February 17, 2022
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Jimena Roquero/Stocksy United
Changing how you think about migraine and viewing the condition as simply part of your biological makeup may help you escape feelings of personal responsibility.
“I shouldn’t have had that second glass of wine,” I told myself.
It’s the day after a family wedding and I’ve woken up with a whopper migraine. I thought I’d done enough to prevent it. I’d been careful not to overindulge in the booze, went to bed early, and even skipped the chocolate dessert, but still, the pain in my head felt all-consuming.
Despite trying my best to avoid my triggers, I couldn’t shift the feeling that this migraine was somehow my fault. Surely, I could’ve done more to prevent it.
This feeling of personal responsibility mid-migraine is an all too familiar one.
I’ve kicked myself for not drinking enough water while struggling with blinding pain, raged at myself for not reaching for pain medication sooner, and even felt at fault when a change in contraception caused my migraine episode to get marginally worse.
Even when there’s no obvious cause for the onset of an attack, I’ll still feel like there’s something I should have done better.
So why do people with chronic migraine often feel at fault when managing an attack, and what can we do to prevent it?
“Chronic migraine is defined as having at least 15 headache days a month, with at least 8 days of migraine features such as severe throbbing pain or a pulsing sensation, nausea, vomiting, and extreme sensitivity to light and sound, for more than 3 months,” says Dr. Daksha Hirani, a psychologist and clinical director.
She suggests that feelings of responsibility can be common among those managing chronic migraine.
“[People] can be left with unhelpful feelings of self-blame, guilt, and shame when they engage in a behavior that brings on the [migraine],” she explains. “Common triggers for [migraine] are lack of sleep, caffeine, alcohol, and food intolerances. Juggling a busy life and daily hassles in this fast world means it is not always easy to balance all of these triggers all the time.”
I’ve found that when I fail at managing my triggers, it can bring on feelings of “I should have known better.”
Even the word “trigger” suggests a level of personal responsibility. It hinges on the assumption that there is always something more I could have done to prevent an attack.
What’s more, heaping on blame during the onset of a migraine can make the experience so much worse. “[People with] migraine can end up engaging in unhelpful behaviors which only worsens their condition as they throw misplaced self-blame and guilt on themselves,” says Hirani.
So, as a person who lives with chronic migraine, how can you learn to kick the habit of self-blame?
One of the challenges of chronic migraine is that it can often impact how you interact with others. It can severely affect your social life, particularly if common triggers like alcohol and rich foods are out of bounds.
Avoiding these triggers is at odds with our need to be social, Hirani points out. “The need to fit in and be part of the hustle and bustle of society is normal. Human beings are meant to live in groups and not isolate on our own,” she says.
From a migraine perspective, that might mean triggers feel impossibly hard to avoid.
For Hirani, the solution is remembering that you are a human being with many competing needs, and that means you can’t — and won’t — do everything perfectly.
“How many of us know it is healthy for us to go to the gym but don’t? How many of us know we shouldn’t indulge in unhealthy foods and yet do? Falling into trigger behavior patterns is to be human,” she says.
Hirani says practicing deep compassion toward yourself while normalizing your experience is crucial. “Go easy on yourself and accept that this can happen from time to time,” she suggests.
I’ve been trying this for myself. I find imagining that a loved one is experiencing a migraine helps.
Would I berate them for experiencing a migraine and tell them it’s all their fault for eating that extra square of chocolate? No, I’d be doing what I could to empathize with them. I’d offer them love, kindness, and understanding.
Extending that same kindness to myself during an attack has been a game-changer. Remembering that your ability to avoid triggers doesn’t define you as a person may help you, too.
Perhaps you have a list of foods and drinks you know to avoid, or you diligently get 8 hours of sleep a night to avoid an attack. Despite being clued up on managing your condition, it can be good to remember that there’s still so much we don’t know about migraine.
No matter how well prepared you are, there’s only so much you can do to prevent one.
“Recognizing that [migraine episodes] are still not well understood and they are caused by multiple different factors [can be helpful],” says positive psychologist and author of “Grow Your Own Happiness,” Deborah Smith, who also lives with migraine.
“The key is understanding, as best as you can, what things you could change to help alleviate the frequency of your migraine, while also accepting that sometimes they happen for no apparent reason at all,” Smith says.
Recently, migraine specialist Dr. Chris Blatchley helped me shift my perspective on how we discuss migraine. He told me that rather than saying one has certain migraine triggers, it’s more accurate to say you have a “propensity” for migraine attacks and that certain things can “bring them on.”
It’s a subtle shift, but one that’s been transformative for me. Looking at my condition this way has helped me realize that living with migraine isn’t my fault — it’s my biology.
Having a “propensity” for migraine is out of my control. It is merely how my body reacts to certain stimuli, and I can only do so much to manage that.
Chronic migraine can be difficult enough to manage without the added torture of guilt and self-blame. Changing how you think about migraine and viewing the condition as simply part of your biological makeup may help you escape any feelings of personal responsibility.
A little bit of self-compassion can go a long way, too.
From now on, when I feel those familiar symptoms, I’ll be doing my best to let myself off the hook — because the last thing I need mid-migraine is to feel somehow responsible. I need self-care and kindness to get through it, just as much as I need a dark room and a cold compress.
Medically reviewed on February 17, 2022
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