Why is Stress Such a Common Migraine Trigger?

Why is Stress Such a Common Migraine Trigger?

How to Understand Stress and Migraine

Stress is one of the most common triggers of migraine attacks, so common, many headache specialists call it “the universal trigger.”  Unfortunately, the relationship between migraine and stress is very misunderstood.  Stress may not be the “reason” behind your migraines, but addressing it in a way that works for you can help your migraines as well. 

What Stress Does to Your Body

When your body undergoes stress, a number of changes start to occur.  Your body begins producing stress hormones like cortisol and adrenaline, leading to physiological changes throughout your body.  This includes changes to your blood pressure and heart rate, and this even affects the part of the nervous system that are in charge of your body’s unconscious functions. For this reason, doctors often say, “stress worsens everything.”  If there is an underlying health issue that you are dealing with - from high blood pressure to diabetes to joint pain or headaches - stress will worsen it. 

How Migraine Triggers Work 

Migraine triggers are not like allergic reactions - rather, triggers are things that you are sensitive to that lower your “migraine threshold”.  Triggers make it more likely for migraine to happen at any time, and most people have unique and specific triggers.  Not everyone with migraine is triggered by weather changes, certain foods or hormones, but everyone is triggered by stress.  Stress can lead to prolonged migraine attacks, long stretches with frequent headaches, and may even make you more sensitive to your other triggers. 

What You Can Do About Stress 

Just as stress affects everyone differently - and different things cause stress to different people - the ways to reduce stress will also be unique and different for everyone.  A number of studies have investigated various specific stress-reducing techniques, and those might work well for you.  Starting a practice of meditation can be effective, and there is a specific type of guided meditation called biofeedback that is considered the most effective form of meditation for migraine.  Mindfulness may be helpful as well, but there isn’t one technique that works for everyone. 

A number of other activities may improve your stress.  Exercise is a great stress management tool, and exercise for 30-45 minutes at least three times weekly is a very effective way to reduce migraine, primarily through reducing stress.  Having a great hobby you can spend time doing allows you to de-stress and decompress. For some people, talk therapies, such as cognitive behavioral therapy with a psychologist or therapist, is helpful to manage their stress.  

When Stress Becomes the Major Problem

Stress may become so severe that it impairs what you need to get done on a daily basis.  There are some migraine preventive antidepressant medications that can help both migraine and anxiety.  Your headache specialist might consider choosing one of those medications, or might recommend referring you to a psychiatrist if they think another anti-anxiety medication might be best.  Your headache specialist and psychiatrist can then work together to recommend the best approach for you. 

The individual treatment plan is essential while you try to manage your triggers and work around them. If you'd like to speak with a neurologist about how you can best manage your headache disorder and help improve your stress, join Neura Health today!

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Thomas Berk, MD FAHS
Thomas Berk is Medical Director at Neura Health, where he treats Neura patients via video visit. He is a former Clinical Assistant Professor at the Department of Neurology at NYU Grossman School of Medicine.
About the Author
Thomas Berk, MD FAHS is Medical Director of Neura Health and a neurologist and headache specialist based in New York City. A former Clinical Assistant Professor at the Department of Neurology at NYU Grossman School of Medicine, he has over 12 years of clinical experience. He graduated from the NYU Grossman School of Medicine and completed his neurology residency at NYU as well. He completed a headache fellowship at the Jefferson Headache Center in Philadelphia. He is a Fellow of the American Headache Society and has been on the Super Doctors list of rising stars for the past five years.

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