Why the “Migraine Personality” is Total Bunk

Why the “Migraine Personality” is Total Bunk

Never heard of the “migraine personality”? Good. But in case you do come across this antiquated psychology, you might want to have some information in your arsenal.

The “migraine personality” was coined in the early 20th century not long after Victorian doctors thought migraine to be a purely psychosomatic phenomenon. Headache researcher Harold G. Wolff believed that people with migraine fell into a certain category of high-strung, perfectionist, anxious worriers and the like.(1) Without much scientific understanding of migraine aside from the dilation of blood vessels, these personality traits became generally understood as the underlying cause of migraine (especially as they were applied to sexually repressed housewives) and the “migraine personality” gained mainstream popularity by mid century.(2) For perspective, keep in mind this was time in the history of neurology when lobotomies were still performed by the thousands in the United States… (i.e. neurologists had a seriously long way to go in understanding how the elusive human brain works).

Fast forward to 2016 and U.S. doctors are receiving less than a day of training on headache disorders in medical school despite migraine being the “sixth highest cause worldwide of years lost due to disability.”(3) Because primary care practitioners and the general public are still so lacking in up-to-date details about migraine, it’s unfortunately not uncommon for people to still fill in the blanks with lingering stereotypes passed down from our parents and grandparents. One of my relatives called them “sick headaches” and declared that her sister was faking the pain. These comments can stay with us, and influence our understanding of migraine unless we have access to more accurate information.

In a 2003 study titled “Personality traits and stress sensitivity in migraine patients” Huber and Henrick found that “The migraine patients […] used coping strategies characterized by the development of physical symptoms, social isolation, and preoccupation with stress. They rated themselves as less calm, less capable of relaxing, and more irritable than did the healthy controls subjects, and they responded more often with internal tension, especially in work and other achievement situations.”(4)

I don’t doubt that the migraine patients reported exactly this. If that same study interviewed a group of people with freshly fractured ankles, I think they would also report more stress and tension than the control group… because pain is stressful! Especially when that pain is frequent or chronic. It can wreak havoc on our lives and cause a whole slew of secondary issues.

The problem with the “migraine personality” does not lie in observations of people with migraine exhibiting higher amounts of stress, tension, anxiety, or depression than the general population. The problem arises when that stress is assumed to be the sole cause of a person’s pain or when the cause of that stress is attributed to an essential part of a patient’s being: namely, their personality. Despite research that shows our personality traits are not fixed and can actually be shift significantly in reaction to our environments and relationships, generally we tend to think of our personalities as a fixed set of characteristics.(5) Many popular “personality tests” reinforce this idea. Believing that our fixed personality has somehow directly caused us pain; that migraine is somehow intrinsically a part of who we are can lead to shame, hopelessness, and self-blame on top of the already difficult mix of emotions involved in living with disabling migraine attacks, and that’s just not helpful.

Stress and anxiety often play a role in migraine as exacerbating factors as well as secondary effects or co-morbidities, and relaxation techniques can be part of a very effective treatment plan. However, reducing migraine to a perceived inherent or unchangeable “personality” or state of “neuroticism” can prevent doctors and patients from looking at the bigger picture, which we now know involves so many factors. It involves stress and tension yes, but it also involves genetics; changes in the brainstem; neurotransmitters going haywire; neuroplasticity; lifestyle factors; diet; socioeconomic status; access to care; co-morbid health issues; a history of abuse or neglect; environmental factors; and the list goes on.

Migraine is a complex disease with a history of sexist assumptions and patient blaming, and we still have long way to go in understanding both the underlying mechanisms and ways to effectively treat the symptoms. These reasons are precisely why it would be so illogical to continue reducing the causes of migraine to anything so simple as a set of personality traits, and why we should simply dismiss the “migraine personality” as a giant stinky load of total bunk.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.
View References
  1. Kempner JL.Not Tonight: Migraine and the Politics of Gender and Health. Chicago and London: The University of Chicago Press; 2014. p.27
  2. Kempner JL.Not Tonight: Migraine and the Politics of Gender and Health. Chicago and London: The University of Chicago Press; 2014.p.34-42
  3. Headache disorders. World Health Organization. http://www.who.int/mediacentre/factsheets/fs277/en/. Accessed August 16, 2016.
  4. Psychopathology Of Migraine And Personality Characteristics - Migraine Comorbidity -.http://www.headachecare.net/migraine/more/55/. Published April 15, 2009. Accessed August 16, 2016.
  5. Popova M. What Is Character? Debunking the Myth of Fixed Personality. Brain Pickings. https://www.brainpickings.org/2012/03/02/character-personality/. Published February 2012. Accessed August 16, 2016.

Comments

View Comments (10)
  • Hendrix12
    1 year ago

    I thought this article might discust some persoalite traits that we had in common as a result of frequent severe pain, and not personality traits that would make us more likely to have migraines. I don’t think there is any correlation between migraines and intelligence. In my case I believe that I am comfortable with being more reclusive. Spending time alone I find that I spend more time reading than most people, and have a tendency toward more introspection , which leads to existential thoughts about life in general., and find I am not happy unless I am working on something that requires a high level of creativity. Time to myself allows me the freedom to do all of these things, which may make me “appear” more intelligent, when meanwhile it has nothing to do with migraine, but more to do with a desire to spend time alone and away from migraine triggers.

  • Glory
    2 years ago

    Wow. Oddly enough, the second I have told any neurologist my kids obviously got inflicted with the “bad genes”, they became much understanding and nonjudgmental. I don’t recall any doctor getting off on the whole migraine brain personality disorder thing. Then, this family line has a ridiculous high incident rate of severe and rare migraine types. I’ve had at least four neurologist doctors who want my brain to study after I die, which is rather morbid.

    What I can add to this discussion… All members of this family test in the gifted/genius range of IQ. Probably most would qualify for at least a shadow Dx of OCD, so driven/perfectionism is probably part of the pattern. So, I do tend to think generics are a big part of the story.

    However, my grandmother would speak of her deceased husband and his “sick” headaches. She was not allowed to have such headaches, since she had to support three children.(Probably double generic whammy here). Now, grandad also had type 4 MS, which muddles the diagnostic picture. My grandfather before his illness was a gifted violinist and cabinetmaker. Can we say OCD yet again?

    My sons both apparently got the bad gene. #1 was early childhood and shrugged it off with medication help after five years or so. #2 was later onset, became chronic around 18, then suffered a TBI after his medications suddenly raised to toxic levels. He now is on disability with all his potential gone. He struggles just day to day.

    Migraine personality? Yea, right. However, there does appear to be some correlation between higher intelligence and migraine difficulties. I haven’t seen any studies linking psychiatric difficulties such as full blown OCD or personality disorders, but I suspect shadow versions are quite prevalent.

  • kd
    2 years ago

    I find the topic an interesting one, but also one where I’d be curious to hear more research (without any judgement related to the results). My son (age 14) has chronic migraines, getting the gene from me, who is on disability for chronic migraines. He has one particularly amazing migraine specialist/neurologist who treats him, and who treats all of the “bad” migraine cases in kids in MN (he has a 6-9 month wait list). Months back he noted how he does seem to see a particular” type” of patient when it comes to serious, chronic migraine cases: driven, highly intelligent and highly functional personalities. In his own words, “I never get dumb patients in here.” His argument was that, yes, going chronic requires a rather perfect storm: genetics, access to quality care for migraines and personality. That, yes, people with the genetics get migraines, but that relaxed, less “driven” personalities rarely go chronic. It’s not that chronic migraine patients are stressed, high strung, etc. people. It’s more that they’re thinkers, highly intelligent, driven, successful people who, yes, are used to constantly using their brains. And yes, all that brain work has an impact. I found his comments interesting because my other son, who also gets migraines, is a very relaxed, not highly driven personality, and he gets a lot less migraines (yes, the reasons are, I’m sure, manifold). But in chronic migraine support groups, the patients DO seem to be highly successful. There is an inordinate amount of masters degrees, high level white collar career professionals in the group… as well as people incredibly well-educated on health issues, as well as topics in general. I haven’t found this group to be terribly reflective of the wider American populace. So maybe that earlier stereotype was picking up on a relationship between highly intelligent, driven/successful women, but mislabeling them as highly strung (i.e. moral attachments to the words) because there was a dislike, at that time, for highly educated, highly intelligent women. I would be curious to see research on the careers of women that transform from episodic to chronic migraines…

  • Anna Eidt author
    2 years ago

    Thanks for the stats Tammy! Certainly a decrease in income and work productivity has correlated with migraine for me.

  • Tammy Rome
    2 years ago

    Actually, the 2014 CaMEO study showed that those with chronic migraine were LESS likely to have advanced degrees and MORE likely to have incomes below $50,000 a year. It is still not know if low SES contributes to the development of chronic migraine or if chronic migraine contributes to low SES. Either way, the sicker we are, the less likely we are to achieve our goals, personality or not.

    Source: http://www.clinicalneurologynews.com/news/conference-news/american-academy-of-neurology/single-view/chronic-migraine-affects-education-employment-and-income/b41269246ad314f80903fcedd8312ad7.html

  • Anna Eidt author
    2 years ago

    KD, these qualities you describe were also associated with migraine (particularly men with migraine) in Victorian times. It may be hard to ever acheive unbiased research on this hypothesis as I assume people who are more highly educated, or driven are people who both have and seek access to care, whereas those with fewer means or motivation might be more likely to go undiagnosed? Whatever the case, I hope science will continue to provide ever better treatment options for your son and all of us! Cheers 🙂

  • Jani8
    2 years ago

    When I was a child, migraines were called sick headaches. I know people (including my Dad) thought I was somehow responsible for my headaches. When I got married, I would often get a migraine when we were entertaining. My husband somehow thought it was my fault. I couldn’t figure out how to fix it. Later, he became very understanding. It was such a gift! He is my main support for my migraines and a lot of other things I have. (You don’t want to know.)

    I have migraine genes on both my Mom’s and Dad’s side. I thought about not having children to pass them down, but did have one fabulous daughter. She does get migraines, but not too often. It is good to know that other people have the same problems (well, not for them). I had no idea until I saw Migraine.com on Facebook. I love reading the articles. It has helped me understand my problems better.

  • Anna Eidt author
    2 years ago

    So glad the articles are helpful for you. We sure do put our heart and soul into them.

    Thanks for sharing so candidly. The children question is so difficult for many of us… Glad to hear your daughter only has them infrequently! And also glad your husband has become more understanding. That support is so, so very important.

    Hope you are having a low pain night 🙂

  • Maureen
    3 years ago

    On the anxious/relaxed scaled scale, I am so good at relaxing, people tease me about when I am going on my next vacation! Once my brother-n-law asked me what my daily stress level was on a scale of 1 to 10, and when I said 8 he said he could not believe that it wasn’t about a 3 or 4. That’s how good at relaxing I am. Even I am totally stressed out by my chronic migraine. And I am totally chill by nature. Sitting around unable to accomplish ANYTHING SUBSTANTIAL on a regular basis is demoralizing even to someone who loves to sit around to and do nothing. The difference is lack of choice or inability. I fake it until I can’t make it, because for fake it til you make it doesn’t heal chronic illness. But it does help me accomplish a few things.

  • Brooke H moderator
    3 years ago

    Hi Maureen,

    Thank you for taking the time to post. It can be hard when others do not perceive our stress level to be accurate to our own inner perception. I’m so sorry you deal with anxiety and stress related to chronic migraine. You’re absolutely not alone – living with chronic illness day in and day out takes its toll. I thought this article on the connection between anxiety and migraine may be of interest to you (if you haven’t seen it already) https://migraine.com/blog/migraine-and-anxiety-a-multi-faceted-relationship/. Please share here anytime and on our Facebook page: https://www.facebook.com/MigraineDotCom/?fref=ts

    Thank you for being a part of the community!

    Best, Brooke (Migraine.com team)

  • Poll