Why Putting on a Brave Face with Migraine Does More Harm than Good

Many people with migraine feel obliged to “push through” and put on a brave face when having an attack. But does it do more harm than good? Daisy Swaffer, a long-time wearer of “The Brave Face,” certainly thinks so.

Since I developed chronic migraine, there is one thing that has played a massive role in my life. I had no idea it was going to be such a big thing. It's so big, in fact, I encounter it every single day.

It's called “The Brave Face” (TBF).

The Brave Face is a migraine coping mechanism that doesn’t help me cope

The Brave Face in preparation to push through a migraine is something I instinctively do, whether I want to or not. I wish I had more control over it.

You can probably guess by what I've called it, but The Brave Face is exactly what it says on the tin. When I feel dreadful and I'm with other people, I automatically act as though I'm feeling much better than I am.

The Brave Face of migraine haunts me in my conversations too. When I'm talking about my illness, I tend to use it as the butt of my jokes. I laugh about them and downplay the whole thing. I do this to make people feel comfortable, but should that really be my priority?

This is by far one of the most frustrating things I do, and I don't have any control over it. I worry that if I show people how I really feel, they'll think I'm making a big deal out of nothing. After all, wasn’t I just the one downplaying the whole thing? 

So, what else can I do? If I slink off early, I fear the whispers: "but she didn't look sick!"

This is a judgement everyone with an invisible illness has to battle. Many people think that I should be able to push through a migraine because they are "just bad headaches". Sometimes I wonder if people think of my migraines as "one of her headaches". Like I'm some whey-faced mass of petticoats and neuroses from an 18th-century novel.

The Brave Face forces me to hide my symptoms

When I'm in pain, whether it be a "normal" headache or a full-blown migraine attack, I want to hide away from everyone else.

That's when The Brave Face kicks in. It won't let me. Every time I deploy The Brave Face of migraine, it's the price I must pay to spend precious time with people.

It's not just for select people either. My husband has to battle every day to spend some time with me. I don't need to hide my symptoms from my partner, and yet I often do it anyway. If I can feel a migraine coming, the face comes shortly after so that we can finish playing a board game or whatever it is we’re doing.

My face may look perky, but the rest of my body is not. The rest of me is screaming that it wants to be alone, so trying to act normal is very tiring. I do this at work too, although I'm trying to stop.

I'm not alone in this either, not by a long way. In Teva's survey Beyond Migraine, around 43% of 7,500 European migraine patients said they'd hidden migraine symptoms from friends, family or employers.

It's interesting that this number is so high. After all, hiding our symptoms from other people is only hurting ourselves.

The Brave Face and feelings of failure

I think The Brave Face and feelings of failure are interlinked. I have to live with this chronic illness, and I think The Brave Face makes it look from the outside that I'm not failing. I'm healthy, I'm successful, I'm. Just. Like. You...

Except, on the inside, I'm in so much pain. And it's relentless.

When I talk about my migraines, I know it's not a nice topic. There isn't a cure, so it rapidly becomes one of those "no hope" conversations. Instinctively, I want to please the person I'm talking to. I want to entertain them, even though I'm trying to convey serious information about my experience.

So, I make jokes and try to push through the migraine and make the whole thing light-hearted and funny. That's not only for my conversation partner's benefit, though. If I didn't rely on humour, I'd be crying instead. That would be much worse, and not least because crying can make an attack more likely!

I wish I had a choice

I wish I could control when The Brave Face comes out and be honest with people. I wish I could tell someone how I'm feeling without minimising my experience and brushing it under the rug.

I can't help but feel that I'm "part of the problem" when I push through a migraine and further contribute to the stigma and misunderstanding about the condition. It looks easy to cope with this disease when I have The Brave Face on.

It's not easy. But I can’t bring myself to show that.

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© 2023 Life Effects by Teva Pharmaceuticals

The individual(s) who have written and created the content in and whose images appear in this article have been paid by Teva Pharmaceuticals for their contributions. This content represents the opinions of the contributor and does not necessarily reflect those of Teva Pharmaceuticals. Similarly, Teva Pharmaceuticals does not review, control, influence or endorse any content related to the contributor's websites or social media networks. This content is intended for informational and educational purposes and should not be considered medical advice or recommendations. Consult a qualified medical professional for diagnosis and before beginning or changing any treatment regimen​. 

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Date of preparation: August 2023
D: COB-GB-NP-00193 (V1.0) / T: COB-GB-NP-00233 (V1.0) / M: COB-GB-NP-00213 (V1.0)