Migraine Risk after a Stressful Event
If you suffer from migraines following periods of stress, new research can explain why those serious headaches seem to kick in while you’re coming down from that stressful time, rather than during the thick of it. A study published in the journal Neurology finds that people are at a higher risk for migraines on the day after a stressful experience.
It seems counterintuitive that a day of reduced stress would result in a migraine, but study co-author Dawn C. Buse, PhD, director of Behavioral Medicine at the Montefiore Headache Center in New York City, says that one reason for this phenomenon is the loss of protection from hormones triggered by stress. She explains that levels of the stress hormone cortisol increase as part of the body’s sympathetic nervous system response to stress or danger—commonly known as the “fight or flight” response.
“Several things occur in the body, including a rise in cortisol, which is protective against perceiving pain,” Dr. Buse says. “This makes sense in terms of survival in a dangerous situation, when we need to get to safety before we feel pain. After a stressful period has passed, the body returns to a state of normalcy and many of the systems that were activated during the stressful period calm down. This includes a drop in cortisol as well as other stress hormones. This drop could set the stage to initiate a migraine.”
Making sense of migraines. A migraine headache is usually described as intense or throbbing pain concentrated in one part of the head. It’s diagnosed by its intensity, as well as by the frequency of attacks. Dr. Buse explains that migraine is a chronic condition and that some people have a genetic predisposition to migraine attacks. She also notes that there is a wide range of potential triggers that vary from person to person. Women, who are much more likely than men to get migraines, can be particularly vulnerable during their menstrual cycles and the hormonal changes that occur during that time. Other common triggers include certain foods, red wine, weather changes, and, of course, stress.
“Triggers also can be additive, so that a combination of several triggers can push someone over the threshold for a migraine attack,” Dr. Buse says.
Be proactive. While Dr. Buse’s research shows that the “let down” after a stressful episode can raise migraine risk, she doesn’t recommend against engaging in healthy calming behaviors, such as exercise and sufficient sleep, in fear they may lead to a migraine.
However, she advises people who are prone to migraines to engage in activities that help balance the nervous system on a daily basis. Rather than let a stressful experience escalate, learn how to keep your stress levels in check all the time.
“This includes regular practice of relaxation exercises and other stress management techniques, physical activity, proper nutrition, and getting enough sleep on a regular sleep cycle,” Dr. Buse says. “Our advice is to manage the mental and physical response to stress during the stressful situation.”
There is strong scientific evidence to back up several approaches to stress management, including cognitive behavioral therapy (CBT), biofeedback and relaxation therapies, Dr. Buse says. “As an added bonus, these techniques also have demonstrated efficacy for migraine prevention,” she adds.“Some approaches, such as biofeedback and CBT, require the guidance of a mental health care professional. Some, such as diaphragmatic breathing and guided visual imagery, can be practiced individually. They are relatively low cost or no cost, fairly easy to learn, and without side effects. In addition, their benefits outlast the time of treatment. Once learned, they can be practiced practically anywhere at any time for the rest of your life.”
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