Understanding The Anxiety and Migraines Cycle

Migraines are the ultimate headache, in every sense of the word. Migraine attacks can rob you of a productive day, ruin experiences you’ve looked forward to for weeks or months, and make everyday things like conversations, lights and concentration completely impossible to tolerate. Knowing you’re at risk for them or knowing you have a history of migraines can cause a lot of anxiety. So it’s fair to ask whether anxiety and migraines are connected. 

If you’re a person who experiences migraine headaches and anxiety, you may feel caught in a revolving door with no signs of stopping. You may even have suffered this problem long enough to notice a pattern — a migraine and anxiety cycle, where one causes the other, which makes the first issue worse, and so on. 

That cycle is not just in your head. In fact, it may be in the heads of many anxiety and migraine patients the world over. 

To understand how to identify the pattern (and maybe even interrupt it), we need to go back to basics. So while it certainly may sound like a headache to some, let us walk you through the important facts about migraines first.

So what causes migraines — are they just anxiety headaches? Here are some fast facts from the National Library of Medicine.

Migraines are a genetically-influenced form of headache. In fact, if you have relatives who experience migraines, you’re three times more likely to experience them yourself.​​

Migraines aren't just severe headaches though. They're a symptom of a disease where sensory information like smells and lights cause sharp, throbbing pains.

Those pains can take a variety of forms. Some may feel migraines as a side-of-the-head sharp throbbing, while others experience them all over the head.

Some people experience migraines with auras — sort of warnings that may include flashes of light or other signs that a migraine is coming shortly before the migraine itself starts.

There’s a wide swath of research exploring connections between migraines and generalized anxiety disorder, and it makes one thing abundantly clear: anxiety and stress can trigger migraine headaches. 

A 2017 study looked at nearly 800 patients, assessing their symptoms of anxiety and depression, as well as how often they get chronic migraines. The results told us a few things. First, they showed a stronger relationship between migraine and anxiety than migraines and depression. Second, the research showed that anxiety was associated with a higher frequency of migraine attacks, specifically because people found it difficult not to worry about when their next headache was going to come, and felt powerless to stop them.

The study did not offer any potential explanations for this comorbidity of anxiety and migraines, but suggested that migraines warranted further study as a physical symptom of anxiety.

A 2020 review, meanwhile, looked at the comorbidity between migraines and anxiety. After looking at more than 2,000 pieces of research, the investigators found that there was a high frequency of psychiatric conditions comorbid with migraines. They even went so far as to suggest that properly treating anxiety with medication could potentially reduce the instances of migraines.

Now, triggering a condition and outright causing it to exist are two different things. Anxiety may trigger migraines, but there is no evidence that stress or anxiety can raise your risk factor for migraines from zero to one. 

That said, there’s no denying the clear triggering association here — if you have migraines and are chronically stressed or have an anxiety disorder, you likely experience more frequent headaches than someone who has no stress or anxiety disorders to speak of.

As recently as 2022, research has explored the connections between migraine headaches and the ways in which they can make psychological conditions like anxiety, major depression and other depressive disorders worse. It’s been the case that previous studies have pointed to a potential cause and effect relationship here, but the exact mechanisms haven’t been determined.

One theory for the link between migraine and anxiety is that they might have shared vascular, genetic or nervous causes that can result in both conditions. This would mean that a central cause is actually to blame for both issues. 

Another potential explanation for anxiety due to migraines is simply that the ongoing issues posed by migraines (and warning signs like auras) could be enough to trigger anxious responses themselves — in other words, you could be anxious about having another migraine to the point that it could become a psychiatric disorder.

Unlike the reverse relationship, it’s entirely possible for people with migraine to become anxious where no previous anxiety existed, meaning that migraines could indeed cause anxiety disorders if left untreated.

When it comes to tension-type headaches or chronic migraines, anti-inflammatory medications like ibuprofen, acetaminophen and aspirin are all commonly accepted and effective first-line treatments for the pain itself. Medications called triptans may also be used as a first-line treatment for migraine management. 

Medications for migraine symptoms like nausea and vomiting and preventative medications like dexamethasone are also both options for treatment. And, there are also some medications available for people with migraines who don’t see benefits from the other medications.

Experts also recommend everything from yoga and melatonin to detoxes and exercise to reduce your instances of migraines in a non-pharmacological manner. You might even see benefits from things like cognitive behavioral therapy, if your headaches are related to stress.

As for anxiety itself, there are three things that may help you with your symptoms: medication, therapy and lifestyle changes.

Cognitive behavioral therapy is proven to reduce stress and anxiety, as well as other psychiatric disorders. It does this by teaching you how to reject anxious thoughts and intrusive ways of thinking that can rev up your anxiety symptoms. Over time, practicing CBT can actually reduce symptoms like panic attacks from panic disorder, and can help reduce your instances of migraines.

A variety of anti-anxiety medications exist as well. Off-label antidepressants like selective serotonin reuptake inhibitors (SSRIs) can reduce your mood swings by stabilizing your levels of serotonin, and medications like beta blockers can reduce physical symptoms of anxiety — everything from tremors to sweating.

And as for lifestyle changes, the National Institute of Mental Health recommends you do the following in your daily life:

• Reduce your alcohol consumption

• Stop smoking tobacco entirely

• Reduce your caffeine intake

• Prioritize healthy sleep and combat insomnia

• Make healthy dietary choices

• Get regular exercise

• Knock off the recreational drugs

• Reduce workplace or home stress as much as you can

• Consider de-stressing practices like meditation, journaling, yoga or mindfulness

Above all, though, if anxiety symptoms and/or migraine problems are causing your function to decline and reducing your quality of life, it may be time to involve a professional in your treatment. You’ll certainly need them for prescription medications and therapy, but they’ll also be crucial in helping you chart the best course for your individual needs.

If you’re anxious about headaches or your anxiety is giving you a headache, you may be caught in an unfortunate spiral — one the medical community is still in the process of exploring. The combination of anxiety and migraines can be pretty miserable, and you’ll understandably want to get rid of them both if you can. 

Luckily, both conditions can be well-managed with proper treatment. 

Your role in this is to seek out that treatment. The sooner you get it, the sooner your risks begin to decrease and your quality of life can start to improve. 

Chronic migraines are the sort of thing you want to bring to the attention of your general practitioner or another healthcare provider — someone who can help you look at your lifestyle, habits, genetics and other factors to root out potential solutions. As for anxiety, a mental health professional is a crucial member of your support team. 

If you’re not sure where to find that support, we can help, Our online therapy platform is available 24/7, and our mental health resources are a great place to learn about anxiety, from common symptoms and the ways anxiety can affect your ability to function to the treatment for anxiety that you might want to consider. 

Yes, seeking treatment is a headache, and yes it can cause anxiety. But if you’re reading