Good Stress Management is Critical For Migraine – Here’s Why

Laying The Foundation: Not All Stress is Bad

Stress gets a bad rap, but not all stress is bad. Temporary or acute stress can be really helpful. It’s the chronic, unremitting stress that can be detrimental. 

Acute stress associated with working out, an argument with your partner, or a deadline at the end of the week is not going to cause any long-term issues. In contrast, research has shown that chronic stress such as that associated with continuous problems in the home or work environment is associated with a number of physical and mental issues including high blood pressure, obesity, diabetes, addiction, mood disorders, pain, insomnia, lack of energy, changes in appetite, reduced socialization and struggling to focus (1).

How Does Stress Interact With Migraine? 

If you experience migraine, have you ever noticed if your attacks commonly arise after relief from chronic stress? For the vast majority of people living with migraine, stress is the most commonly cited trigger for an attack. For example, may people will have multiple migraine attacks while on vacation when they experience relief from the chronic stress of their job, work or home life. It’s this ‘stress letdown‘ that appears to be the most universal migraine attack trigger.

From a biological perspective, there are numerous ways in which stress may interact with migraine. These interactions could be a product of neurochemical release, hormone response, and other changes related to the physiological stress cascade. Research supports the association between chronic stress and migraine, but the mechanisms remain elusive (2, 3).

The Role of Your Amygdala

Why is this interesting? Well, regardless of whether it’s a looming deadline or a lion standing infant of you, the amygdala is the region of the brain that sets off the alarm bells. It is responsible for warning the rest of the body that a physical or emotional stressor is present and triggering fight-or-flight” mode (5).Thus, a larger amygdala volume in people living with chronic migraine suggests an association between your stress response and migraine attack frequency. People with chronic migraine may have a hyperactive alarm system, which could exacerbate their attack frequency, duration and intensity. 

No Stress, No Migraine?

Unfortunately, no. It’s a two-way street. Data show that migraine attacks amplify stress. For example, people with more than three ‘headache’ days per-month are at a greater risk of anxiety (6). As Becker and Sauro put it, “migraine attacks themselves can act as a stressor, thereby potentially leading to a vicious circle of increasing migraine frequency” (7).

What Does All of This Mean?

It’s likely that the most important factor in the stress–migraine interaction is your responses to stressors, suggesting that having effective stress management skills has the potential to reduce the impact of stressors on your migraine. This in conjunction with successful approaches to mange migraine itself will give you the best chance at living well with migraine.

Tools and Practices for Stress Management:

Preventative/Proactive Approaches:

1. Daily meditation 
2. Mindfulness practices
3. Cognitive behavioral therapy (CBT)
4. Consistent exercise 

Acute Stress Management:

1. Box breathing 
2. Movement 
3. Meditation 
4. Journaling
5. Productive distraction – call a friend or a therapist, watch something funny, etc. 

References

1. https://www.yalemedicine.org/conditions/stress-disorder
2. https://www.tandfonline.com/doi/abs/10.1080/14737175.2022.2041414
3. https://www.sciencedirect.com/science/article/abs/pii/S0306452219304762
4. https://www.medrxiv.org/content/10.1101/2020.08.31.20185397v
5. https://www.health.harvard.edu/staying-healthy/understanding-the-stress-response
6. https://www.nature.com/articles/s41598-021-87352-2
7. https://headachejournal.onlinelibrary.wiley.com/doi/abs/10.1111/j.1526-4610.2009.01486