uniquely associated with higher disability and poorer quality of life, even when migraine symptoms and psychological factors were considered. Our preliminary validation of a social ecological model for migraine found that stigma (a variable that represents the interaction between the person and the social systems in which they are embedded) mediated the relationship between monthly headache days and migraine-related disability and quality of life.8 This link suggests that if we want to understand the whole picture of migraine quality of life, we have to understand the role of stigma. These results were not surprising. They joined multiple other research reports describing the negative health consequences of stigma in chronic illnesses broadly,9-11 and migraine specifically.12, 13 Several lines of research are needed to better understand and ultimately reduce migraine stigma. For the individual with migraine, interventions are urgently nee","journal":"Headache The Journal of Head and Face Pain","year":2023,"id":408573,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9556,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":724394,"name":"Amanda Parker","orcid":"0000-0003-2207-744X","position":1,"is_corresponding":false},{"id":476672,"name":"Robert E. Shapiro","orcid":"0000-0002-7401-0514","position":2,"is_corresponding":false},{"id":473394,"name":"Dawn C. Buse","orcid":"0000-0002-3784-6144","position":3,"is_corresponding":false},{"id":937324,"name":"Matthew S. Robbins","orcid":"0000-0002-5426-5333","position":4,"is_corresponding":false},{"id":234917,"name":"Richard B. Lipton","orcid":"0000-0003-2652-2897","position":5,"is_corresponding":false},{"id":304039,"name":"Elizabeth K. Seng","orcid":"0000-0002-8938-4949","position":0,"is_corresponding":true}],"reference_count":20,"raw_metadata":null,"created_at":"2026-07-19T01:21:18.414003Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}