What’s the Connection Between Stress and Migraines?

Among the many common migraine triggers, stress is perhaps the most well-known.

80% of people who get migraines report that stress can set off these severe headaches.

For most of us, stressful situations are part of everyday life.

So if you experience migraine headaches, it’s helpful to understand the connection between your stressors and migraine.

Then you can take action to try to prevent stress-induced migraines.

This article will explore how stress and migraines are related as well as symptoms of both high stress and migraines.

Then we’ll address how to relieve stress migraines and stress in general.

Plus, we’ll discuss how to know when you should see a medical provider about migraines.

Can Stress Cause Migraines?

Stress is a risk factor for migraine.

But what causes stress and leads to migraines varies from person to person.

How your body processes stress is what makes it likely—or not—to bring on this type of headache.

What the research says

A significant amount of studies validate the link between stress and migraine.

To sum it up:

• Researchers believe that sudden changes in stress levels may lead to biological changes that can lower a person’s tolerance against migraine.

• When stress is higher in the previous year, a person is more likely to experience migraine. Similarly, a migraines may happen after a stressful day. There are some studies that show an association, but there are also some studies that don’t support this association as well. However, even if research shows mixed results, it does not discount your own experience.  In other words, if you notice stress is a trigger for migraines, then we would consider it a trigger.

• Stress—especially chronic stress—can increase the risk of developing chronic migraines.

• Childhood trauma and physical abuse may increase a person’s susceptibility to having migraines.

Symptoms of High Stress

If stress is a trigger, you may be able to prevent migraines or reduce their severity by noticing when you feel stressed.

Then you can take action to decrease your levels of stress.

Symptoms of stress include:

• Nausea
• Reduced or increased appetite
• Muscle tension
• Irritability and mood swings
• Fatigue
• Chest pain
• Increased heart rate
• Feelings of sadness

Symptoms of Migraines

There are four phases of migraine attacks.

Not everyone experiences all four phases.

Also, sometimes phases overlap or happen at the same time, or some phases may happen earlier or later than listed here.

Prodrome phase

The first phase is called the prodrome phase or pre-migraine.

This often occurs a day or two before a migraine.

Some symptoms of stress overlap with symptoms of prodrome, which include:

• Food cravings
• Gastrointestinal changes such as constipation or diarrhea
• Mood swings or low mood
• Sensitivity to light and sound
• Excessive yawning
• Fatigue
• Poor concentration
• Muscle pain
• Increased urge to urinate

Migraine with aura

Around one-quarter of migraine patients experience aura.

It may happen just before, during, or after a migraine attack.

Common symptoms of migraine aura include:

• Flickering lights, bright lines, blind sports, or blurred vision
• Tinnitus (or ringing in your ears), or other noises
• Numbness, tingling, or “pins and needles” feelings
• Extreme sensitivity to light, sound, or scents

Attack phase

The attack phase is when typical migraine pain sets in.

The pain is concentrated on one side of the head and can range from moderate to severe.

It may feel like pulsating, throbbing, stabbing, or pounding.

It tends to worsen with movement, bright light, or loud noises.

Beyond head pain, the attack phase of a migraine may cause nausea, vomiting, or sensitivity to light, sounds, scents, and tastes.

Migraine attacks can last anywhere from a few hours to 3 days.

Postdrome phase

Also called the post-migraine phase, the postdrome phase occurs after head pain has ended, but you don’t feel quite normal yet. Symptoms can include:

• Fatigue
• Dizziness or weakness
• Mood changes
• Decreased concentration

Postdrome may last for a few hours or a few days.

Even though the head pain is gone, be careful to avoid migraine triggers or you may have another migraine.

This is especially true for people who have frequent migraines.

How to Relieve Stress Migraines

Medications, therapies, and lifestyle changes may help relieve stress migraines.

Try one or more of the below and see what works for you.

Different remedies may work at different times.

Medications

The following over-the-counter pain relievers may be effective for migraine:

• Aspirin
• Ibuprofen (Advil, Motrin)
• Acetaminophen (Tylenol)
• Naproxen (Aleve)
• Excedrin (a combination of acetaminophen, aspirin, and caffeine)

If you take any prescription medicines, do not take OTC painkillers unless your doctor has cleared it. 

If OTC pain relief is not strong enough to address your migraine pain, a healthcare provider may prescribe one of the following:

• Triptans (sumatriptan, rizatriptan)
• Dihydroergotamine
• Anti-nausea drugs (chlorpromazine, metoclopramide, or others)

If none of these provide relief, your healthcare provider may prescribe opioids.

In some cases, preventive medicines such as the below may help decrease the number of migraine attacks you experience:

• Anticonvulsants (gabapentin, levetiracetam, pregabalin)
• Antidepressants (amitriptyline, fluoxetine, paroxetine, sertraline, others)
• Beta-blockers (atenolol, metoprolol, propranolol, others)
• CGRP antagonists (erenumab, fremanezumab)
• Calcium channel blockers (diltiazem, nimodipine, verapamil)
• Botox injections

Therapies

Some research finds that stress management therapies may help decrease stress and reduce the frequency and severity of migraine attacks.

These treatments include:

• Biofeedback
• Cognitive behavioral therapy (CBT)
• Meditation
• Yoga

Life-style changes

If you are experiencing high levels of stress or you feel a migraine coming on, the following lifestyle changes may help relieve stress and prevent severe headaches:

• Rest in a dark, quiet room or take a nap
• Get a healthy amount of sleep each night (too much or too little can trigger migraines)
• Exercise or be physically active most days of the week
• Avoid food triggers such as red wine, dairy, MSG, and food additives
• Stay hydrated

Other Tips to Lower Stress

There is no single best way to manage stress.

Just as stress affects each person in different ways, everyone handles this anxiety differently.

Consider the things below.

• Find time to regularly pursue creative activities, hobbies, or fun social activities.
• Set healthy relationship boundaries with family and friends. 
• Ensure that you have work-life balance.
• Find ways to laugh more in your day-to-day life, such as watching funny YouTube videos or attending an improv show.
• Try relaxation techniques such as deep breathing or meditation.

When to See a Doctor for Migraines

Migraines occur because of neurological changes in the brain.

You may only have one, or you may get them frequently.

See a healthcare provider if: 

• You experience a migraine (or what you think is a migraine) for the first time
• You experience frequent headaches or migraines
• OTC pain relievers can’t reduce your migraine pain
• Your headache becomes disabling and prevents you from functioning
• You develop other neurological symptoms

Seek emergency medical care if you start to have trouble speaking or develop weakness on one side of the body.

This can be a sign of a hemiplegic migraine, but it may also be a sign of transient ischemic attack or stroke.

Unless you have been diagnosed with this rare migraine disorder, go to an ER to rule out a medical emergency.

How K Health Can Help

Did you know you can get affordable primary care with the K Health app? Download K Health to check your symptoms, explore conditions and treatments, and if needed text with a provider in minutes. K Health’s AI-powered app is based on 20 years of clinical data.