Stress can be a trigger for migraine headaches. However, everyone has different migraine triggers. Some people have no identifiable triggers at all.

In cases where stress is a trigger, people may notice that this symptom correlates with their migraine episodes. For example, these episodes may increase during stressful times or when stress levels suddenly decline — such as when a person takes time off from work after a busy period.

There is also some speculation that stress or traumatic events may play a role in migraine onset or contribute to the symptoms becoming chronic. However, scientists are not sure whether or how stress directly causes migraine.

This article discusses whether stress causes migraine and considers the role of anxiety. It also explains whether stress can cause chronic migraine and what might help.

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Scientists are not sure why some people develop migraine while others do not. Various factors seem to raise the risk, particularly genetics.

However, longitudinal studies have also found a correlation between early exposure to stress and new migraine onset. For example, a 2019 study in Canada found that people who experienced the following during childhood were more likely to get migraine as adolescents:

  • family dysfunction
  • punitive parenting
  • having a parent or caregiver with symptoms of depression

The same researchers also found that adverse childhood experiences may raise the risk. These include events that can be traumatic, such as abuse or the death of a parent. More research is necessary to understand this link.

For people who already have migraine, stress can be a trigger for their symptoms. It can trigger an episode in several ways.

Stress may trigger migraine symptoms during acute stress. Alternatively, people who are accustomed to stress may experience migraine symptoms when they relax, and their stress levels suddenly drop.

Having migraine can also be stressful in itself. For some people, this may create a cycle of stress and chronic pain.

However, stress is not always a direct trigger. It can also cause symptoms or behavioral changes that result in more frequent episodes. For example, stress can result in a person:

  • getting less sleep
  • eating less regular meals
  • forgetting to take medications
  • consuming more or less caffeine than usual
  • developing muscle tension in the neck, back, or jaw
  • using substances, such as alcohol, to relieve stress

Any of these factors could contribute to more migraine episodes.

It is also worth noting that stress is very common, so it may seem to be a trigger when it is not. Keeping a migraine journal can help someone identify their triggers.

Learn more about migraine triggers.

As with stress, some people find that anxiety can trigger their migraine symptoms.

People can also have anxiety because of migraine. They may worry about when the next episode will occur or feel as though they cannot control their condition.

Stress and anxiety differ in that stress occurs in response to a specific stressor, such as giving a presentation. Anxiety persists even when a person is not in a stressful situation.

However, both cause similar physical symptoms and changes in the body, which may explain why both can be migraine triggers.

Scientists are not sure what the exact relationship between stress and migraine is. A 2021 review of previous studies notes that although there is strong evidence that the two have a connection, it is unclear how they relate to one another.

The researchers suggest that the reason for this is that the processes that cause migraine are highly complex. Additionally, people have different responses to and coping mechanisms for stress, as well as different migraine triggers. This makes the relationship hard to study.

However, stress does cause a cascade of changes in the body that affect hormone levels, the nervous system, and the brain. It is possible that this process makes migraine onset more likely or increases the frequency or severity of symptoms.

It is possible that stress might contribute to episodic migraine becoming chronic, although scientists have not conclusively proven this.

A person has episodic migraine if they have migraine pain on less than 15 days per month. Sometimes, episodic migraine can become chronic, with symptoms occurring on more than 15 days per month. This process is known as chronification.

A 2021 paper explains that the transition from episodic to chronic migraine is complex and often occurs due to multiple factors in people who are genetically susceptible.

The researchers assert that frequent exposure to “unpleasantness” makes this more likely by activating the trigeminovascular pain pathway. This includes the trigeminal nerve, which begins at the ear and has branches extending to the eye, nose, and jaw.

When this pain pathway becomes activated on a regular basis, it makes the pathway more prone to changes, which could lead to chronic pain.

However, it is important to remember that only about 4% of people with migraine go on to develop chronic migraine each year.

If a person has concerns that stress is contributing to their migraine symptoms, they can take steps to reduce or manage it.

Stress reduction

The American Migraine Foundation emphasizes that if stress is a migraine trigger, it is important to look for ways to reduce stressors. This may help reduce symptoms and improve quality of life.

The organization suggests:

  • Prioritizing: A person can try thinking about what tasks are the most important and aim to eliminate any that are unnecessary or stressful.
  • Protecting one’s time: It is important to schedule time for self-care and avoid scheduling too many activities. Where possible, a person can say “no” to events or invitations that will cause stress.
  • Making time for fun and relationships: Connecting with others and having fun help relieve stress and take a person’s mind off the things that are worrying them. Scheduling regular time to spend with loved ones may be beneficial.
  • Communication: It is helpful to learn how to communicate assertively but respectfully, particularly when setting boundaries. This could help with negotiating flexible hours at work or enlisting other family members to take on more of the household chores.

Relaxation therapies

Relaxation therapies aim to “switch off” the body’s stress response, lowering stress levels. Headache experts agree that relaxation therapies can be a useful part of migraine treatment.

Some approaches that people may wish to try include:

Biofeedback

Biofeedback is a therapy that can help with both stress and migraine symptoms. It works by helping people become aware of unconscious bodily functions, such as muscle tensing, breathing, and heart rate. A person can then learn how to control these functions to bring themselves to a calm state.

Learn more about biofeedback therapy.

Anxiety treatment

Anxiety can feel overwhelming, but it is highly treatable. If a person has anxiety, they may wish to seek support.

Talk therapy is an effective treatment for many types of anxiety, and people can choose from numerous types of therapy.

For example, cognitive behavioral therapy (CBT) works by helping someone identify how their thoughts affect their emotions and physical symptoms. A therapist can then teach the person how to change the thoughts and beliefs that are unhelpful.

Medication to reduce the symptoms of anxiety is also an option. However, it is important to note that migraine medications called triptans can interact with anxiety drugs called selective serotonin reuptake inhibitors. Due to this, a person should disclose their current medications to a doctor when discussing treatment options.

Stress and anxiety may trigger migraine symptoms for some people. Other stress-related factors, such as difficulty sleeping, muscle tension, and changes in routine, could also contribute.

Scientists are not sure exactly how stress causes migraine or whether stress could play a role in the onset of the condition. However, it is clear that there is a relationship.

People may find relaxation techniques, biofeedback, or therapy helpful for avoiding this migraine trigger. Anyone who needs support can speak with a migraine specialist about integrating these therapies into a treatment plan.