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Wrestling With Self-Criticism and “Shoulds”

I should be writing more. I should keep the kitchen from getting so messy. I should call my mom more often. Some form of “should” is a nearly constant refrain in my mind. Thanks to cyproheptadine, the migraine pain is far less that it used to be. The pain tops out at a four or five most days. But the other symptoms still come on in full force and I still get a migraine almost every day, usually when I am asleep. It is nice to not have to deal with the migraines much — usually I just go back to sleep — but my days are spent in migraine hangover, physically exhausted and mentally foggy.

With the nighttime migraines and subsequent hangovers, I’m pretty useless until at least 4 p.m. Then I start moving about slowly, sometimes I don’t get much better than that, but other days I reach full steam by 6 p.m. or so. I am immensely grateful that the pain is less and that I can often get four or five productive hours in a day. But I have that nagging voice that says, “You’re so much better than you were. Why aren’t you doing more?” I try reminding myself that “better” is far from great, but I still feel like I’m not doing enough.

I see my husband working when he’s in a migraine hangover and question my motivation and work ethic. Then I think about a friend who recently had a migraine all day when she was at work and I wonder why I’m not pushing harder. Reminding myself that they both have episodic migraine is somewhat helpful. I tell myself that having a migraine at least 28 days of every month, no matter how mild, is physically exhausting. Each migraine is a trauma that the body has to recover from and my body barely gets enough time to recover before having another one.

No matter how many reassuring or positive messages I tell myself, I continue to believe my ambition/drive/productivity to be lacking. Meditation has lessened the input from this critical voice, though it won’t be silenced entirely. I am writing this post to try to quiet it down for the day. At least I’ll have answered one of my “shoulds” for today. But I can’t shake the thought that trying to accomplish more only feeds the beast of self-doubt and criticism.

I thought this post would be cathartic, but I’m near tears. If you also have chronic migraine and a not-so-helpful internal voice, I’d like your help. How do you cope with the loss of productivity that accompanies migraine attacks? How do you tame your internal critic?

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.


  • Dawn
    5 years ago

    Kerrie, thank you so much for sharing and in doing so, informing us all we’re not loathsome, lonely trolls who belong under old broken bridges. It’s obvious when reading your post and the responses that we’re intelligent, caring individuals who SHOULD not put ourselves through more pain than we already have to endure. Yet we do because it’s the way we are raised, the rules of society we are taught. We value hard work, contribution, and appearance. Most of us here probably were high achievers before we became chronics and we just can’t accept our new selves. Mostly because we are used to the infuriating frustration of being misunderstood, even by doctors! I once had it all, but I’ve lost so much to chronic migraine, relationships, job, house…yet I blame and torture myself daily. I routinely tell my husband of one year stories of how I used to be, reassuring him that I will be that girl again. And I am a little better, due to a combination of Botox and Cymbalta…so I am grateful as well as hopeful. (Topamax worked once, too!) I am getting a bit more done, but after 13 years, my learned behavior is not much different. To get to the point, I think the SHOULDS can only go away if we accept ourselves as we are now, and unlearn our self-deprecating behavior. If we change our attitude, shouldn’t the people around us respond positively? And if we are at peace with ourselves, happier…shouldn’t we get more checks on our “to do” lists? It sounds so easy for me to say, doesn’t it? I’m going to work at it, as you all have inspired me by letting me know I am not the disgusting lazy slob I thought I was. Thank you all so much. I pray you find relief and peace soon.

  • Lisa J
    5 years ago

    Oh those shoulds! Was just doing this to myself as I reach the end of my tether.

    I said this year I would look at all I do get done…. Must do that…

    All you fabulous migraineurs, carry on warriors!

    Thanks you for commenting on this site, always good to share the pain!!

  • msruff
    5 years ago

    I have the “shoulds” all the time. I see others doing what I want, despite obstacles or an otherwise full schedule, and I wonder why I can’t do that myself. What is it that won’t let me ignore the inner voice and just go ahead and be productive/happy with myself. I have yet to find a good answer – I just blunder along in the hope that one of these days, if I push hard enough, what I want will come to be. Not a very good strategy, if you ask me, but it’s all I have.

  • Anne
    5 years ago

    This is a good one – I completely have the shoulds. I have chronic migraine (last month was a bad one with 16 headache days plus the rest fatigue/dizzy/ect. days), but nowhere near as bad as yours. It’s really hard – I write as well and I find it impossible to write during or after an attack. I think there’s a different area of the brain that creativity accesses, and while I’m able to go to work and tough it out, I couldn’t write to save my life. Even writing this now is hard as it’s the day after a migraine. I don’t know why we have to go through this – I hate not being able to put time into the things that will move my life forward, but for right now, the best I can do is just survive. It sucks and I know people that don’t have a chronic condition can’t understand, but there’s no way to pull yourself up by your bootstraps when your whole physiology is fighting you.

  • Cluster Girl
    7 years ago

    Thank you, Kerrie, for this article! It it indeed a blessing to not only read it, but all of the comments from others. “Should” has long been a word in my personal dictionary…My counselor today asked me why I am a “perfectionist.” how ironic in that I am so disorganized. I have chronic cluster headaches, including one I’ve been dealing with for about the last month…plus I also have a few diagnoses: bipolar 1 and schizoaffective disorder 1 among them. These only increase my feelings of inadequacy and “should have” in my mind. So even aside from my cluster headaches, I am very hard on myself (I’ve been told) and spend a great deal of time worrying, panicking, fearful, and yes, paranoid. It’s just that when I have the clusters, things get worse, and even more skewed. I get confused even more, and I stumble when I walk, so people might think I’ve been drinking. (which I do not) I worry too much what others think about me, and am too sensitive in my feelings…not to mention the PAIN. Oh and I am limited to only 3 pain tablets a week, due to the possibility of liver damage…so if things don’t change soon, it’s off to the ER—again. (where docs mistake my red eye for “pinkeye” and not cluster headaches…) I feel so guilty for not using the crafts and things I’ve bought, to DO something. This is no way to live…I pray for help, more for my emotional problems. With my emotions right, I can handle the physical problems. How ’bout we each pray for each other at a specific time of day, say 5 PM cst. that way we know at that time we’re thinking of each other.

  • tucker
    7 years ago

    Do you see how much company you have? I just had a “should” breakdown a couple weekends ago and totally skipped a meeting (actually I drove to it, sat in the parking lot and cried, then drove around for an hour, went to Target, bought some cards, including some thinking of you cards for some friends and drove home, amazed that no one had called me wondering where I was). My meltdown lasted 3 days before I found a post here about getting help with coping and managed to call my PCP for the name of a counselor. Armed with a name, I felt empowered! Just by making that phone call, I felt like I had admitted I could not do everything by myself. (Funny how the Adult Male and 2 adolescent males in my house are rather useless when it comes to helping….)

    In the weeks since, I have “cleaned” my office, my son’s room and mostly cleaned the 4 “public” rooms for the company that will see our house this weekend. It’s a Sunday school group that rotates houses every month and we have a new family this year. I was hoping to host in November but my husband volunteered us for Oct. I have asked for the kid’s help when appropriate (the office is all my junk) and even tonight, I managed to do the work I was supposed to do weeks ago for that meeting. Oh well. I couldn’t ignore the emails forever.

    The other thing I did was restart my “Things I’ve Accomplished” journal. And guess what? I don’t care if I just managed to wash dishes on a day I have a migraine – it’s going in there! Shoot, I might even classify that as – cleaned kitchen if I’m feeling sassy. And I do it by the week instead of the day so I don’t have to worry that one day might be amazing and one day lame.

    I never have called that counselor – I’ve been too busy! But I have her name and I feel much better inside for the time being. Next week may be a different story. My life is a cluster of illnesses and I have to cope with it as it comes. I still have a running “things to do” notebook just like a grocery list, but this week I don’t feel that pressured about it, even though strangers will see my still pretty cluttered and not so spic and span house in 3 days. The way I see it, I set the bar so they don’t have to be any better than me, right?

  • flojo
    7 years ago

    I can really relate to you article, I have had had migraines for years but over the last year suffered from bouts of cluster migraines, my life has been on virtual hold. My should list has got longer as time has gone on and the nagging guilty voice in my head got louder, but even some family members fuel the guilt , probably because they don’t understand enough about migraines and I let their comments get to me. I know I should do more but can’t .

  • Kerrie Smyres moderator author
    7 years ago

    Thank you all for sharing your stories and advice. You have reminded me that I’m doing the best I can, as is every one of us. It seems that merely wondering if you are lazy and using migraine as an excuse indicates that you are not doing so!

    As with all things migraine, some days are better than others. Your kind words help me hold myself with a little more compassion and keep the feelings of guilt at bay. Again, thank you.


  • Julie
    7 years ago

    Just remember you have to be kind and compassionate to yourself. Look in the mirror and then think of what you would say to another fellow migrainer going through the same exact thing you are going through. You are kind, compassionate, loving and full of all things good. You would give that fellow migrainer you would be looking at face to face the same advice. Now you take that advice you’d give to someone else and apply it to you. We are always worse on ourselves than we are to others. Just be good to yourself and when you have a good day then you can do what needs to be done. Just be sure to not overtax yourself so you don’t pay for it later. Take care

  • Julie
    7 years ago

    Kerri. Thank you for writing this. This hits home for so many. We are all our own worst critics and we are all so hard on ourselves and we should not be. And even those who have spouses or signifigant others or other family members that make it difficult on us then shame on them. We have so much on our plate in just dealing with being so chronically ill all the time and trying to take care of ourselves! And why should we be made to feel guilty for being sick! We should not! It has taken years for me to come to this place of where I can say to myself “I can only do the best I can do when I can do it so there”. And on days when I can do a little more I will. But on days when I can’t I just remind myself that when I feel up to doing more when I feel better I will and I will then tell myself to let it go! It’s not easy at first and it takes a LOT of practice, but being sick takes so much out of you in the 1st place you don’t need to take more energy out by beating yourself up over something you have no control over and something you didn’t ask for. We didn’t ask for this disease. We didn’t ask to be this sick. We don’t have anyone taking care of us around the clock. Most of us are our own caregivers and have to retreat to recover and then when we’re better then we can get back into the day-to-day aspects of life. But beating ourselves up does not solve anything nor make anything better. It tenses you up and adds to the guilt that you should not be feeling. Why should you be guilty? Again, I’m rambling, but it’s taken me years to get to this point. I do the best I can do and when I’m feeling better I pick up where I left off but I make sure I don’t over do it. You have to come to terms with the fact your health is your #1 priority when you are sick and that comes 1st! Then everything else falls into place. It takes time but you will get there.

  • lauren
    7 years ago

    Kerrie, be kind to yourself–you’re all you’ve got (you also have me for the moment but I am no practical help). You speak for all of us–and don’t believe a migraineur who says “Oh, I don’t have that problem.” When my meds work, I face the question–do I do something to enjoy myself (as harmless as going grocery shopping!) or do I face the mess–clean house, sort my mother’s clothes for the Goodwill, anything that tugs emotionally or tires me out. And every time I have to decide–there’s no automatic answer. I have certainly found the book “Simple Abundance” helpful because it was written for frazzled women who need to choose to take care of themselves. And advice comes in teaspoonfuls, a thought a day, so I don’t feel yelled at. Here’s a story: I was teaching Science Writing when the story broke that ulcers were caused by bacteria shaped like corkscrews, not by bad behavior or worrying. Plenty of people got antibiotics and recovered–but who apologized to them for dumping on them all those decades? The dumpers just found somebody else to blame for something that was not their fault. So stand up to the voice of people like that, especially when it’s coming from inside your head. We care–we’re all standing together–Lauren

  • Paula
    7 years ago

    Kerrie, I wish I knew how to deal with it because that is exactly how I feel. I too have daily migraines; it has bee 7 1/2 years now. It is so hard because people who always feel good (like I used to) just can’t understand. It helps to come on a forum like this and know that other people are struggling with the ‘shoulds’. Wish I knew the answer.

  • katkittypro
    7 years ago

    If I knew a way to deal with my own disappointment in myself, I feel my life would be a lot better. Unfortunately I keep beating myself up for not getting in the shower by a certain time or not getting enough done that day or for constantly putting off a task that needed to be done a while ago. I tried counseling, but no matter what the counselor says, I have to convince myself, kind of like an alcoholic has to want to get better in order for the treatment to be effective. My issue is that I think I want to get better, but then I go back to questioning myself; am I just lazy and blaming if on my migraines.

    The only thing that has somewhat helped me is anti-depressants. They help me to not think so negatively about myself and my actions, it lack there of. But, as with most migraine meds, when taken with anti-depressants, requires carful dosage and monitoring, and unfortunately I’ve maxed out on the anti-depressants so that if my dosage was to be increased, the mixture with my migraine meds, would be harmful to my body.

    So in short, I still beat myself up on a daily basis for not doing more.

  • Teszla
    7 years ago

    I wish I could deal with the “shoulds”. The fact is, I beat myself up 5/7 days because I don’t do enough, because I don’t do what I used to do, because I’m a burden to my family, because my house is a mess, because I work 40 hours a week and am exhausted when I come home. I *can’t* take a day off from work because of a migraine, I don’t have enough staff to do that. And yet, according to the questionaires I have filled out previously “you likely don’t have migraine” because of it. I am filled with self loathing so much of the time because of what I *should* do instead of what I do.
    I am crying right now because I feel your pain, it is my pain too.

  • pamelacurtis
    7 years ago
  • terri
    7 years ago

    Someone said something really simple to me a few years ago, but it has made all the difference. Don’t “should” on yourself. Think about it. Either you’re able to do something,or you’re not. Beating yourself up over it, or trying to hold yourself up to somebody else’s standards (or your own impossible ones) is wasting time. You wouldn’t shame a 6 month old for having a wet diaper. All you can do IS all you can do, and all you can do has to be enough.

    That being said, my head hurts, but i’ll get this other thing here done (and break time is over) because i’ll beat myself up if i don’t!

  • Diana-Lee
    7 years ago

    This is a very hard issue for me, too. I’m naturally inclined to shame myself, and living with chronic migraine certainly doesn’t help.

    Something that does help me is to try to focus on the ways I am a good partner and the things I am able to do to contribute to our household. But it’s hard.

  • Heather R
    7 years ago

    After reading all the posts here I am in tears. I forget to look at this site when its really bad but when I do its always an AhHa moment. I am plagued daily with the “shoulds” even having a semi-understanding hubby I know he gets mad sometimes because Im not doing my “part.” I have to remind myself to let go because if I push myself and do the things that he gets pissed about I end up worse. I wish I had a way to do both what needs to be done and what I want to do without hurting so much. My kids help as much as they can but I usually end up re-doing what they tried to get done. Im not sure if anything can help but we all just need to hang in there and do the best we can, keep telling people what we are going through and hope they understand and give us a little slack.

  • Ellen Schnakenberg
    7 years ago

    How do I deal with the loss of productivity?

    I lower my expectations, then I close my eyes.

    At this point in my disease, cleaning the house is a big day for me, and the days I am able to be up and active enough to do it are so far and few between that it is a job that I just get farther and farther behind. Hubs helps, but the honest truth is, I really need help at this point. Closing my eyes to the undone chores that surround me only works to a point. Being a person that really needs to be in surroundings that relax me, this tends to be a snowball down a hill. So, I try hard to remember that I am doing my very best. I am disabled and in constant pain. I am still able to see the joy in my life despite these shortcomings. I am far from perfect, but I am better than I was. I will get there eventually, it just takes time. I guess that makes patience a big part of dealing with this too.

  • elizabethfoster
    7 years ago

    I am there with you. It is very difficult to deal not only with the voice in my head but the crapy comments people make who have no idea what I’m dealing with. The comments that said just a few time can cut deep.
    For instance “have you tried excederen migraine it works for me when I have a bad headache”. Or “what is wrong with your spiritual life? YOU JUST NEED TO GET WRIGHT WITH GOD.”or ” What did you do to end up with that?”. And I just hate when people make comments about the state of my house. Yes I only work part time, I only have two kids, and my husband is great at helping out with dishes but I also spent 25 hrs this week in a fog dizzy or rithing in pain. So no I’m not scrubbing my house I’m going to hula hoop and play with my girls do my yoga because it helps and sleep for 9hrs a night because I want to be with my kids before they grow up and if I slack on treatmemt or sleep it makes thing worse.

    Ok rant over.

    I remind myself, after a bit of a pitty party that there are truly important thing and there are thing that will always need to be done. I have let my house go to being well lived in and clean when it needs it.
    I text my husband with my frustrations and he reminded me that its ok. That he wont let the house get to bad, that this too will pass.
    I vent to my friends and they vent to me and we laugh at the silly thing we think are important and remind ourselves that life is short. Seize the day. Be thankful for what we have. Remember how quick our lives have passed and try to live in the moment when we are in a good moment. To love with all of who we are.
    When I’m stuck in bed because I’m to foggy to do any thing else I listen to an audio book to take me away from the crap because my hearing is first to recover from a migraine and I can down load them for free from my library. Then it is always nice to feel understood and i read articles of others with chronic disorders and I don’t feel so alone.
    I search again, looking for things that I can do and remember that I cant control some trigger. Like the weather.
    I remind myself to re-balance. To pick myself up and go again because I am loved and my life has purpose even when I’m not able to do any more then love
    Thanks. I needed that. It has been a rough week of being sick.

  • alig0118
    7 years ago

    Thank you, thank you, thank you. I’m so glad it’s not just me that feels this way. I too have chronic migraine and choose my family and friends over many things when I feel well. I wish more non migraine sufferers would understand that when a migraine is ‘over’ you still have the fog, the haze, the blah, and everything else from the residual effects of the migraine and medications.
    Keep reminding yourself you are doing the best you can with what you can do. Make a ‘done’ list, I’ve found that helps.
    Good luck and best wishes.

  • marybethrosebrook
    7 years ago

    Thank you for writing this, you put exactly how I feel and how I function into words…I often think of myself as being lazy, feel guilty and reflect on how things used to be ie; clean house, laundry done, groceries in the house, bills paid, etc. things one step forward and two steps back, constantly. On the other hand…what’s more important on a pain free day? Cleaning house or doing something enjoyable? I remind myself that THERE IS A GOOD DAY ON THE WAY!!

  • pooh2you
    7 years ago

    Your post made me feel so much better about myself. Everyday I tell myself that today is the that I will clean the living room or the bathroom or do the dishes. My daughter and I moved into our house a year

    ago and I still have not unpacked everything! The worst part is my mom is always on my case about my house not being clean, why don’t I have pictures hung yet, etc. I c

  • lauren
    7 years ago

    Oh please–hang in there! My Mom has just started losing her memory–and she doesn’t remember telling me I was fat when I was in high school or helpfully cleaning my stove when she came to visit my home because it wasn’t sanitary. How sad that I remember these things and she doesn’t! So I’m learning to forget hurtful comments from ANYBODY as soon as they happen. It’s like your mind getting touched with something dark–rinse it out–it’s not a permanent dye! If my Mom doesn’t have the memory, why should I?
    Here’s some advice if you want some–pick a corner of a room you like and keep it tidy. Let the rest go. Then when you need relief, retreat to the corner! What you can’t do, remove from sight. I tend to put impossible jobs in the middle of the room “to remind myself.” Remind myself OF WHAT? Good bye, I think I’ll go hide the ironing now.

  • kimberlysmith
    7 years ago

    Kerrie thank you for posting this. I almost cried reading it. I to suffer from chronic migraines and get Soooo frustrated with myself and my body for how much time I spend in bed not able to function like a “normal” person. I agree that migraine is a disability, but I only admitted it to myself after suffering for almost 20 years. New if we can only get society to agree and try to understand how we suffer and how it affects our whole body and lives.

  • migrainemama
    7 years ago

    Kerrie- I feel this way everyday. I’m so sorry that you are going through this, please know that your voice helps people like me feel less lonely suffering from chronic migraine. If you ever find a way to push away the ‘shoulds’ for good.. please let me know how!

  • sheri2u2
    7 years ago

    Kerrie your post hit home to me. Every day I’m filled with shoulds. I should be doing more. I should have more energy. I don’t have a migraine at this moment, I should be doing something productive. Thank you from the bottom of my heart for making me feel “normal” from a chronic migrainers point of view. This is as “normal” as I can get right now.

  • Nancy Harris Bonk moderator
    7 years ago

    Kerrie I battle this demon every day. It has only been over the last few weeks, after a very low period, that I have been giving myself a break. I’m not sure what’s happened or how long it will last, but I am actually allowing myself to believe that I am disabled….what a concept! Seems different than accepting it, maybe it is another phase. All I know it has been a very long 16 years in the making. Either way, migraines make life different and difficult.

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