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Can Stress Cause Migraines

Medically reviewed by Deena Kuruvilla, MD — By Adrienne Santos-Longhurst — Updated on September 21, 2022Migraine is a neurological condition that can cause a variety of symptoms, including throbbing, pulsing pain on one or both sides of your head. The pain is most often felt around the temples or behind one eye. Pain can last anywhere from hours to days. Other symptoms that can occur during a migraine episode include nausea, vomiting, and sensitivity to light. Migraine is not the same thing as headaches. What causes it isn’t well-understood. But there are known triggers, including stress. According to the American Headache Society, about 4 out of 5 people with migraine report stress as a trigger. Relaxation following a period of high stress has also been identified as a possible trigger for migraine attacks. So, what’s the connection between stress and migraine? We explain the research, symptoms, and coping strategies to get you feeling better, sooner.

What does the research say

Though what exactly causes migraine hasn’t been established, researchers believe they may be caused by changes in the levels of certain chemicals in the brain, such as serotonin. Serotonin helps regulate pain. In one study, about 80% of people with migraine reported that stress is a trigger for their migraine episodes. In addition to the stress itself, some people believe that relaxation after high levels of stress may be a trigger for migraine. Some call this the “let-down” effect. A 2014 study found that people with migraines who experienced a reduction in stress from one day to the next were significantly more likely to have a migraine the next day. If stress is a migraine trigger for you, finding ways to lower your stress is worth the effort. The American Migraine Foundation says reducing stress can reduce your symptoms.

Symptoms of stress and migraines

You might notice symptoms of stress before the symptoms of a migraine episode. Common symptoms of stress include:upset stomachmuscle achesirritabilityfatiguechest painhigh blood pressurefeelings of sadness or depressionlack of interest in your usual activities The symptoms of a migraine can begin a day or two before the actual migraine episode. This is called the promonitory stage or prodrome stage. The symptoms of this stage may include:fatiguefood cravingsmood changesmuscle tendernesslight sensitivityyawning Some people experience migraine with aura, which occurs after the prodrome stage. An aura typically causes vision disturbances. In some people, it can also cause problems with sensation, speech, and movement, such as:seeing flashing lights, bright spots, or shapestingling in the face, arms, or legsdifficulty speakingtemporary loss of vision The third phase of a migraine episode is the headache phase. Symptoms of this phase can last from a few hours to a few days, if left untreated. The severity of symptoms varies from person to person. Symptoms may include:sensitivity to sound and lightincreased sensitivity to smells and touchthrobbing or pulsing head pain, often on one side of your headnauseavomiting The final phase is called the postdrome phase. It can cause mood changes that range from euphoria and feeling very happy to feeling tired and worn out. You may also have pain in the location where the headache was.

How to get relief from migraines caused by stress

Migraine treatments include medications to relieve your symptoms and prevent future attacks. If stress is causing your migraines, finding ways to reduce your stress levels can help prevent future attacks.

Medications

Medications to relieve migraine pain include:over-the-counter (OTC) pain relievers, such as ibuprofen (Advil, Motrin) or acetaminophen (Tylenol)prescription pain relievers, such as naproxentriptans, such as sumatriptan (Imitrex), almotriptan (Axert), and rizatriptan (Maxalt)ergots, which combine ergotamine and caffeine, such as Cafergot and Migergotubrogepant (Ubrelvy), which can be used to treat migraine symptoms during an episoderimegepant (Nurtec ODT), which can be used to prevent migraine episodes or treat the symptoms OTC migraine medications are available that combine acetaminophen, aspirin, and caffeine, such as Excedrin Migraine. However, these can sometimes cause a side effect known as medication overuse headaches or rebound headaches. Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen have been found to increase the risk of gastrointestinal bleeding and ulcers as well as heart attacks. Frequent use isn’t recommended. You may also be given anti-nausea medication if you experience nausea and vomiting with a migraine episode. Corticosteroids are sometimes used with other medications to treat severe migraines. However, these aren’t recommended for frequent use because of side effects. You may be a candidate for preventive medications if:You need to use pain relieving drugs three or more times per week.You don’t get relief from pain-relieving medications.Your attacks make you miss work or social occasions, or otherwise interfere severely with your daily life. Preventive medications are taken regularly, usually every day. Preventative treatment is intended to reduce the frequency, length, and severity of your migraine attacks. If stress is a known trigger for your migraine episodes, your doctor may recommend taking the medication only during times of high stress, such as leading up to a stressful work week or event. Preventive medications include:beta-blockers, such as propranololantidepressants, such as amitriptyline or venlafaxine (Effexor XR)CGRP receptor antagonists, such as rimegepant (Nurtec ODT) or atogepant (Qulipta)anti-seizure medications such as topiramate (Topamax)Botox injections in areas involved with migraine symptoms Calcium channel blockers such as verapamil (Calan, Verelan) are sometimes prescribed for migraine prevention. This is an off-label use, because they are not FDA-approved to treat migraine.

Other treatment options

There are a few things you can do to lower the risk of a migraine episode from stress. These things may also help relieve the symptoms caused by both stress and migraine. Consider the following:Incorporate relaxation exercises into your daily routine, such as yoga and meditation.Rest in a dark room when you feel a migraine episode coming.Get enough sleep, which can be achieved through keeping a consistent bed time each night.Try massage therapy. It can help prevent migraine episodes, reduce cortisol levels, and decrease anxiety, according to an older 2006 study.Exercise more days than not. It can lower stress levels and may help reduce the frequency, intensity, and length of migraine attacks.Consider seeing a therapist who offers cognitive behavioral therapy. This type of psychotherapy may help migraine episodes happen less often, and reduce their impact on your life.Give biofeedback therapy a try. It teaches technques to help you recognize and manage the physical effects of stress. If you’re having trouble dealing with stress and find that stress is a trigger for your migraine episodes, speak to your doctor. They can recommend ways to cope with stress.

The bottom line

If stress is a trigger for your migraine episodes, work to reduce or eliminate the source of your stress. Medications and self-care measures can also help you get relief from symptoms and prevent or reduce the frequency of your migraine attacks.

Article resources

Bae J, et al. (2022). Cognitive behavioral therapy for migraine headache: A systematic review and meta-analysis. https://www.mdpi.com/1648-9144/58/1/44/htmBarber M, et al. (2020). Exercise and migraine prevention: a review of the literature. https://pubmed.ncbi.nlm.nih.gov/32529311/Coxib, et al. (2013). Vascular and upper gastrointestinal effects of non-steroidal anti-inflammatory drugs: Meta-analyses of individual participant data from randomised trials. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)60900-9/fulltextDodick, DW. A phase-by-phase review of migraine pathophysiology. https://headachejournal.onlinelibrary.wiley.com/doi/10.1111/head.13300Headaches. (n.d.). https://adaa.org/understanding-anxiety/related-illnesses/headachesLawler SP, et al. (2006). A randomized, controlled trial of massage therapy as a treatment for migraine. https://academic.oup.com/abm/article/32/1/50/4631717Lew C, et al. (2022). Migraine medications. https://www.ncbi.nlm.nih.gov/books/NBK553159/Lipton RB, et al. (2014). Reduction in perceived stress as a migraine trigger: Testing the “let-down headache” hypothesis. https://n.neurology.org/content/82/16/1395Living well with migraine: Behavior and lifestyle. (n.d.). https://americanheadachesociety.org/wp-content/uploads/2018/05/Behavioral-Infographic_V3_FINAL.pdfMaleki N, et al. (2012). Migraine: Maladaptive brain responses to stress. https://headachejournal.onlinelibrary.wiley.com/doi/10.1111/j.1526-4610.2012.02241.xMigraine. (2021). https://www.womenshealth.gov/a-z-topics/migrainePhysical activity reduces stress. (2021). https://adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/stress/physical-activity-reduces-stRuschel MAP, et al. (2022). Migraine headache. https://www.ncbi.nlm.nih.gov/books/NBK560787/Signs and symptoms of stress. (2022). https://www.mind.org.uk/information-support/types-of-mental-health-problems/stress/signs-and-symptoms-of-stress/Stress and migraine. (2017). https://americanmigrainefoundation.org/understanding-migraine/stress-migraineSwanson SA, et al. (2013). The contribution of stress to the comorbidity of migraine and major depression: Results from a prospective cohort study. https://bmjopen.bmj.com/content/3/3/e002057 Last medically reviewed on September 21, 2022

How we vetted this article

HistoryOur experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Current Version Sep 22, 2022 By Adrienne Santos-Longhurst Edited By John Bassham Medically Reviewed By Deena Kuruvilla, MD Copy Edited By Copy Editors Aug 10, 2020 By Adrienne Santos-Longhurst Edited By Frank Crooks VIEW ALL HISTORY Share this articleMedically reviewed by Deena Kuruvilla, MD — By Adrienne Santos-Longhurst — Updated on September 21, 2022

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