A study has revealed that migraines are a common condition affecting 12%¹ of adults in the US, with women getting more frequent attacks² than men.
Further research³ shows that half of the people with migraines experience anxiety. Patients with migraine are five times more likely to get depression⁴ than those who don't suffer from the condition.
So what is the connection between anxiety and migraines?
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Mental health issues and migraines are closely linked. According to Dawn Buse,⁵ Ph.D., an associate professor in the Department of Neurology at Albert Einstein College of Medicine in New York, 20% of people with episodic migraines experience anxiety, and 30% to 50% of those with chronic migraines have anxiety.
Studies⁶ have shown that migraines are likely to impact your quality of life, although doctors still do not fully understand the connection between migraines and anxiety. For some patients, mental health issues such as depression and anxiety occur before they experience migraines. For others, anxiety and depression start after living with migraines.
Scientists have, however, reported a few explanations showing the link between migraines and mental health. One possible explanation is that certain bodily processes could cause migraines.
One such process is linked to levels of the hormone serotonin, which aids communication between nerve cells). Researchers studied 150 Danish families with migraine and found that the condition may be linked to a variation in the genes related to how serotonin levels are managed in the brain.
Another explanation is that you could get migraines when there is a drop in the body's concentration of estrogen. This explains why three times more women⁷ (of childbearing age) get migraines than men.
As the name suggests, anxiety migraines are migraines that occur alongside anxiety. A migraine may make you anxious, or anxiety could trigger a migraine attack. Scientists aren't entirely sure which causes which, but they believe anxiety migraines could be caused by how your brain works.
No term clearly defines anxiety migraines, but most migraines have a link to anxiety.⁸
Migraines are a common symptom of various forms of anxiety, particularly generalized anxiety disorders (GAD). GAD is a condition in which you experience unrealistic worries about different aspects of your life.
Migraine headaches can occur on the left or right side of the head, and the pain can be so severe that it interferes with your daily activities. However, not everyone with migraines experiences head pain. Migraines can progress through four different stages:
Aura (some people experience migraines without aura)
You may notice a few signs that indicate an impending migraine attack a few hours or days before. These include:
Mood changes, from depression to euphoria
Sensitivity to light
During an aura migraine, you may experience the following symptoms before or during a migraine attack:
Numbness on one side of your body
Zigzags in your vision
When a migraine attacks, it could last between a few hours to a few days if you don't seek treatment. During an attack, you may experience the following:
Though migraine pains are frequently one-sided, they may occur anywhere on the head, although some people don’t experience pain
Light and sound sensitivity
Throbbing or pulsating pain
During the postdrome, also known as a migraine hangover, you may experience multiple symptoms such as a stiff neck, fatigue, and difficulty concentrating. These symptoms may signal the end of a migraine attack.
The cause of migraines is currently unknown. However, scientists believe that genetics and environmental factors play a role.
In the past, doctors believed that migraines were due to abnormal brain activity that temporarily affected the nerves, blood vessels, and chemicals in your brain. The exact cause of these abnormalities is still unknown.
Now, however, scientists believe that migraine is a sensory-perceptual disorder,⁹ mainly because sensory systems are altered during a migraine attack. People with migraines are often impacted by sensory overload because of their increased sensitivity to various external stimuli. Doctors also believe that certain things can trigger migraines. These include:
Most people diagnosed with migraines have reported stress to be a key trigger. The high levels of stress and migraine connection occur more in women than in men. Some people experience migraines during regular stressful situations; others experience them after a major stressful event.
If you experience stress frequently, your brain functions will likely change, and the changes will probably continue until the stressful event is over. Whether bad or good, all kinds of stress tend to trigger a migraine if you are prone to them.
Getting enough sleep can help you avoid many diseases, including migraines. Enough sleep will help regulate your immune system, memory, internal organs, and learning abilities. When you don't get enough rest, all these functions are negatively affected, leading to mental and physical complications.
Research¹⁰ has shown a link between lack of sleep and headache disorders such as tension headaches, migraines, and cluster headaches. A systematic review published in The Journal of Headache and Pain¹¹ found that people who experience migraines are also likely to suffer from sleep disorders.
A study published in Neurology¹² found that lack of rapid eye movement (REM) sleep results in more painful migraines. REM sleep, which occurs in intervals of 90–120 minutes, is responsible for memory formation, learning, and mood regulation.
The characteristics of this stage of sleep are:
Increased heart rate
If you suffer from migraines, you may notice you're more prone to developing a migraine attack before or after menstruating. These menstrual migraines are caused by hormonal changes. When progesterone and estrogen levels drop before and during menstruation, the rise and fall of hormones cause blood vessels to constrict, resulting in migraines.
Hormonal changes that occur during menopause result in reduced migraines. Your migraines reduce after menopause largely because estrogen surges stop, and their levels become consistently low.
Serotonin, a neurotransmitter that also acts as a hormone, supports nerve cell communication. Low levels of serotonin dilate your blood vessels which could trigger a migraine.
Serotonin levels affect both men and women. The neurotransmitter influences libido and moods and significantly impacts the constriction of blood vessels.
There are multiple triggers for migraines. It's advisable to make the following changes to prevent a migraine from being triggered:
Lifestyle changes, such as getting enough sleep, regular exercise, avoiding alcohol, reducing stress, and practicing good posture
Take medications to prevent a migraine attack, if appropriate
Be aware of your migraine triggers and avoid them
Recognizing and avoiding your triggers is one of the best ways to protect yourself against migraines. For instance, if you get migraines when you don't get enough sleep, try to improve your sleep hygiene and develop a healthy sleeping pattern. If your migraines are triggered by sensitivity to light, wearing sunglasses can help reduce migraine attacks.
To help you identify your triggers, jot down the following aspects of your migraine attack in a journal:
The day and time it occurred
All the warning signs leading up to the migraine attack
How long it lasted
The symptoms before, during, and after a migraine attack, e.g., headache, aura, nausea, vomiting, light or noise sensitivity
The medication you took, if any
Whether the medication was effective
Tips to help prevent frequent migraine attacks include:
When you notice the onset of a migraine, take the following steps:
Dim or turn off the lights: Light and sound sensitivity often increases with migraines, so sitting or lying down in a dark, quiet place helps
Temperature therapy: Applying cold or hot compresses to specific areas can help prevent a migraine attack
Drink enough water: Dehydration can trigger a migraine. Sometimes drinking enough water can prevent a migraine
Lack of sleep can trigger migraines. Follow these tips for sound sleep:
Get enough sleep: If you take naps during the day, ensure you limit them to less than 30 minutes
Minimize distraction when going to bed: Remove electronics from the bedroom and make sure the bedroom is only for sleeping
Don't force yourself to sleep: The more you try to fall asleep, the harder it will be to drop off
Reduce your caffeine intake: Don't drink caffeinated tea or coffee before bed, and remember that some medicines contain caffeine
As stress is one of the main contributing factors of frequent migraines, it’s important to manage your stress levels to keep migraines at bay. Breathing exercises and practicing mindfulness can help you reduce stress and prevent frequent migraine attacks.
Other stress management techniques include:
Proper time management to avoid getting overwhelmed by overcrowded schedules
Adopting a positive attitude to carry you through challenging times when things aren’t going as planned
Taking breaks, especially when you have a lot to accomplish. A simple break can help take your mind off difficult tasks, giving you room to mentally regroup and find solutions.
Delegate tasks to reduce your workload, if need be. You don’t always have to handle everything on your own.
Preventative medicines and supplements can help you:
Reduce the chances of getting migraines
Make migraine pain less severe (if you have headaches with yours)
Reduce the amount of time that your migraines last
Depending on your symptoms, these treatments can help:
Lifestyle changes such as stress management, eating a balanced diet, getting quality sleep, and exercising regularly
Medications and supplements
Mind–body therapies like cognitive behavioral therapy, massage, and biofeedback
Since there is no cure for migraines yet, symptoms can be managed and treated as soon as they occur. Migraine medicine works by relieving symptoms and preventing more attacks.
There are two types of migraine medication:
Abortive drugs (such as triptans) aim to stop a migraine immediately after it starts, relieving symptoms. One theory is that during a migraine attack, the blood vessels in the brain expand and the surrounding nerves become inflamed and hypersensitive. Abortive drugs work by shrinking the blood vessels and reducing nerve sensitivity, thereby relieving the migraine.
Preventive drugs are recommended if you get migraines regularly or get severe symptoms. Preventive drugs are taken daily because the goal is to reduce the number of migraines you get.
Acupuncture is an ancient Chinese healing practice that involves inserting thin needles into specific areas of the body to stimulate sensory nerves in the muscles. Treatments take an hour, and patients are advised to attend once a week for at least six sessions.
Acupuncture has been shown to reduce the frequency of migraine occurrences for some people by more than 50%.¹³ The treatment can be a safe, long-lasting, and effective treatment for migraines and other headaches if you are finding that other measures are not working for you.
Biofeedback is a mind-body therapy that monitors how your body responds to stress and makes you aware of your body’s response. Stress is a major trigger for migraines, so by better understanding how stress impacts your body, you can manage the symptoms to try and prevent migraines.
Though regular headaches aren't serious, anxiety migraines can be painful and interfere with your daily activities. Understanding the connection between migraines and anxiety, and how they differ from other types of headaches can help you manage and prevent the condition.
In general, seeking anxiety treatment can be one of the best ways to prevent the condition if you have anxiety migraines. Your doctor can also help you manage the effects of migraines, and make a treatment plan tailored to your specific needs.
Migraine | MedlinePlus
The link between migraine, depression and anxiety | American Migraine Foundation
Dawn C. Buse, PhD | Dawnbuse.com
Sleep and headache (2017)
Acupuncture and migraine: Finding a combination that sticks | American Migraine Foundation
Headaches | Anxiety and Depression Association of America
Migraine prodrome: Symptoms and prevention | American Migraine Foundation
Migraine, menopause and HRT | National Migraine Centre
Top 10 migraine triggers and how to deal with them | American Migraine Foundation
Hydration and migraine | Migraine Canada