How Can Headache Be Related To PTSD?

Evidence suggests that post-traumatic stress disorder (PTSD) and headaches, which commonly occur together, are related. Despite headaches not receiving the same attention as other PTSD-related symptoms, the connection between the two has been strongly supported by research.

According to one study,¹ PTSD often comes with chronic migraines (CM) or chronic tension-type headaches (CTTH). Despite this strong correlation between PTSD and headaches, not many studies have been conducted about the relationship between the two conditions. 

What is PTSD?

Posttraumatic stress disorder² is a psychiatric disorder that may occur in individuals who have experienced a traumatic event, like a car crash, violent encounter, or being physically or sexually abused. 

After a traumatic event, it’s normal to experience fear, sadness, or anxiety, but sometimes those feelings don’t go away. PTSD is characterized by experiencing intrusive memories and thoughts, flashbacks, avoidance of people and places, affect mood, and a wide range of other symptoms.

Although PTSD is not an anxiety disorder, the affected person will often experience anxiety-related symptoms, like hypervigilance, fear, panic, and avoidance of specific situations.

PTSD can be chronic, lasting many years or even a lifetime, if left untreated. Those who suffer from PTSD may notice that certain places or situations trigger memories of the traumatic event, often accompanied by intense physical and emotional reactions. 

What are the symptoms of PTSD?

The symptoms of PTSD are similar to those of many anxiety disorders but include emotions other than just anxiety. People suffering from PTSD often experience shame, intense anger, or flashbacks when they’re triggered, and the triggers can cause them to relive their traumatic experiences. 

Common symptoms of PTSD include:

1. Re-experiencing the traumatic event through intrusive memories, nightmares, or intense physical and emotional reactions when thinking about or being reminded of the trauma.

2. Avoidance and emotional numbing, such as avoiding anything related to the traumatic event, losing interest in activities that used to be fun, or feelings of detachment from friends and family.

3. Hyperarousal symptoms like irritability, issues with sleeping, chronic anxiety, aggressive behavior, or outbursts of anger. 

4. Negative thought patterns like feelings of alienation, isolation, distrust, or difficulty focusing on tasks.

The connection between headaches and PTSD

The connection between PTSD and headaches is complex, though the correlation between the two is undeniable. Research³ has shown a clear link between the two conditions, but no further investigation has been conducted into how they are linked. 

Given headaches and PTSD are both related to an abnormally reactive nervous system, the relationship is understandable. Chronic stress has been found to increase the occurrence of headaches, and those struggling with PTSD are often in a hyper-alert condition.

There may well be another relationship in play between tension in the shoulders and neck, which may also cause headaches.

If you’re experiencing PTSD and chronic headaches, you should speak to a doctor about treatment options. Some medications may help you recover from your PTSD, but a fast-acting treatment may be available for managing your headaches.

How to manage PTSD

PTSD is best managed through a multi-faceted approach, the primary method being psychotherapy. Sometimes called “talk therapy,” psychotherapy involves analyzing the traumatic event or events, what the patient felt, and how they reacted. Occasionally, medications are also used to assist with recovery from or management of PTSD.

Common medications used for PTSD or anxiety include selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), and monoamine oxidase inhibitors (MAOIs). 

These medications lessen the intensity of certain symptoms, thus enabling those afflicted by PTSD to work through their trauma more comfortably. If you suffer from PTSD, discuss medications with your doctor, as they may be an option for you. 

How to manage headaches

There are a few different ways to manage headaches that are associated with PTSD. Over-the-counter pain relief is a great place to start, but you can also try closing your eyes, relaxing, and resting in a comfortable place. This is often an underestimated but effective remedy since PTSD headaches are often associated with increased physical and emotional stress.

Reducing or eliminating caffeine from your diet or getting a shoulder/neck massage can also be effective management techniques, particularly if you think muscle tension could be a factor. 

Drinking more water can also help with dehydration, which can trigger headaches.

The lowdown

PTSD and headaches go hand in hand, but effective treatments are available. A combination of psychotherapy and medication can help you work through PTSD and reduce or eliminate symptoms. In the meantime, headaches can be managed with pain relief, rest, and drinking plenty of water.

Frequently asked questions

How does PTSD cause headaches?

No studies have definitively determined how PTSD causes headaches, but researchers have identified multiple possibilities. One theory is that the association is related to dysfunction of the central monoaminergic system⁴ and the hypothalamic–pituitary–adrenal axis.⁵

These two areas are related to the nervous system, and dysfunction of these areas may occur when a person is in a state of chronic stress, like that caused by PTSD.

Are headaches a symptom of PTSD?

Yes, headaches are a common symptom of PTSD. Up to 69% of PTSD sufferers report PTSD symptoms preceding the onset of a severe headache, suggesting the two are closely related.