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Aaaargh! The Painful Connection Between Stress and Migraine

Stress and migraine often team up to make you miserable.

Can stress cause migraines?

Yep.

It’s not generally clear what causes migraine. But many migraine patients say that stress and anxiety often trigger their migraine attacks.

Not only does stress trigger many people’s migraine symptoms, but stress is also more common among people who live with migraine.

Like, seriously? Give us a break.

Not only can migraine occur during periods of high stress, some people experience migraine in the aftermath of a stressful incident. When you finally let your guard down and relax, the migraine hits.

This phenomenon is known as the migraine let-down effect.

We look at the link between stress and migraine attacks — and how to tell both to f*ck off.

person under sheets recovering from stress migraine header
Juan Moyano/Getty Images

How stress can trigger migraine

Physical or emotional stress can trigger migraine, and patients commonly point the finger at anxiety as a trigger.

In a 2020 survey of 1,990 female university students in Saudi Arabia, 70 percent said stress triggered their headaches. An earlier study put the figure closer to 80 percent.

Research also has shown that stress levels are higher among people with migraine than those who don’t experience migraine. No sh*t. Regular, day-ruining headaches will do that.

People who experience chronic daily migraine are especially likely to see stress as the culprit.

How to know when it’s a stress migraine

It can be pretty tricky to work out the exact cause of your migraine attack, but it can be super helpful for migraine management.

Stress and anxiety are common triggers for migraine. So give yourself a once-over for the common symptoms of both if you feel a migraine attack coming on.

Typical symptoms of stress and anxiety include:

What are the symptoms of stress migraine?

The symptoms of stress migraine tend to be the same as those of migraine from other common causes, like sleep disruption, diet, hormones, dehydration, and allergies. A migraine wearing a different hat is still a migraine.

Common migraine symptoms include:

  • a throbbing headache
  • sensitivity to light and noise
  • nausea
  • vomiting
  • lethargy

What is the difference between stress migraine and stress headaches?

Stress and anxiety can also trigger tension headaches. But tension (or stress) headaches and migraine attacks mess with your head differently.

People typically experience a tension headache as a sense of tightness around the head — like a headband that’s a couple size too small.

Tension headaches tend to be sharp but only mildly to moderately painful. They might also cause tightness and soreness in the shoulders. People usually feel tension headaches in both sides of the head.

A stress migraine may share some of these symptoms. But they’re far more likely to cause debilitating, throbbing, and severe pain. Unlike tension headaches, a stress migraine attack usually presents only on one side of the head.

You might also be able to spot a stress migraine by the symptoms that happen alongside it:

  • nausea
  • being ultra-sensitive to light and sound sensitivity
  • sensory disturbances known as migraine aura

Make it stop: Treatments for stress migraine

The treatment for stress migraine is the same as treatment for other types.

This may include medications like:

  • an over-the-counter (OTC) pain relief cocktail that combines acetaminophen, aspirin, and caffeine like Excedrin Migraine
  • nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen for short-term pain relief
  • triptan drugs that work on serotonin receptors
  • nonmedication interventions to reduce stress, improve hydration and fitness, and improve sleep and diet (some natural remedies can make you feel at least a tiny bit better)

If this doesn’t help or you still really can’t handle the pain, head to your nearest ER. They can administer an infusion of drugs called a migraine cocktail that can provide relief.

Stay the heck away: Prevention

Stress has its uses. It can give you the focus you need to get through a short-term crisis, just as it gave our ancestors the mental focus to escape saber-toothed tigers and other threats.

But chronic stress can take a toll on your physical and mental health, including (but hardly limited to) triggering stress migraine. (Saber-toothed tigers shouldn’t be a chronic issue for you anymore.)

The key to preventing stress migraine is to reduce the amount of stress and anxiety in your life. Seems simple, right? Well, you can’t avoid some stress. But you can still manage how you react to it.

There are proven techniques that can calm your mind and reduce the risk of triggering a stress migraine. And, indeed, the general unpleasantness of stress itself.

How to avoid stress and anxiety triggers

The causes of stress and anxiety differ from person to person. But there are some common triggers including:

Social problems, like conflict in the workplace, discrimination, and living in an unsafe environment can also cause stress.

Traumatic events, like losing a loved one, experiencing physical and sexual assault, or going to war, can also cause profound stress. The stress from catastrophes like these can result in the clinical diagnosis of post-traumatic stress disorder (PTSD).

Seems like stress can hit you from every angle, right? It’s important to take stock of your life and determine the sources of stress you can eliminate, like a bad job or a toxic relationship.

What if I have PTSD?

This isn’t a source of stress you can outrun or dodge.

If you’ve experienced a traumatic event and notice the following symptoms, you need to seek clinical help:

  • intrusive and distressing thoughts, like reliving the event through vivid flashbacks
  • avoiding triggering memories of the event, talking about it, or even thinking about it
  • altered memories, misplaced guilt, or ongoing terror, anger, or shame
  • self-destructive behavior, sudden outbursts, or hypervigilance

You may need to seek therapy or start taking prescribed medications. Speak with a doc ASAP about your next steps.

Keep a headache diary

A headache diary can be an essential tool for recognizing migraine triggers like stress, helping your doctor make the right diagnosis, and making sure that treatment is working.

As well as logging information on stressful events in your life, a headache diary should include:

  • when migraine symptoms occur
  • how often symptoms occur
  • what symptoms occur
  • the type and location of migraine pain
  • how long migraine attacks last
  • which treatment you’ve taken, and whether it worked
  • the medication you take for other conditions
  • what and when you eat
  • vitamins or other health products you take
  • exercise, social, and work activities
  • other possible migraine triggers, such as the weather or pollen count on that day
  • for women, details on the menstrual cycle

Managing your stress

Reduced stress = reduced risk of stress migraine. Simple math. These steps can help you kick stress in the pants (gently):

But the first step toward managing your stress is to recognize when your stress and anxiety levels are elevated.

Signs of stress include:

Relaxation 101

That migraine’s going to haunt you unless you find ways to unwind.

Relaxation exercises to prevent stress migraine

Relaxation exercises can be an effective way to reduce your stress and anxiety and prevent stress migraine. Examples of stress-reducing exercises include:

A breathing exercise to try right now

Pursed lip breathing is one simple focused-breathing exercise that you can use to reduce your stress:

  1. Relax your neck and shoulders.
  2. Keep your mouth closed and inhale slowly through your nose while counting to 2 in your head.
  3. Pucker or purse your lips like you would if you were whistling.
  4. Exhale slowly, blowing air through your pursed lips while you count to 4 in your head.
  5. Repeat for as many times as it takes to relax.

When to see a doctor

If you suspect that stress is behind your migraines, tell your treating physician.

You also should see a doctor about reducing chronic stress and anxiety in your life, particularly if it’s causing noticeable changes in your physical or mental health.

Takeaway

Stress is among the most common suspected triggers of migraine. Symptoms of stress migraine are similar to migraine due to other causes. But they’re different than symptoms of tension headaches or allergy headaches.

Likewise, treatment for stress migraine is identical to treatment for other types of migraine. People with migraine should learn to recognize the signs of stress that can trigger migraine attacks and learn techniques for reducing their stress and anxiety levels.

Professional help is also available for reducing chronic stress.

And a headache journal can help you keep track of your migraine incidents, identify stressors in your life that may be linked to migraine attacks, and help you develop an effective plan for prevention and treatment of stress migraine.

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