When You’re a Perfectionist, Migraine Can Feel Like a Personal Failure

I’ve always tried to hide my migraine condition to maintain a façade of perfectionism. But that wasn’t helpful, and now I know why.

Tucked away between my old photos and notebooks is a math test I completed in kindergarten. The paper, yellowed with age, proudly displays my grade: 100/100. A perfect score.

If you look closer, between my answers are tiny circles my mum taught me to draw when I was learning to add and subtract. The circles represent what I considered the “messy part,” a behind-the-scenes look at what goes into trying your hand at something new.

It’s the part where I work things out, make mistakes and try again. This is the side that I have learned to conceal as a perfectionist.

It’s like this with migraine, too. I would only let people see the grade at the top while I tried to power through pain pulsing behind my right eye. I’d convince myself this temporary discomfort paled in comparison to the stress of falling behind at school or work.

On the outside, perfectionists often appear self-reliant, achieving their goals with relative ease. When you add migraine to the equation, the “messy part” is now on full display, and it can feel impossible to maintain a façade of perfectionism.

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Perfectionism and migraine

Perfectionism is a trait that affects how you view yourself and the world around you. Consumed by self-doubt, you hold yourself to unattainable standards and treat mistakes as unacceptable. You tend to avoid taking risks or trying new things for fear of failure.

In my own case, holding myself to such high standards has made my migraine condition feel like a personal failure.

Although perfectionism doesn’t cause migraine, it can be a risk factor for headache disorders. Perfectionists tend to perceive situations or interpersonal interactions as more stress-inducing which, in turn, can affect the onset, frequency, and severity of migraine.

While my perfectionist tendencies have often made me try to ignore and work through a migraine attack, I now know that managing the expectations of my perfectionism will actually help the severity of my migraine symptoms.

I have slowly learned methods that help me to manage some of my perfectionist traits and, in turn, my migraine condition.

Trait: Using productivity as a measure of success

When I have a migraine episode, it’s impossible to maintain my usual level of productivity. The nausea and light sensitivity are a sign that I need to slow down and rest. And yet, all I can think about is pushing myself harder.

I tell myself to keep going, so I can rest in some distant future that will never come. And the worst part is I end up being much less productive, caught between frenetic thoughts and brain fog.

Scrolling through social media is additional confirmation of how unproductive I’m being as I compare myself to others.

Strategy: Letting myself have a migraine

To help disentangle productivity from success, I’ve found that I need to let myself be sick before trying to get better. As well, it’s important to acknowledge that the quality of my work decreases the more I keep going.

When you have a chronic condition, it can seem as though your job is to get better, sometimes by pushing through the pain.

In trying to unlearn these messages, I tell myself that my “job,” right now, is to have a migraine episode. That’s it. Getting better comes later.

Trait: Fixating on minor details

Something as simple as sending an email or writing a social media post brings out my perfectionist tendencies. I’ll continue searching for typos or obsess over my choice of words. The result is more screen time and eye strain, which can either trigger a migraine episode or prolong its duration.

Ruminating over mistakes also affects the quality of my sleep. Being tired not only leaves me more vulnerable to anticipating mistakes, but it can also increase the severity of my migraine attack.

Strategy: Giving myself permission to make mistakes

To reduce migraine triggers, I’m working on letting go of these obsessive thoughts and behaviors.

For instance, I try to be more accurate and realistic about the costs of making mistakes. I remind myself it’s not helpful to check and recheck small details that have little consequence for my work and a high cost to my well-being.

Interrupting this cycle starts with giving myself permission to make mistakes and not seeing them as a reflection of my self-worth.

Trait: Overemphasizing the negative

In my training to become a therapist, I learned about the connection between perfectionism and negative thinking.

Perfectionists are especially prone to filtering. This is the process of discounting the positive and amplifying the negative. For example, if I receive a job offer, I’ll tell myself, “There must have been few skilled candidates to choose from, so I just got lucky.”

In addition to filtering, another negative thought pattern I’m especially susceptible to is catastrophizing. This involves assuming that the worst will happen. I often do this when I need to stop and rest. I’ll think to myself, “If I take a break now, I’ll never get this done.”

I often find that my tendency for negative thought patterns become worse during a migraine episode, and commonly focus on thoughts about the condition.

Studies have found that those with a migraine condition have a greater tendency to catastrophize, which in turn can impact the onset of symptoms.

Strategy: Reframing my thoughts

I have learned how reframing my thoughts can help me keep my perfectionism in check. For starters, I pay attention to what I’m telling myself. I listen for specific words, like “should,” “must,” “never,” and “always.” This helps with my tendency to filter out the positive.

In moments of catastrophizing, I challenge my thoughts and reframe them. For example, instead of telling myself, “If I take a break now, I’ll never get this done,” I tell myself, “If I take a break, I will feel more rested, and I’ll be able to get this done faster.”

This helps me to be less negative in general, but most importantly, to be kinder to myself about my migraine condition and to challenge my assumption that it’s a personal failure.

Trait: Procrastination

Perfectionism can go hand in hand with procrastination. Perfectionists often delay starting tasks, because they worry about not doing things perfectly.

The anxiety that can ensue because of procrastination can be a risk-factor for my migraine condition and my overall well-being.

Strategy: Learning the difference between procrastination and healthy distraction

Often, what helps me is to think of the difference between procrastination and healthy distraction.

Trying to start another project or mindlessly scrolling through social media are ways to procrastinate and avoid negative emotions associated with the task I’m avoiding.

In contrast, taking 30 minutes to rest, walk my dogs, or chat with a friend is a healthy form of distraction. These activities involve intentionally taking a break that will help improve my mood, decrease stress, and consequently help my migraine condition.

The takeaway

Having migraine is a daily struggle for me, which can feel like living with imperfection.

Implementing these strategies has helped me realize migraine is not a personal failure. In fact, it’s made me realize I can actually help my condition and my overall well-being by keeping some of my perfectionist traits in check.

I’ve also learned I’m worth caring for, even when my perfectionist thoughts are telling me the opposite.

If you’re experiencing symptoms of perfectionism, it could be a sign of underlying anxiety. Anxiety is also common amongst people living with migraine, with a review of studies finding that 43 percent of individuals with a migraine condition also have anxiety.

If you live with migraine, have perfectionist tendencies that have ever caused you concern, or think you may have anxiety, you should speak with a doctor.

Beyond the strategies I shared in this article that personally helped me, there are many other possible treatments that could help those with diagnosed anxiety.