Is Stress Causing Your Migraines?

Anyone who’s had the unfortunate experience of a migraine knows that they are more than just a headache, progressing through multiple stages of different symptoms, and sometimes lasting multiple days. Although there are effective treatments to relieve the symptoms of migraines when they do occur, it’s preferable to examine and limit any lifestyle and environmental factors that could be leading to the development of your migraines. One such facet of our lives that has a number of knock-on effects on our health is our stress levels, and whilst the ultimate causes of migraines are still being researched, it’s no surprise that high stress is likely to be a contributing factor. In this article, we’ll explore the relationship between stress and migraines, identify some methods to limit these disturbances, and outline effective medication to take if you anticipate a migraine coming on.

What is a Migraine?

A migraine is a common medical condition affecting approximately 20% of women, and 7% of men^[1]. Typically, migraines cause a throbbing headache that in most cases only affect one side of the head, but set themselves apart from regular headaches by also causing nausea and vomiting, as well as visual and other sensory disturbances. They are often characterised by a four-phase progression:

1. Prodrome - appearing one to two days before the “Attack” phase, subtle bodily changes such as frequent yawning, increased thirst, or abnormal food cravings can serve as a precursor to your migraine headaches.
2. Aura - occurring before or during the “Attack” phase, this stage affects the nervous system, most commonly causing visual hallucinations such as seeing flashes of light or bright spots. You may also experience pins and needles in the arms and legs, difficulty speaking, or auditory hallucinations amongst others. Whilst these typically last for a few minutes, they may continue for up to an hour.
3. Attack - also known as the “Pain” phase, this stage is where a throbbing headache will make itself present, you may feel nauseous or vomit, and you will likely be overly sensitive to light, sound, and sometimes other sensory stimuli. Without appropriate treatment, this phase can last for between four days and three days.
4. Post-drome - this last stage differs for everyone, but it’s not uncommon to feel drained and confused after the “Attack” phase, however this stage may well not affect you.

How Does Stress Affect Migraines?

Although the exact causes of migraines remain unknown, many individuals report stress as triggering their frequent migraines. In a study of 1,750 migraine sufferers in 2007, 80% of participants reported stress to trigger their migraines, making it the most commonly recorded trigger^[2].

Interestingly, most people tend not to experience a migraine at the point of increased stress (either physical or emotional) but rather once they’re able to relax after the stressful event. A 2014 study found that whilst increased stress levels didn’t lead to increased migraines occurrences, their perceived decline in stress levels the following day was in line with a spike in reported migraines^[3].

This is due to a phenomenon known as the let-down effect. When encountering periods of acute stress, the body releases various hormones to prepare the body for fight or flight and bolster the immune system. A rise in cortisol, for example, helps protect against the perception of pain, that whilst being practical at the point of stress, can lead to a migraine being initiated once the cortisol levels reduce in the period following. Alongside migraines, this let-down effect from stress is associated with flare-ups of other chronic pain conditions such as arthritis and fibromyalgia, and reactivate viral infections like cold sores from the HSV-1 herpes virus.

Whilst there’s more research to be done in order to fully understand the causal relationship between stress and migraines, the promising early research gives food for thought.

How Do I Reduce Stress and Relieve Migraines?

Regardless of the causal link between stress and migraines, the correlation is undoubted, with painful migraines also resulting in greater stress which in turn can continue the cycle. Establishing healthy habits that support your mental and physical wellbeing will help reduce or even eliminate the daily hassles that contribute to acute stress.

• Improve your sleep quality - with 85% of migraine sufferers experiencing poor sleep quality, putting yourself in the best position to enjoy a full night of quality deep sleep is a must^[4]. We explore this in detail in our guide to sleeping better at night, but some takeaways include establishing regular wake and sleep times to align with your circadian rhythm, and reducing the use of blue and white light emitters like phones and laptops in the run-up to bedtime.
• Protect your time - with time being arguably the most important resource we have, it’s easy for time to run away from us as we spend longer than we’d like on activities that either don’t bring us joy or actively contribute to stress. Break down how you spend your time, what activities you’d like to do more of during the day, week or month, and what activities negatively affect your mental or physical wellbeing. Prioritise your time efficiently, scheduling in periods where you can put your feet up and relax or do something you enjoy, and make sure to protect these valuable blocks of downtime.
• Grow and maintain relationships - since spending time around other people has been shown to reduce our stress levels, you should surround yourself with people you can connect with, especially those who can provide support during a period of intense stress. Being around friends and having a laugh is not only a great relaxation tool and stress reliever, but being able to openly talk through your experiences might help find solutions you may not have considered.
• Avoid unhealthy consumption - whilst it may go without saying, alcohol, smoking caffeine or illicit drugs are not conducive to relieving stress, although many people turn to these when going through a rough patch. Whilst they might appear to offer temporary relief, this avoidance behaviour fails to tackle the actual cause of your stress, damaging your sleep quality and your relationships amongst other variables that may inflate stress levels further.
• Exercise - exercise is recommended for everyone, increasing our overall health and wellbeing, but it comes with some specific benefits for relieving stress. Exercise increases our endorphin production, causing the brain to feel good, as well as being connected to improving mood, confidence, ability to relax, and helping us sleep better.

How Do I Treat a Migraine?

Although having migraines is not a condition that has a known cure, appropriate treatment taken as soon as symptoms occur will significantly reduce the severity and duration of painful symptoms.

• Rest - many people find that sleeping or lying down helps reduce the symptoms, and being in a dark, silent room creates the best environment for removing sensory stimuli that typically aggravates migraine symptoms.
• Over-the-counter pain relief - taken early enough, pain relief such as ibuprofen and Nurofen migraine capsules may help to relieve painful symptoms. However, taking these in the middle of the painful “Attack” phase may not stop the symptoms, and it’s important not to take more than the recommended dose if this is the case.
• Triptans - this family of medications bind to the serotonin receptors in the brain’s blood vessels and nerve endings, narrowing the blood vessels and relieving a migraine headache. Popular and commonly prescribed triptans include Sumatriptan, Rizatriptan, Zolmitriptan and Migraitan. These treatments effectively relieve migraine headaches within 45 minutes and, unlike OTC pain relief, are effective even in the midst of the “Attack” phase.