Up to 70% of people who live with migraine say that stress can trigger a painful attack.
Brady Hoffman, a social media influencer, is one of them. "The worst is when I'm in a really high-stress situation for an extended period of time," he says.
For instance, when he's studying for his nursing school finals, "there's so much pressure hanging over your head for multiple exams for a week or two at a time, which can be extremely triggering for me and my migraines," he says. "And then, the stress of thinking about getting a migraine during these times makes me even more stressed out."
Stress has been a trigger for Hoffman since he first started having migraine attacks as a child.
"Obviously, getting older as an adult, the stress has only gotten more impactful and more real," he says. "As a 15-year-old, my stress was my history homework, and now it's life and paying rent."
It's not possible to get rid of all the stress in your life. But "being able to manage your stress helps to decrease the number and severity of your headaches," says Jessica Schultz, MD, a neurologist at Memorial Hermann in Sugar Land, Texas.
What's the Connection Between Stress and Migraine?
Stress sets the stage for migraine a few different ways. When you feel stressed:
Your usual self-care may drop off
"One of the problems with being under more stress is that we stop taking care of ourselves as well as we do when we aren't under stress," Schultz says. For instance, you might feel too overwhelmed to sleep, go for your usual run, or pack a healthy lunch to take to work.
"For some people, these are triggers for migraine, even apart from being under stress," she says.
Your muscles get tense
Feeling stressed activates your body's "fight or flight" system. That includes the release of special stress hormones that cause your muscles to tighten. You might notice it most in your neck and upper shoulders. "This sort of muscle pain and tightness is also a migraine trigger for many [people]," Schultz says.
About 89% of people who live with migraine have neck pain.
Your brain chemistry changes
Experts still need to learn more, but stress, like any migraine trigger, can upset the chemical balance in your brain. "We know that people with migraine have brains that are more sensitive to things like light, smell, and noise," Schultz says. "It's thought that the migraine brain responds differently to stressors as well."
If you're been under stress for a while, you can also get a migraine when it finally ends and you're able to relax. Experts call this a "let-down migraine."
How to Manage Stress to Help Prevent Migraines
Trying to keep your stress level low is a key part of migraine prevention. To do that:
Make self-care a priority
Whether Hoffman's making time to work out at the gym or skipping fast food except as a rare treat, "I just choose to live a pretty healthy lifestyle to try and help combat [migraines] as much as I can," he says.
Try to:
- Drink plenty of water.
- Get enough sleep.
- Find time to exercise.
- Say "no" to things you don't want or need to do.
- Take time for hobbies and activities you like.
- Try not to skip meals.
- Choose healthy foods that are high in protein, as well as plenty of fruits and vegetables.
"Taking time to take care of yourself will actually give you more time to face the stressors that you have to deal with," says Schultz.
Find ways to relax
Different relaxation techniques can help switch your body from "fight or flight" to "rest and digest" mode. That can help slow your heart rate, improve your blood circulation, and loosen tense muscles.
Some techniques that can help with migraines include:
- Meditation
- Breathing exercises
- Yoga
- Biofeedback, which teaches you to control your breathing and heart rate
- Cognitive behavioral therapy (CBT), which helps you change certain thought patterns
- Acceptance and commitment therapy, (ACT), which helps you move toward your goals, even when you have negative thoughts and feelings
There are no right or wrong ways to relax.
"Something as simple as sitting on the couch and watching TV, like my favorite show, really helps me decompress," says Hoffman. (Schitt's Creek, Gossip Girl, and Sex and the City are currently on his watch list.)
Hoffman also relaxes by doomscrolling on his iPad and taking a hot shower or bath. "Anything like that really helps me just calm my brain down and settle down," he says.
Stick with your treatment plan
If your migraine attacks increase because of stress, you may go through your medication faster than usual and switch to over-the-counter products so you can keep functioning. "This is a very easy trap to fall into," says Schultz.
While OTC medications can provide short-term relief, "frequent and repeated use will actually start to trigger headaches," she says. These are called medication overuse, or rebound, headaches.
Let your doctor know when you're going through a stressful time. They can make sure you have enough medication or suggest another treatment that could help.
Coping With Different Types of Stress
How you deal with stress can also depend on the type that you're facing.
Stress you can plan for
This type of stress happens at certain times of year or with events that you can see coming. You know tension's on the way – but you can prepare for it.
"Planning ahead is necessary to be able to get through those times with limited impact from migraine," Schultz says.
For instance, you might set daily goals for sleep and how much water you'll drink every day. Limit your commitments and say "no" when you sense you're getting overwhelmed.
Ongoing stress or stress you can't plan for
Stress can also happen all of a sudden, as with a job layoff. Or it can slowly weave itself into your daily life, as when you're caring for a sick family member.
"During these times, it's important to ask for help," Schultz says.
Talk to others about what you're going through. You can turn to friends, a migraine support group, or a counselor.
"Trying to manage stress so that I don't get migraines is pretty difficult," Hoffman says. "However, I will say that I have a very good support system at home with my family and with my boyfriend, [so] it's honestly not that hard to decompress."
