Your Content Goes Here
Most women with migraine name stress as their number one trigger. But what exactly happens in your body during stressful times, and how does this chain reaction lead to the throbbing headache, sensitivity to light and sound, and other overwhelming symptoms of a migraine attack?
How Your Body Responds to Stress
When you feel stressed, your body switches into “fight or flight” mode, starting a series of changes originally designed to help you face danger. While this response is helpful in truly dangerous situations, it can spell trouble if you’re prone to migraines.
A 2020 study by Buse and colleagues in the Journal of Headache and Pain found that stress activates your body’s stress control center (called the HPA axis), which releases cortisol and other stress hormones. These hormones change blood flow in your brain, cause inflammation, and affect how you process pain—all important factors in migraine (Buse et al., 2020).
What Happens in Your Brain
Recent research shows that stress affects key parts of your brain involved in migraine:
- Nerve Pathways: Stress can trigger the release of pain-causing chemicals from the trigeminal nerve (a major nerve in your face and head), including CGRP, which makes blood vessels expand and become inflamed. A 2019 review by Dodick in Nature Reviews Neurology confirmed this connection (Dodick, 2019).
- Brain Wave Activity: A 2021 review by Charles and Baca published in Nature Reviews Neurology found that stress hormones can make it easier for unusual electrical activity to spread across your brain—this spreading electrical activity is what causes migraine aura (the visual disturbances some women experience before a headache) (Charles & Baca, 2021).
- Pain Sensitivity: A 2018 brain imaging study by Borsook and colleagues published in Neuroscience Letters showed that ongoing stress changes how your brain processes pain signals, potentially making you more sensitive to things that might trigger a migraine (Borsook et al., 2018).
How Stress Affects Brain Chemicals
Stress has a big impact on the chemical messengers in your brain that play important roles in migraine:
Serotonin: A 2022 review by Warfvinge and Edvinsson in Frontiers in Neurology showed that stress can lower your serotonin levels. Since serotonin helps control pain and blood vessel size, having too little may contribute to migraine attacks (Warfvinge & Edvinsson, 2022).
Glutamate: Research from Fried and colleagues (2017) found that stress increases glutamate—a brain chemical that excites nerve cells. Too much glutamate can make your brain cells overactive, which is thought to be a key part of how migraines begin (Headache, 2017).
The “Let-Down” Effect
Surprisingly, many women report getting migraines not during their most stressful moments, but right after the stress ends—this is called the “let-down effect.” A 2018 study by Lipton and colleagues in Neurology confirmed this pattern, finding that migraine risk went up significantly in the 12-24 hours after stress levels dropped (Lipton et al., 2018).
Why does this happen? Researchers believe it’s because stress hormones actually help reduce inflammation while they’re high. When these hormones suddenly drop after a stressful period ends, your body can experience a bounce-back inflammation response that triggers a migraine.
The Stress-Migraine Cycle
A 2020 research review by Peres and colleagues found evidence of a two-way relationship between stress and migraine. Not only does stress trigger migraines, but worrying about getting migraines creates more stress, creating a difficult cycle that’s hard to break (Cephalalgia, 2020).
A 2019 study by Seng and colleagues in Headache also found that women with chronic migraine (15 or more headache days per month) often have more trouble coping with stress compared to those with occasional migraines, which might help explain why some migraines become chronic (Seng et al., 2019).
What This Means for Treatment
Understanding how stress triggers migraines has led to better treatments. A 2021 clinical trial published in JAMA Neurology by Wells and colleagues found that mindfulness-based stress reduction techniques lowered both how often migraines occurred and how bad they were (Wells et al., 2021).
Similarly, a 2020 study by Holroyd and colleagues showed that therapy focused on managing stress (cognitive behavioral therapy or CBT) resulted in significantly fewer migraine days compared to just taking medication (Headache, 2020).
Taking Control
The connection between stress and migraine involves many systems in your body—hormones, nerves, and inflammation. Recent research is helping us understand exactly how stress triggers and worsens migraines, leading to better treatments.
If you suffer from migraines, managing your stress through proven techniques—mindfulness, therapy, regular exercise, and good sleep habits—may be just as important as your migraine medications in reducing how often and how severely you experience attacks.