Early childhood trauma increases migraine risk

Why haven’t I addressed this sooner?

Well, it’s because I’m a chicken.

When the studies were first published earlier this year my gut reaction was raw emotion.  As hard as I tried to keep an open mind, each headline grated on my nerves like fingernails on a chalkboard. I was not thinking like a therapist at all. My initial response was as a migraineur who had been abused by a system that called me weak, fragile, and crazy. Like many of you, I have been subjected to “it’s all in your head”, “learn to relax”, “just take a pill”, and “maybe a therapist could help you work through your issues.” I hated the idea that doctors might start assuming every migraineur who didn’t respond to medication was a victim of abuse in need of therapy. I was afraid that these findings would destroy all our hard work at breaking down stigma.

Unfortunately, mental healthcare has played a role in creating and maintaining stigma about migraine. Having been the victim of that myth more than once, I know what it’s like to have your symptoms dismissed as psychosomatic. When it comes to migraine, I’m not crazy and neither are you. I didn’t want to appear as though I was supporting these outdated notions.

I also worried that by linking migraine with abuse, it would weaken the genetic inheritance theory. Coming from a large extended family in which nearly everyone has migraine, I am emotionally invested in the idea that risk for migraine is genetic. The very idea of an environmental cause for migraine sends me reeling.


I finally realized that I was engaged in all-or-nothing-thinking. Why couldn’t migraine have both genetic and environmental causes?  A lot of other diseases do. I had to get past my own faulty thinking long enough to understand the study results. I knew that once I understood the results, I could explain it to you. Now I think I’m finally ready.

An overview of the facts

To view all migraineurs as victims of early childhood trauma would be a mistake.  Anyone who tries to tell you the studies support this is wrong. The number of subjects in the study who disclosed early childhood trauma made up less than 25% of all migraineurs studied.

Just because you experienced early childhood trauma doesn’t mean that is the only reason you now have migraines. It also doesn’t mean that your migraines are caused by mental illness.  What it does mean is that those early childhood experiences may have changed the way your brain works.

If one in four migraineurs has a history of early childhood trauma, it stands to reason that some pediatric migraineurs may still be experiencing trauma, abuse, or neglect. Identifying those vulnerable kids, getting them to safety, and starting the right treatments may reduce their risk for lifetime chronic migraine.

What is early childhood trauma?

Most of you are probably thinking about child abuse. Any type of physical, emotional, verbal, or sexual abuse could certainly count as early childhood trauma. Neglect in all its forms applies as well. Several studies on the impact of early childhood trauma were conducted using subjects from orphanages where they were subjected to hours of isolation and lack of human contact. Their physical needs were met, but not their emotional needs and they still showed changes in their brain structure.

It also includes experiences most of us wouldn’t consider abuse at all. Imagine the impact of any of these on a young child: house fire, flood, earthquake, tsunami, war, famine, tornado, hurricane, and so much more. Young children who lived through Hurricane Katrina in New Orleans are perfect examples of early childhood trauma that is not abuse. Almost any disaster or traumatic event you can think of will have a greater impact on the developing brain of a young child. Even serious childhood illness can be traumatic. To ignore non-abuse trauma is a mistake.

The effects of trauma are cumulative. A young child who experiences a single traumatic event (i.e. a house fire) will be less affected than one who is exposed to a chronic cycle of neglect, abuse, and tragedy.

Why does it matter?

Children younger than 5 years lack the developmental ability to process emotions or cope with traumatic events. The child’s brain is able to sense threatening stimuli but not able to modulate the severity of the threat. Small children watch the response of their primary caregivers to determine the risk. In the absence of healthy caregiving, a child is unable to develop healthy responses to stress.

From age 15 months to 5 years certain structures of the brain that are responsible for the “fight or flight” instinct are most vulnerable to permanent damage. They develop smaller in size, more reactive to stress, and less resilient.  Other brain structures are vulnerable at different times during child development, but none have the same far-reaching impact as damage done in the first five years.

All forms of trauma affect all ages. It’s just that early childhood trauma has the potential to alter brain structure and function in such as way as to make the child vulnerable to both psychological and physiological disorders for a lifetime. Trauma can alter a person’s DNA to make them more vulnerable to certain physiological disorders later in life. We now know that migraine is one of those diseases.

How trauma affects the brain

Early childhood trauma produces long-term changes in the way the “fight or flight” response works. Essentially, trauma causes this instinct to kick in more frequently even when the person isn’t in mortal danger. It sets a person up for a chronic state of alert and elevated stress hormones. This abnormal functioning of “fight or flight” as well as high levels of stress hormones have also been observed in patients with chronic migraine.

That’s not to say that everyone with chronic migraine was also a victim of childhood trauma. Remember, less than 25% of all migraineurs in the study reported a trauma history. What it does tell us is that for patients with a history of early childhood trauma, the risk of chronic migraine is higher. Imagine if your doctor knew at the very first appointment that your stress hormones were high and your brain’s fight or flight response was hypersensitive. What if that doctor also had therapies available to retrain the brain and repair some of that damage? That is the point of this research.

There are other effects of early childhood trauma that may also impact the risk of migraine. Chronic trauma can permanently alter your brain’s ability to process several brain chemicals implicated in the migraine process.

Early childhood trauma also increases inflammatory chemicals. These have been linked to a variety of chronic pain conditions. When tested, migraineurs show an abnormally high baseline for inflammatory chemicals and an increase of these same chemicals during an attack.

Even genetics can be altered by early childhood trauma. Certain genes make people more likely to react badly to trauma.  If a child has this particular vulnerability, then they are more likely to suffer long-term changes to their brain as a result of trauma. There are also genes that make people more resilient to trauma. Severe, chronic trauma can even alter DNA.

What can be done about it?

Obviously, working to prevent early childhood trauma is essential. It is also critical to provide tools to those who work with children to identify at-risk kids and offer early interventions to mitigate the damage from trauma. Once these children have been identified, health care providers can educate parents and the child about the long-term health risks of early childhood trauma.

With regard to migraine, doctors can begin to screen migraineurs for a history of early childhood trauma and develop treatment protocols that are tailored to meet the needs of this migraine population subset. Maybe anti-depressants are chosen as first-line treatments. Maybe these patients are offered behavioral treatments designed to offset the damage done by trauma early in treatment instead of as a last resort when medications fail. Who knows what will work unless we try?

So what if I do have a history of early childhood trauma?

The research is still new. There will be a lot of trial and error before treatment protocols will be well-established. If you have a good headache specialist, you may try starting a dialogue with your doctor about these studies and how they might impact your treatment. You can also take steps yourself to add therapies that actually retrain the brain’s stress response.

Maybe you’ve tried therapy before without any change in your migraine frequency or severity. That’s certainly possible…especially since very few therapies designed to treat trauma are also designed to repair the brain. To get the best chance of success, look for a therapist who specializes in treating chronic pain. They will often use very specific therapies that may include: CBT, Behavior Modification, DBT, EFT, or EMDR. To learn more about these treatment options, see Treating migraine with talk therapy.

What if I don’t have a trauma history?

This doesn’t change the fact that migraine is a genetic, neurological disorder. Not everyone with migraine has a trauma history. Not everyone with a trauma history will develop migraine. It merely explains how sometimes traumatic events occurring at just the right time in development can alter DNA to increase someone’s vulnerability to migraine.

It is also a good reminder to all of us that migraine is still a mystery. We are witnesses to the discovery process. Sometimes uncomfortable topics must be explored in order to get all the answers.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.
View References
  1. Buse, Dawn C., PhD and Tietjen , Gretchen E., MD. (2014), Abuse, Post-Traumatic Stress Disorder and Migraine, retrieved 12/27/14 from http://www.achenet.org/resources/abuse_post_traumatic_stress_disorder_and_migraine/
  2. Buse, Dawn C., PhD, Schulman, Elliott A. MD, Tietjen , Gretchen E., MD. (2014), Abuse, Childhood Maltreatment and Migraine, Information for healthcare providers, Retrieved 12/27/14 from http://www.americanheadachesociety.org/assets/1/7/Dawn_Buse_-_Abuse,_Childhood_Maltreatment_and_Migraine.pdf
  3. Campbell, Jodi S. W. MS ,Trauma and the Brain: a brief look at how trauma can cause physiological changes in brain structure and chemistry, KidsPeace Institute, Retrieved 12/27/14 from http://www.kidspeace.org/healing.aspx?id=2514
  4. Dong Hoon Oh (2012). Traumatic Experiences Disrupt Amygdala – Prefrontal Connectivity, The Amygdala - A Discrete Multitasking Manager, Dr. Barbara Ferry (Ed.), ISBN: 978-953-51-0908-2, InTech, DOI: 10.5772/48691. Available from: http://www.intechopen.com/books/the-amygdala-a-discrete-multitasking-manager/traumatic-experiences-disrupt-amygdala-prefrontal-connectivity
  5. Tietjen, Gretchen E., MD, Peterlin, B. Lee, DO, (2011). Childhood Abuse and Migraine: Epidemiology, Sex Differences, and Potential Mechanisms, 2011;51(6):869-879. Retreived 12/27/14 from http://www.medscape.com/viewarticle/743962_5
  6. van der Kolk, Bessel A. MD , The neurobiology of childhood trauma and abuse , Child Adolesc Psychiatric Clin N Am, 12 (2003) 293 – 317 , Retrieved 12/27/14 from http://www.thefpr.org/traumaprivate/pdf/DEV_van_der_Kolk.pdf
  7. Whiteman, H. (2014, December 26). "Child abuse linked to increased risk of migraine in "Medical News Today. Retrieved from http://www.medicalnewstoday.com/articles/287320.php

Comments

View Comments (16)
  • LuckiestWife
    4 years ago

    Thanks for this article!
    I started dealing with migraine in my pre-teens (I’m 48) and it’s definitely had an impact on my life, as I’m sure you can imagine. Strangely enough, birth control pills and pregnancy/nursing helped to lessen the attacks somewhat.
    I also have major depression, anxiety, PTSD, and chronic nerve pain. I’ve only recently begun to discuss my childhood difficulties with a therapist, and I’d never realized the actual physical changes/consequences from what I experienced. I’ve always blamed myself for being ‘weak’, but articles like this are a huge help in furthering my understanding and self-acceptance. I see now that it’s all more inter-connected than I’d ever realized!
    And Finley, thanks for the book recommendation, I’ll be looking for it.

  • finley
    4 years ago

    There’s a wonderful book that discusses the biological connection between physical and psychological aspects. It helped me understand that stress and anxiety DO affect my health, but it’s not my fault. I highly recommend it – Why Zebras Don’t Get Ulcers, by Robert Sapolsky.

  • peeperview
    4 years ago

    Thanks Finly. Sounds like a book I would get a lot out of, too.

  • body
    4 years ago

    A good article, Tammy. When I first read the study, I did a lot of thinking. Definitely, migraine is genetic in my family and I do not recall anything I would consider abuse in my early childhood. However, that said, my father was diagnosed with Rheumatoid Arthritis when I was 5 years old, and that is the first time I can remember my migraines starting. My younger sister was diagnosed with Rheumatic Fever a year later and between my other two sisters and the needs of my father and younger sister, attention was pretty scarce for a while.

  • body
    4 years ago

    I should add, it important for us to remember that migraine is a neurological condition. As migraineurs we are thought to have an inherited sensitivity of the nervous system, which makes our brains hyper-excitable. This hyper-excitability gives us a predisposition to migraine attacks. Numerous studies have shown stressful events to be associated with the initial onset of migraine attacks. So, in my case, perhaps the initial onset of my attacks was related to my father’s illness 🙂

  • vitamin_migraine
    4 years ago

    Your preamble, and that “gut nausea” like you couldn’t address it for awhile, the chronic non-responsive migraines and the abuse (mine started in childhood but I was told I was difficult and beat up more — if I threw up I was an ungrateful picky eater…) All of it. 100%. I hear you.

  • Nina Rose
    4 years ago

    I’m actually glad that it is something other than genetics. I am the only person in my family (on both sides) who has migraines so I never really understood how it could be genetic.
    Although, I’m saying that and yet I don’t think I’ve had a childhood trauma either..What qualifies as childhood trauma anyway? We’ve all had bad experiences growing up but I don’t exactly feel they’ve affected me. I’ve never been abused or experienced any sort of disaster like fires, flooding etc, and I had bad falls but most of those were when I was at least 10 and older so that couldn’t count as early childhood trauma could it?

  • Jeff
    4 years ago

    Great article! My own reading has been leading me to suspect a migraine connection with this “fight or flight” mechanism. Your article makes me want to explore that more. Are there any good books that can start one down the road of retraining the brain when stress happens?

  • Tammy Rome author
    4 years ago

    There is a lot of support for utilizing Dialectical Behavior Therapy to help people who have difficulty coping with stress and don’t respond to biofeedback, relaxation therapy, or traditional therapy. You might want to look at some of that research.

  • Anne
    4 years ago

    interesting,but is there a link to the study? There was actually a study recently that said that children of people who experienced trauma were more likely to have unhealthy reactions to stress, so I think there are many more factors in play. I am concerned by this, too, as it does the old finger pointing to ‘you are just too sensitive,’ rather than a physiological condition. Many questions…

  • Tammy Rome author
    4 years ago

    At the end of the article there is a link that says “View References”. That link will display all the source material I used to write this article.

    I get concerned about people not understanding the full meaning of the research and jumping to conclusions about the mental state of all migraineurs. Abuse/trauma occur in migraineurs at about the same rate as the general population (that is, one in four). It’s one possible link, but there’s no causative proof.

  • peeperview
    4 years ago

    Tammy,
    Well this article practically has me shaking in my boots right now. I gasped as I read each paragraph. See, I’ve been wondering sometime now (silently to myself) if there’s some correlation between some of us that become Chronic migrainuers and “unresolved” childhood trauma. Crap. I don’t remember the first five years of my life, or really my childhood at all, but I have an idea it was not good. Now I have to face all that, deal with it, as a means to completely treat my Chronic Migraines?!? I’m just going to pretend none of this happened. Lol. Honestly, very good article and thank you for being brave enough to write it. I guess I have a lot of (scary) work to do.

  • Tammy Rome author
    4 years ago

    Just remember that trauma can have a negative impact on any health problems we face. Anyone who has unresolved trauma should get help, migraine or not. Best of luck to you!

  • Lifelongmigraines
    4 years ago

    I am the poster child for childhood trauma! I grew up with an alcoholic father who regularly verbally and emotionally abused me from as early as I can remember through my teens. I had stomach migraines from middle school through about age 16. We just didn’t know what it was then! I had my first migraine at 16. I am now 55 and I am on disability for them. I was a happy and successful biology teacher until my husband got sick and my son started getting into trouble. The migraines that had bothered me once or twice a month became a biweekly event. I am also the oldest child and inherited the caretaker gene. My mother is almost 80 and is starting to need more medical care. I offered to go with her to an out-of-town dr appointment. She told me that she would have to have a backup because I just wasn’t dependable anymore because of my migraines. That upset me so much I am on the fourth day of a migraine. This just skims the surface of my life story! I sometimes wonder if I have PTSD! My migraines are hereditary, too, so one does not preclude the other! Thanks for listening.

  • Tammy Rome author
    4 years ago

    My daughter has back-up child care for her daughter just in case I am too sick to care for her. I love being with my granddaughter, but when a bad migraine hits, I am no good to her. I insisted that she make these arrangements. Try not to let it get you down.

  • Sandy
    4 years ago

    great job. thank you.

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