How to Help a Coworker With Migraines, Quietly

The desk beside yours has gone quiet. Screen brightness at zero, or the monitor off entirely. The water glass hasn’t moved since ten. You’ve seen this before, every few weeks, same shape, and you still don’t know the etiquette: say something and you might be intruding, say nothing and you’re the fourth person today pretending not to notice.

Here’s the thing that makes your position different from everyone else’s in the building. You have no authority over this person and no obligations toward them. Their manager’s concern is never just concern; it arrives with the absence record standing behind it. HR’s concern comes with a process attached. Yours can be nothing but help, and that’s exactly why it lands differently.

What a peer can do that a manager can’t

A manager helping someone through an attack creates a file, however informal. A colleague helping them creates nothing. That’s your advantage, and it’s worth using precisely.

The best version of it is cover without commentary. “I’ve got the 3pm. Go.” Six words, no question mark, no debt. Compare it with “are you okay?? you look terrible” — a question that forces someone with a nail behind one eye to compose a reassuring answer about their own face. The first is help. The second is a request for a performance of being fine.

Declarative beats interrogative in almost every version of this:

• Take the meeting notes without being asked. Then send them without ceremony. Not “notes attached since you missed it!!” with the exclamation marks doing the announcing for you. Just the notes, the decisions, the one action item with their name on it.
• “Stepped out” is a complete answer when someone asks where they are. You are not the press office for their condition.
• Move the loud thing. The lunch crowd that assembles around the desks at 12:30 can assemble in the kitchen today, and you can be the one who says “let’s take this over there” without giving a reason.

None of this requires them to have told you anything. That matters. They may never have disclosed it to anyone at work, and they don’t owe you the explanation first. Help that demands one before it’s delivered isn’t help, it’s a toll.

Interference no one has to thank you for

Some problems in an office are only accommodations if they have a name attached. The same problems, raised by you, are just maintenance.

The strip light that flickers over that corner of the floor: if your coworker files the ticket, it’s a request from the person with the health condition, and now it’s about them. If you file it, a light is flickering and facilities should fix it. Identical ticket, entirely different weight. The same goes for the colleague who’s warming up to a ten-minute tour of her new perfume two desks away. You can be the one who moves that conversation along, and nobody needs to know it was a rescue.

This is the quiet structural work a peer is uniquely placed to do: you can fix the environment without attaching it to a person. A manager fixing the lighting is implementing an adjustment. You’re just someone the flicker was annoying.

Three things that feel like help and aren’t

Announcing. Telling the new hire “she gets migraines, by the way.” Explaining their absence in standup. Mentioning it in the channel so people “understand.” Whether colleagues know is their call, never yours, and The Migraine Trust’s guidance on migraine at work is explicit that telling a manager, employer, or colleagues is the person’s own choice. However kindly you meant it, disclosing on someone’s behalf takes a decision that belonged to them.

Relaying remedies. Your aunt’s magnesium, the podcast about diet, the cousin who fixed everything with cold showers. They have heard all of it, from people who love them more than you do. The full catalogue of well-meant sentences that land badly is in what not to say to someone with chronic migraines, and the workplace does not grant an exemption to any of them.

Keeping score. “Another one? That’s three this month.” Even said with warmth, you have just told them you’re counting, and now every attack comes with an audience. Monitoring frequency is a job that belongs to them and their clinician, not to the desk next door. A colleague keeping tally is surveillance wearing a cardigan.

The discretion test

One question sorts genuine help from its imitation: would it still work if they never found out you did it?

The rerouted meeting passes. So do the facilities ticket and the notes sent without a flourish. The pointed message in the team channel about how “we should ALL be more mindful of scent in this office” does not work without an audience, which tells you what it actually is.

Helping quietly and performing allyship look similar from a distance and feel completely different to the person being helped. One shrinks their bad day. The other converts their bad day into your good deed.

If you’re genuinely worried

Sometimes the pattern is visibly worsening. Closer together, longer, a person who used to power through now disappearing for whole afternoons. You’re allowed one honest sentence about it, said to them, in private, once: “I might be wrong, and tell me to drop it, but these look like they’re getting rougher lately.” Then drop it, whatever they say. Whether that’s a conversation for their doctor is between them and their doctor.

What you don’t do is take your worry to their manager. That converts a private observation into a workplace matter without their consent, and it isn’t yours to convert, however good the intention.

The one exception is immediate safety. A colleague who can’t see straight and is about to drive home is not a privacy question, and stepping in there isn’t overstepping. Everything short of that is theirs to escalate or not.

You get one pointer, so place it well

If they’ve mentioned the condition to you and they’re plainly white-knuckling through with nothing in place — screen at full brightness under a fluorescent tube, dragging themselves in after visible nights — you get one resource mention. There’s a guide to asking for migraine accommodations at work written from the employee’s side, down to the opening sentence and the specific asks that cost an employer nothing. Mention it once, the way you’d mention a good mechanic. A resource offered once is a door. Offered monthly, it’s a nag, and nagging is just monitoring with citations.

Why you shouldn’t play manager

There’s a version of this written for managers, and it’s worth knowing why it’s different. Lighting policy, flexible hours, how absence gets counted: those need authority, and attempting them from the next desk means lobbying the boss about a colleague’s health, which discloses and oversteps in a single move. The rest of the migraine-at-work guides cover that territory from the chairs it belongs to.

Your lane is narrower, and on a bad Tuesday it’s faster. The manager’s help takes a meeting and a follow-up. Yours takes six words and no reply.

“I’ve got the 3pm. Go.”