Anxiety induced migraines
The Link Between Anxiety & Headaches Explained
Written by William Moore
In this Article
- What Is an Anxiety Headache?
- Anxiety Headache Causes
- Types of Anxiety Headaches
- Anxiety Headache Symptoms
- Treatment for Anxiety Headaches
- Anxiety Headache Prevention
What Is an Anxiety Headache?
Anxiety headaches happen along with a feeling of anxiety. Having a headache may make you anxious. Or a headache can be a physical symptom of your anxiety.
Doctors believe the two can be linked, but they don’t understand exactly how.
It may have to do with how the brain works. The cells in your brain that control mood, sleep, and pain use a chemical called serotonin to send messages to each other. When people get migraines, these cells get much more active than normal. That changes your serotonin levels, which may lead to anxiety.
As doctors learn more about how headaches and anxiety affect each other, they can offer better treatments for both. Make sure to tell your doctor about both conditions so you can get the care you need.
Anxiety Headache Causes
Does anxiety cause headaches, or is it the other way around? The answer's not so simple.
Headaches are a common symptom of different types of anxiety, like generalized anxiety disorder (GAD). That's a condition where you constantly worry and find it really hard to control your anxiety. Headaches are one of the signs doctors look for when they check for GAD.
Often, though, it's not clear how to tease apart cause and effect when it comes to anxiety and headaches. It may be that if you're someone who's more likely to get one of those problems, your chances go up that you'll get the other. For example:
- Some folks have a history of migraines before they have GAD or other anxiety issues. Others have anxiety first and develop migraines later.
- People with migraines are more likely to have anxiety and depression. When you have all three, it usually starts with anxiety, then migraines kick in, and then depression shows up.
- For people who don't typically get as many headaches, anxiety increases the odds of getting them more often.
Things that may contribute to anxiety headaches include:
- High sensitivity to pain
- Muscle tension
- Lack of sleep
- Low serotonin levels
- General anxiety disorder
Types of Anxiety Headaches
Doctors don't have a separate name for a stress or anxiety headache. But the most common types of headaches all have a link to anxiety.
Tension headaches. Almost everyone gets one at some point. When you hear people say they have a headache, it's usually this kind. Typically they're not too painful.
Tension doesn't mean stress in this case, but refers to how the headache feels, which may be like a tight band around your head. It can be triggered by anxiety, but it's not clear why this happens.
Migraines. These are more severe headaches that can cause painful pounding or throbbing. They can last for hours or even days. Besides pain, migraines can also make you vomit and feel sensitive to light and noise. They're very common in people who have anxiety disorders.
Cluster headaches. They aren't as common as the other two. They're very intense and tend to give you a burning or piercing pain, usually behind the eyes.
They're called cluster headaches because of how they happen. You might get them a few times a day for a few weeks or months, and then they just go away. They may not come back for months or years.
People with cluster headaches are more likely to have anxiety -- typically in the months of downtime between bouts of headaches. Doctors aren't sure how cluster headaches and anxiety are connected or which one causes the other.
Anxiety Headache Symptoms
Your pain and other signs may differ, depending on which type of anxiety headache you have.
- Mild or moderate pain on either side of your head
- Pain can last hours or days
- Headache doesn’t get worse with physical activity
- Sharp and intense throbbing pain
- Often happens with nausea and sensitivity to light
- Pain may be just on one side, and may be focused on the eye, the back of the head, and other areas
- Headache can last a day or longer
- Extremely severe pain
- Each attack can last 15 minutes to several hours. You can get multiple attacks a day.
- Watery eyes
- Runny nose
- Sweaty face
Treatment for Anxiety Headaches
The first thing to do, if you haven't already, is talk to your doctor. They’ll likely ask about your symptoms and health history. Try to give as much detail about your symptoms as you can.
Your doctor may suggest:
Medicine. Some drugs for anxiety, such as anxiolytics, tricyclic antidepressants, and monoamine oxidase inhibitors (MAOIs), can also treat headaches. If they don't work for you, you may need more than one drug.
You'll have regular checkups to see how well the medicine works for you and to make sure your headaches don't get any worse.
Therapy. You might also get different types of therapy to help with anxiety issues. Cognitive behavioral therapy (CBT) has been shown to be particularly effective for people with anxiety and migraines. It helps you become more aware of your thoughts and behaviors so you can change them to lessen your worry and anxiety. You can often see results within a few months.
Pain relievers. You can start with over-the-counter medications such as aspirin, ibuprofen, or naproxen. Prescription drugs called triptans may help if you have both migraines and tension headaches.
Muscle relaxants.Tizanidine (Zanaflex) may help prevent some tension headaches.
Certain non-medication treatments may help, too.
Biofeedback. You use a machine that relays electrical signals to help you control your muscle movements and breathing to help you relax.
Heating pads. Putting them on your shoulders and neck may help ease tension and keep the headache away.
Acupuncture. Studies suggest that this needle-based therapy can cut the number of headache days as well as make them hurt less.
Often, a combination of therapy and drugs is better than just taking medicine. No matter what treatments you choose, it's important to get care for both headaches and anxiety.
Anxiety Headache Prevention
Lifestyle changes and paying attention to your headache triggers can help avoid them before they start.
- Manage your stress.
- Track your triggers.
- Do exercises that get your heart beating fast.
- Get enough sleep.
- Practice good posture.
Anxiety and Depression Association of
For some people with anxiety disorders, headache pain, sometimes severe, may be all too familiar.
Headaches can be a common symptom — and sometimes a good indicator — of an anxiety disorder, particularly generalized anxiety disorder, or GAD. And chronic co-occurring headaches can make functioning even more difficult for someone with an anxiety disorder.
But you can manage anxiety disorders and such pain to lead a full and productive life.
A migraine is severe pain felt on one or both sides of the head. The pain normally occurs around the temples or behind one eye or ear.
A migraine may also cause nausea and vomiting and sensitivity to light and sound. The pain can last from a few hours to several days. A classic migraine usually causes an aura, or visual symptoms such as flashing lights 10 to 30 minutes before an attack or losing vision. A common migraine may cause nausea, vomiting, or other symptoms, but no aura.
Migraine and Anxiety Disorders
Researchers have suggested that a common predisposition to anxiety disorders, depression, and migraines may exist. Migraines and chronic daily headaches are common in people who suffer from anxiety disorders.
Migraine headaches can precede the onset of mental disorders, according to a 2009 study. Researchers found that 11 percent of participants in the study had migraines and a variety of disorders: major depression, general anxiety disorder (GAD), dysthymia, bipolar disorder, panic attacks, panic disorder, substance abuse disorders, agoraphobia, and simple phobia.
Many studies have found that people with GAD and panic disorder in particular experience migraines or other types of headaches.
And people with a co-occurring anxiety disorder and migraines have an increased likelihood of experiencing major depression; as many as 40% of patients with migraine also experience depression.
New research also suggests that people with chronic and episodic migraine are more likely to have posttraumatic stress disorder (PTSD) than the general population.
Studies show that the occurrences over a lifetime of depression, anxiety disorders, and bipolar disorder are significantly higher in migraine sufferers than in the general population, as are epilepsy and stroke. In those who suffer from major depression and an anxiety disorder, the onset of anxiety usually preceded migraine, but followed major depression.
Special treatment challenges exist for a doctor treating a person with a co-occurring anxiety disorder and chronic headache pain.
A doctor may select a medication because it is effective for an anxiety disorder as well as headache pain, such as some anxiolytics, tricyclic antidepressants, and monoamine oxidase inhibitors (MAOIs). These medications may be used to treat an anxiety disorder alone, too. The doctor will closely monitor any side effects to make sure that the anxiety medication is not making the headaches worse or vice versa.
In addition, research suggests that cognitive-behavioral therapy (CBT) be considered for those who have migraines and PTSD.
KCNK18 gene disorder, stress, alcohol
- >Migraine causes
What are the causes of migraine? Can you predict if your child will have a migraine? Approximately 70% of patients mention the presence of migraine in family members. It is believed that migraine is transmitted genetically, more often through the maternal line. If the mother suffers from migraine, the risk of developing the disease in the child is 72%, if the father is 20%, if both parents, about 90%. In September 2010, a revolutionary discovery was made, the cause of migraine was identified - a gene that is responsible for the development of migraine with aura in some patients. Abnormalities in this gene, called KCNK18, lead to the wrong production of a protein that makes you so sensitive to pain that various external factors can easily activate pain centers in the brain and trigger headache attacks, that is, become the causes of migraines. Perhaps in the future, a drug will be created that can affect this protein and prevent the development of migraine attacks. nine0013
Until recently, the only form of migraine for which a gene was identified was the so-called familial hemiplegic migraine. This is a migraine with a special type of aura, in which paralysis of half of the body develops for several tens of minutes: arms and legs. For all other forms of migraine, specific genes have not been identified.
Therefore, basically, we can talk not about the causes of migraine as such (they are not yet fully known), but about the provocative factors that cause migraine attacks. nine0013
The factors that cause migraine in any given case are called triggers. Some of them can be avoided if you know in advance. Pay attention to what causes a migraine for you.
Alcohol causes migraines
Yes, soft drinks such as champagne and wine can cause migraines. This type of alcohol has a pronounced vasodilating effect, therefore it is a provocateur. Strong alcohol causes migraines much less often, as it does not have this property. Cognac, perhaps, does not dilate blood vessels at all, therefore it is the preferred drink if the situation requires it. nine0013
Food can also cause migraines.
Food causes migraines slightly less frequently than alcohol. The most hostile foods are foods containing tyramine: aged cheese (cheddar), beer, smoked meats. Less common causes of migraine are chocolate, bananas, citrus fruits. A migraine attack can also be triggered by the flavor enhancer monosodium glutamate (E-621).
Caffeine in some cases and in small doses has a weak analgesic and vasoconstrictive effect. However, if you drink a lot of coffee (more than 200 mg per day), then caffeine withdrawal can also cause a migraine attack. nine0013
In our practice, there are cases when, after testing for the most common food allergens, patients completely excluded these foods from their diet. After a while, they noticed that migraine attacks began to disturb them much less often. Worth trying!
Can liquid cause migraines?
Dehydration is also a stress factor for your body and can cause a migraine attack. Try to drink about 1.5 liters of fluid per day. This recommendation is especially relevant in the summer and when playing sports. nine0013
Some medicines, especially those with a vasodilating effect, may cause migraine and headache. Most often this occurs after taking nitroglycerin and dipyridamole (chimes).
Migraine loves regularity and doesn't like sudden changes in your established lifestyle. Any unexpected change is stressful for the body, and stress can be the cause of a migraine.
Migraine cause diet
It's not just what you eat that matters, but how you distribute your food throughout the day. By skipping meals, you provoke the onset of hypoglycemia - a drop in blood glucose levels. Glucose is food for the brain. And if the whole organism as a whole can wait until the reserves of adipose tissue begin to break down, then it is difficult for the brain to wait that long. Therefore, with hunger, the likelihood of a migraine attack increases. Try to eat little, but more often!
Many patients wake up at night with a severe headache. If your attacks happen at night, think about what time you usually have dinner. Often, women wanting to lose weight do not eat after 6 pm. nine0013
Stress is the cause of migraine
Of course, stress is impossible to avoid. But you need to learn to be more resilient to them. Relaxation is always helpful. Master the techniques of yoga, biofeedback (BFB-therapy), consult a psychotherapist to learn how to cope with stress. Typically, a headache (migraine) does not start during an acute situation when you are tense, but more often the next day, when you are tired and exhausted by an unpleasant and traumatic situation.
The specialists of our clinic will be able to teach you any necessary relaxation techniques.
Fitness and migraine
If you suffer from migraine, it is important that you exercise regularly. Try to avoid intense physical activity and a guest visit to a fitness club will not change anything in your physical form, but it can cause a migraine attack.
Finding the cause of your migraine can be a long one. But if you have already experienced what a migraine is, you probably already know: this work is worth the effort. After all, it is likely that you will be able to avoid a large number of migraine attacks. Recently, a study was conducted in the USA, during which patients in one group lived a normal life and simply took painkillers in case of attacks, while in the other group they followed all the above recommendations for lifestyle changes. In the second group, the number of seizures decreased by almost a widow! And this is without special treatment. nine0013
To control migraine it is necessary:
- not to provoke attacks,
- to relieve pain quickly,
- to make attacks less frequent.
Our specialists will help you find the causes of your migraine and cope with it:
Margarita Valentinovna Naprienko
Head Physician, MD, professor, neurologist of the highest category nine0013
Oknin Vladislav Yuryevich
Neurologist, Doctor of Medical Sciences
Ekusheva Evgenia Viktorovna
Latysheva Nina 1
therapist, reflexologist, candidate of medical sciences
Mikhailova Svetlana Anatolyevna
Neurologist, candidate of medical sciences
Typically caused by migraine, the headache lasts 4 to 72 hours and increases in intensity with exercise. Patients suffering from migraine often present with disorders such as depression, anxiety and panic disorders. In migraine-sensitive patients, various factors can cause headaches. Some of the most common factors include certain foods and additives (wine, chocolate, caffeine, cheese), fasting or skipping meals, excessive or insufficient sleep, strong odors, changes in atmospheric pressure, intense light changes (bright flashing), psychological disorders, hormonal changes, menstrual bleeding, medications, and exercise. In about 15% of cases, migraine headache is accompanied by one of the most excruciating phases, called aura, which is a harbinger of migraine, followed by neurological symptoms that last no more than 1 hour. Most often, during the aura, visual disturbances such as the appearance of blind spots, flashes of light or zigzags can be observed, less often there are tingling or numbness in the fingertips, there are difficulty in speech or difficulty in choosing words, hallucinations and other visual disturbances. Paresthesias are the second most common type of aura. With such manifestations, a numbness similar to "crawling" occurs, which unilaterally begins at the fingertips and spreads to the arm and shoulder area, reaches the face, nose and mouth. In addition, although rarely, such symptoms as with an aura can also be observed: impaired speech, hearing and smell, dizziness and hallucinations. Headache usually begins within 5-30 minutes immediately after the onset of the aura. nine0013
Symptoms of classic migraine include loss of vision, weakness, sensory disturbances, and headache that lasts for several minutes. The duration of attacks in classic migraine can be several hours, in common migraine this duration can take several days. Pain may be accompanied by increased sensitivity and anxiety to light and sound. At the same time, symptoms such as abdominal pain and diarrhea may appear in other parts of the body. nine0013
Treatment of migraine, along with medication, also includes the elimination of factors that can cause it. Meanwhile, if migraine pain attacks are observed more than 3 times a month, while their intensity is strong enough and causes neurological disorders and certain inconveniences in everyday life, preventive treatment should be added to the existing treatment.
Arising spontaneously and irregularly, cluster headaches are a pronounced pain syndrome in the areas of the projection of the brain on the walls of the cranium. The causes of this type of headache are still unknown. The intensity of the pain is very high and on average can last for 30 minutes. Most often, pain occurs around the eyes, in the temporal region, behind the ears and around the proximal molars of the lower jaw. The pain usually comes on at night and causes sleep disturbance. The strength of the pain is so great that it can lead to suicide attempts in order to get rid of pain. Vegetative symptoms that characterize cluster headache include hemorrhage of the eyeballs, lacrimation, nasal congestion, runny nose, sweating of the forehead and face, drooping of the eyelids, pupil diminution, and swelling of the eyelids. Unlike patients with migraine, patients with cluster pain prefer to be in well-lit rooms, go outside and take walks instead of being in a dark room. The duration of periods of cluster headache may vary in each patient in different ways. More often they last for 2-3 months. A completely painless, calm period lasts for 6 months to 1 year. Painful periods occur almost every day, sometimes several bouts of pain can occur per day. In 4% of cases, the pain may be bilateral.