How Migraine, Depression, Guilt & Shame Are Linked

Mind-Body Connection | 5 Min. Read
Author: Care Tuner Migraine Team
Reviewed by: Ctrl M Health Medical Directors


  • Guilty feelings are nearly universal to people with migraine, who worry they’re letting other people down. Societal stigma plays a role.
  • Over time, those guilty feelings can become internalized and turn into shame — from “I am failing” to “I am a failure.”
  • Shame has a high correlation with depression, addiction, and suicide.
  • Breaking the cycle of guilt and shame involves self-compassion.

Full Article

Another day, another migraine, and with it, another set of last-minute canceled plans. Your dinner out with friends, your cousin’s baby shower, your work deadline. Sorry, I can’t make it, after all. Yet again, you find yourself alone in a dark and quiet room, enduring yet another painful migraine attack — and beating yourself up with migraine guilt for your perceived failings.

Graphic excerpt that reads: “No one with migraine is at fault for their disease or how their migraine and depression are linked. Yet, people with migraine almost universally feel guilt and shame, often because they feel they consistently disappoint others and, worse, disappoint themselves.”

 I feel terrible about missing out.

They’re all disappointed in me.

Why did I have to ruin things again?

Sound familiar? No one with migraine is at fault for their disease or how their migraine and depression are linked. Yet, people with migraine almost universally feel guilt and shame, often because they feel they consistently disappoint others and, worse, disappoint themselves. The fact that our culture doesn’t understand migraine, and thus isn’t very forgiving or sympathetic, just makes those negative feelings worse. Guilt and shame are more than just a downer. If unchecked, they can become destructive.

When Migraine Turns to Guilt & Shame 

A little dose of guilt is meant to be a good thing. Guilt is a corrective signal that our behavior was wrong, and needs to be made right. For example, if you were to accidentally hit a parked car, you’d feel awful. But if you left a note on the windshield with your phone number (and resolved to drive more carefully), your guilty feelings would evaporate.

But what happens when you feel guilt around behavior you can’t change, like migraine? In that case, the unresolved guilt builds with each migraine attack, growing more powerful until it metastasizes into its evil twin––shame. Unlike guilt, which describes how you feel about your actions, shame describes how you feel about yourself. Psychologist Brené Brown, who specializes in the study of vulnerability, defines guilt and shame like this: 

      • Guilt  = “I did something bad.”
      • Shame = “I am bad.”

Consider the world of difference between those two definitions. If guilt says, “I have disappointed someone,” then shame says, “I am the disappointment.” Guilt describes a fixable mistake. Shame says, “I am the mistake.”

Shame is a toxic emotion when dealing with migraine and depression, signaling hopelessness (“This is never going to get better”) or helplessness (“I don’t know how to make things better”) and often both. Little wonder, then, that shame is highly correlated with dangerous disorders like addiction, depression, eating disorders, and suicide.

Breaking the Cycle of Migraine And Depression, Guilt And Shame

Once you know you’re caught in the vicious cycle of guilt and shame, it’s important to break it by showing yourself kindness and compassion.

Recognize your feelings. Know that your frustration, anger, and sadness are valid and real, and you have every right to feel them — they’re just being misdirected at yourself.

    • Try telling yourself: “If I could change my situation, I would. But these are the cards I’ve been dealt, and I’m doing the best I can. I’m allowed to be sad and mad, and I’m going to let myself feel them, but I won’t let myself get stuck there, because that’s not what’s best for me in the long term.”

Compassionate self-talk. If your best friend were in your situation, what would you say to them? What words of encouragement or comfort would you give? Think of your response — and then say it to yourself. Try it, out loud or in your head, and repeat often.

    • Try this: “It’s going to be okay”; “I’m here for you”; “I love you”; “I’d do anything to make this better for you”; “You are wonderful”; “You can always turn to me.”

Quiet the mind. Steer yourself away from negative thoughts about the past or future by focusing on the present moment. Mindfulness practices like meditation or relaxation are brain-training techniques that help clear away the mental clutter that can lead us to believe false and harmful narratives about ourselves.

    • Try this: Set a timer for one minute. Breathe a little slower, and a little deeper, at a comfortable pace for you. Pay full attention to the flow of your breathing. Each time a thought appears in your mind — about literally anything else — notice it, then gently turn your awareness back to your breath. Repeat until the timer goes off.

Push through discomfort into the reward. At first, meeting yourself with compassion feels awkward, overwhelming, even terrifying. We aren’t used to showing ourselves love, and when we finally do, a lot of stuffed-down feelings tend to rise to the surface.

    • Like a soda bottle that’s been shaken up, those negative emotions may at first stream out in full force. That’s no time to force the cap back on! Try not to be frightened by difficult emotions. Emotions are just chemical messengers asking us to pay attention. They can’t harm us if we don’t act on them. They will calm down once you get past that high-pressure gush.
    • A therapist can be an invaluable part of the process by helping you cope with and navigate those feelings in an environment that feels safe and secure.

The burdens of migraine are heavy enough without the added burdens of guilt and shame. Take control by recognizing and gradually ridding yourself of them, and you’ll find yourself that much closer to healing.

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