Taking Control Of Your Pain: Migraine Stress Management

If you have ever experienced a migraine, you know how debilitating this condition can be. Migraines are one of the leading causes of outpatient and ER visits, and 39 million Americans¹ suffer from them.

While scientists are yet to discover what causes migraines, research singles out several common triggers. Almost 70%² of people who face this condition report stress as one of them.

Learning how to reduce stress can help avoid migraines or reduce their intensity. Let's take a closer look at migraine stress management.

Stress and migraines: the link

There is a strong connection between stress and migraines. While more studies are needed, several theories exist.

Hypoglycemia and migraines

When your body experiences stress, it begins producing extra glucose so you can generate more energy and, for example, run away from a tiger.

When the danger passes, the levels of glucose in your blood drop, which can lead to hypoglycemia (low blood sugar). This condition could lead to a migraine, especially in people with diabetes.

Migraines after stress decline

According to the American Headache Society, people don't just report stress as a highly common trigger. They also say that both increases and decreases in stress intensity can trigger migraines. A small study³ showed that a decrease in stress causes a migraine attack the next day.

Researchers report⁴ that during the first six hours after a decline in stress, the risk of migraine onset is five times higher. They believe that the hormone cortisol that spikes when you experience stress could also trigger migraines after acute stress passes.

This confirms the importance of stress management in preventing stress levels from increasing. Even if you manage to reduce stress after it peaks, you're still likely to trigger a migraine.

The link exists 

While more research needs to be done to explain why stress leads to migraines, surveys and studies show that the link exists.

For example, one study⁵ showed that high levels of stress in early childhood led to a higher incidence of migraine in adolescents and adults. Another study⁶ demonstrated that people who experienced abuse as children were more prone to migraines as adults.

A 2019 systematic review⁷ demonstrated that stress is a risk factor for the new onset of chronic migraines. One of the studies showed that major stressful life events a year before could lead to the development of chronic migraines.

A retrospective study⁸ of 1,207 patients demonstrated that stress was the most common trigger (79.7%) for people who suffered from acute migraines.

Symptoms of stress and migraines 

The key to migraine stress management is preventing stress levels from escalating. You can notice symptoms of stress long before the onset of migraine. These symptoms can be physical, emotional, and cognitive.

Physical symptoms:

• Fatigue

• Stomach problems (constipation or diarrhea)

• Aches and pains

• Nausea

• Chest pain

• Rapid heartbeat

• Problems with sex drive

• Cold or sweaty hands and feet

• Dry mouth

• Clenched jaw, grinding teeth

• Panic attack

Emotional and cognitive symptoms:

• Agitation, frustration, and anxiety

• Feeling out of control

• Low self-esteem

• Feeling lonely, worthless, pessimistic, and depressed

• Racing thoughts

• Forgetfulness

• Hindered judgment

When your body faces stress, it releases hormones such as adrenaline and cortisol, which are responsible for the symptoms you experience. The signs of a migraine can surface anywhere from one hour to several days after the stress sets in.

Migraines usually have four stages, each with specific symptoms:

• Prodrome: Fatigue, mood swings, food cravings, thirst, neck stiffness, frequent yawning, nausea, sleep problems, sensitivity to light and sound

• Aura: Numbness and tingling in different parts of the body, vision problems

• Headache: Throbbing, pulsating, debilitating headache; nausea and vomiting; sensitivity to light, odors, and sounds; nasal congestion; anxiety; depression

• Postdrome: Fatigue, mood swings, problems with concentration

The duration of these stages can vary from person to person and from attack to attack. Some people experience migraines without an aura. The full migraine cycle can last from a few hours to several days.

When you have a migraine attack, the stress you experience could cause other problems, such as a tension headache or high blood pressure.⁹

What type of stress triggers migraines?

Any type of stress can trigger a migraine. It doesn't have to be associated with something negative. "Happy" stress can trigger a migraine as well. Anything from losing a loved one to buying a new home can trigger a stressful reaction, which in turn may lead to a migraine.

Perceived stress

You don't need to experience actual symptoms of stress to face a migraine. Studies show that perceived stress is the most common trigger for migraines.

Perceived stress is different from actual stress. Actual stress is your body's reaction to changes in your life that require a response (life events, lack of control, loss of loved ones, too much work). 

These changes are real things you have to deal with.

Perceived stress occurs when you are thinking and worrying about problems such as lack of control, the possible loss of a loved one, or an upcoming work overload. By worrying about something that may or may not happen, you are triggering reactions similar to how your body acts when a problem occurs.

In short, worrying about upcoming stressful situations can also trigger migraines.

How to manage migraines triggered by stress

People who suffer from stress-triggered migraines are losing their quality of life. This disabling condition can pull you out of everyday life for several days. The stress associated with migraine anticipation could lead to anxiety, depression, and more migraines.

Here are a few things you can do to manage this condition.

Contact your doctor 

If your key migraine trigger is stress, make sure to tell your doctor about it. Unfortunately, only 5%¹⁰ of people who suffer from migraines seek professional medical attention.

By diagnosing the problem promptly and working out a course of treatment, it may be possible to prevent, treat, and manage migraines.

Start by contacting a primary care physician. They can help diagnose the problem, rule out underlying conditions, make recommendations, and refer you to a neurologist or, in some cases, a psychiatrist.

Before going to a doctor, write down everything you remember about your migraines, including frequency and symptoms. Consider keeping a migraine journal to see what other triggers apart from stress may be causing your headaches.

Take medication 

According to a review¹¹ of 5.5 million patients, the most common medications used to treat migraines are:

• Triptans: These help treat acute migraines. They can stop the attack and alleviate such symptoms as pain, nausea, and sensitivity to lights, odors, and sounds. They work by stimulating serotonin (a messenger in your brain) to reduce inflammation and constrict blood vessels.

• Pain medication: Simple over-the-counter pain medications such as paracetamol and ibuprofen can relieve some of the pain during the headache phase of the migraine. In rare cases, a doctor may prescribe opioid-based painkillers.

• Anti-emetics: These drugs treat such symptoms as nausea and vomiting. A doctor may prescribe this anti-sickness medication if these symptoms are overwhelming. Anti-emetics also improve the gut absorption of other drugs, such as painkillers. A doctor will recommend taking them at the same time as other migraine medication.

• Anti-epileptic drugs: Studies show¹² that these drugs can help reduce the frequency of migraines. Your doctor may recommend them as a preventive measure.

• Tricyclic antidepressants: These can be effective for migraine prevention. However, they come with several side effects that you should discuss with your doctor.

If you are already experiencing a migraine, over-the-counter NSAIDs (e.g., ibuprofen or naproxen) can help reduce the pain. When your attack is over, contact your doctor for other medication options.

Home remedies 

If you are experiencing a stress-triggered migraine, you could try some home remedies. They can help alleviate some of the symptoms and reduce the stress associated with the attack.

• Apply an ice pack: Applying ice to your head and neck could reduce the intensity of your symptoms. Studies show¹³ that after 25 minutes of cold therapy, many migraine sufferers experience a reduction in headache severity.

• Get some rest: Lying down in a cool, dark, and quiet room can reduce the symptoms of your migraine, especially if the sensitivity to light, odors, and sounds are one of the symptoms. Don't try to rush into daily activities as soon as the headache subsides, as you may worsen the postdrome symptoms.

• Acupuncture: This involves injecting tiny needles into specific areas of your skin. A review of studies¹⁴ showed that acupuncture might decrease the intensity of migraine headaches. In one of these studies, the frequency of headaches in people who tried this method was reduced by 50%.

When the headache stage is in full swing, there is only so much you can do to stop it. However, many effective preventive measures exist. They include:

• Sticking to a regular sleep schedule (going to bed and waking at the same time; sleeping seven to nine hours)

• Keeping a migraine journal to see what triggers besides stress could be preceding your migraines

• Eating at regular intervals

• Exercising regularly

Overall, leading a healthy lifestyle can help prevent migraines.

How to prevent migraines triggered by stress 

The key to preventing a stress-triggered migraine is reducing the amount of stress in your life. Since it's impossible to eliminate stress, you also need to learn how to control it.

Practice yoga 

Yoga is a combination of physical and mental exercises that help reduce stress and anxiety. Studies¹⁵ show that besides being an excellent way to strengthen your muscles and improve flexibility, regular yoga practice can help with stress management.

A 2021 study¹⁶ of 61 migraine patients demonstrated that yoga could also reduce the frequency of migraine headaches.

Try meditation 

While more research is needed, some scientists believe that meditation can inhibit the part of your nervous system that's responsible for stress. By practicing meditation, you may be able to reduce migraine symptoms and prevent stress-induced conditions.

Consider massage

According to the American Massage Therapy Association, massage can help prevent and reduce pain-related migraine symptoms. A small 2006 study¹⁷ confirms this theory and mentions massage as a nonpharmacologic treatment for migraine sufferers.

Regular massage sessions can help you relax, reduce stress, and get extra rest. This can also play a major role in migraine prevention.

Change stressful patterns 

To change stressful patterns in your life, you need to dive deeper into the four A's of stress management:

• Avoid: Avoid any unnecessary stress in your life by saying no, managing your to-do list according to your abilities, and minimizing interaction with people who stress you out.

• Alter: Be ready to change your life to minimize stress. This may involve reviewing your schedule, asking for assistance, and seeking compromises.

• Adapt: If you can't avoid stress, learn to adapt to the stressful situations in your life. To do that, you may want to try cognitive behavior therapy (CBT), which teaches you how to adjust your thinking and behavior.

• Accept: Learn to accept things you can't change because worrying about them simply brings on more stress and triggers headaches.

Learning how to manage stress won't just help with migraine stress management. It can prevent a variety of health conditions,¹⁸ including cancer, ulcer, coronary heart disease, and more.

When to see a doctor 

If you have stress-related migraines, you need to see a doctor. Don't try to treat migraines on your own. Instead of achieving results, you could be making matters worse by increasing the stress intensity.

Don't wait until you can figure out what your common migraine triggers are. Contact your primary care physician and work out a course of treatment.

The lowdown 

Stress is one of the most common migraine triggers. To alleviate stress-related migraine symptoms and prevent the onset of this condition in the future, it's important to contact your doctor.

Migraine stress management involves taking medication, trying to minimize the amount of stress in your life, and learning how to cope with situations you can't avoid.