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A woman with migraine who is hiding her face in her dark blue sweater.
Asger Hee Stjernholm, MSc

How Are Migraine and Stress Connected?

There are many different triggers of migraine attacks. If you’re someone who suffers from migraine, it’s important to be aware of the types of factors that can lead to a migraine attack. This will give you the best chances of preventing attacks, or reduce their intensity. In this article, we will examine one of the most common causes of migraines: stress.

Indeed, the link between migraine and stress is common for many people, mostly because stress is such a persistent factor in our lives. So, if you’re prone to migraine, then stress could lead to regular attacks. However, you can gain control over this common migraine trigger. By making a conscious effort to reduce your stress levels, you may notice a significant reduction in your migraine attacks.

Migraine and stress often go hand in hand

As the Migraine Trust highlights on its website, stress is a common migraine trigger, and the two are “strongly linked”. According to the American Headache Society, 4 out of 5 people report stress as a migraine trigger. So, if you feel that migraine and stress go hand in hand for you, know that you’re not alone. This is a recurring problem for many people.

Stress symptoms to watch out for

In understanding the connection between migraine and stress, it’s crucial to recognise stress when it arises. The usual symptoms of stress include:

  • Muscle tension
  • Irritability
  • Fatigue
  • Upset stomach
  • Chest pain
  • Rapid heart rate
  • Lack of sex drive
  • Sadness and depression
  • Low energy
  • Insomnia
  • Aches and pains

How stress can trigger migraine

One of the intriguing things about the migraine and stress connection is that many people report their migraine attacks beginning when their stress passes. This is sometimes known as weekend migraines. It refers to the experience of having a busy and stressful week at work and then suffering from migraines at the weekend when you’re more relaxed.

A 2014 study published in the journal Neurology found that people with migraine who had a decrease in stress from one day to the next were significantly more likely to suffer a migraine attack the next day. In fact, many researchers believe that relaxation following high levels of stress is a more significant trigger of migraines than the stress itself. This is known as the let-down effect and it occurs with the onset of colds and other conditions too. For example, people will tend to come down with an illness or experience a flare-up of a chronic condition, not when they are severely stressed but after the stress passes. This also seems to occur with migraine attacks.

When you’re stressed, you experience a rise in cortisol and other stress hormones that help to protect you from the perception of pain. But as the psychologist Dawn Buse explains:

“After a stressful period has passed, the body returns to a state of normality and many of the systems that were activated calm down. This includes a drop in cortisol as well as other stress hormones [which could] set the stage to initiate a migraine.”

It is still not precisely clear how stress causes migraine attacks. However, changes in chemicals, such as stress hormones, do appear to play an important role. Researchers also believe that stress-induced changes in the levels of certain neurotransmitters – serotonin being one – can trigger a migraine. This is because serotonin helps to regulate pain.

Reducing stress can help you to manage migraine

If stress is triggering or contributing to your migraine attacks, it’s vital that you take practical steps to reduce stress in your day-to-day life. This will help to prevent future migraine attacks. Try the following:

  • Relaxation techniques and exercises. This can include engaging in a regular type of yoga and/or meditation.
  • Sleep. Ensure that you get adequate and restful sleep. This involves getting 7-8 hours of uninterrupted sleep every night. You can achieve a healthy sleep pattern in a number of ways, such as having a consistent bedtime, avoiding TV/smartphone use for the last hours leading up to bedtime, avoiding late-night meals, caffeine, and alcohol, and ensuring that your room is conducive to a comfortable sleep (e.g. not too hot or cold and sufficiently dark).
  • Massage therapy. This can help to reduce stress levels and, in turn, the likelihood of a migraine attack.
  • Exercise. A routine of exercise is another evidence-based method for reducing stress hormones, which will make you less likely to fall prey to the let-down effect.

Sometimes, lifestyle changes alone are not enough to reduce stress levels and prevent a migraine from occurring. For example, during high periods of stress (such as the lead- up to an important event or a busy week), you may find it difficult to cope. In these instances, your doctor may prescribe a medication to help reduce stress, recommending that you use it only in certain circumstances. This could include beta-blockers or mild tranquilizers.

Conclusion

Many causes of stress are hard to gain control over. We can’t fully resolve the many kinds of stress we experience, whether they are related to our finances, family life, relationships, or work. However, it’s also true that we can make changes to our life that make us feel more at ease and relaxed. This would include setting aside time for regular relaxation and leisure time and trying to be less busy in general.

Moreover, some people are simply more prone to stress, worry, and anxiety than others. If this applies to you, then trying out therapy or counselling for stress could be helpful. Cognitive therapy, for example, is effective for stress management. This form of therapy teaches you to recognise and change negative thought patterns that lead to or worsen stress.

Of course, everyone’s approach to stress reduction will be different. For one individual, playing music is beneficial, whereas, for someone else, it’s martial arts. Experimenting with – and combining – some of the above techniques may serve you best in the long run.

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A woman who is first shown as healthy and then lying in bed with a migraine attack.
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