Can a Migraine Attack Be Triggered By Crying?

Recently, I was at my daughter’s elementary school graduation. It was a challenging year for all of us, to say the least. In addition to all of the stress of COVID and remote school, my daughter was diagnosed with Type 1 diabetes in December. It was a lot to pile on in one year. I’m an emotional person. I cry at things like weddings and graduations. This graduation hit me especially hard, after the year we had - I was so proud of my daughter for being strong and making it through like a champion. Needless to say, I cried. A lot!! I was a mess. After we went home, I immediately felt a migraine attack coming on. Can crying trigger a migraine? I wondered, as I took two Excedrin and tried to sleep it off.

What does a neurologist have to say?

After finding only some random anecdotal reports, I asked Dr. Sara Crystal about my theory. Dr. Crystal is a neurologist and headache specialist currently serving as Medical Director for Cove, a digital health program that allows patients to access expert care for migraine.

“There seems to be some evidence that crying, and strong emotions in general, can lead to a migraine attack. This may occur in the context of a stressful event or an emotional one. Interestingly, only emotional crying seems to trigger migraine attacks, whereas crying from cutting an onion, for example, does not,” Dr. Crystal explains.

What happens when we cry?

Dr. Crystal adds that crying is a complex behavior that involves many physiological processes. “It involves the release of neurotransmitters, primarily acetylcholine, which causes the lacrimal (tear) glands to produce tears. It also activates the sympathetic nervous system, leading to the release of stress hormones like cortisol. After a crying episode, there may be an abrupt drop in stress hormones, which may leave a person vulnerable to a migraine attack. These are similar to the ‘letdown headaches’ one may feel after completing a big project or at the end of a stressful week,” she says.

Dr. Crystal notes that crying may also trigger an attack by causing sinus congestion and pressure that may cause facial pain.

What should you do if you know you're going to cry?

I asked Dr. Crystal if people with migraine who anticipate crying (such as going to a funeral or graduation) should prepare in any way, such as taking medication ahead of time. She tells her own patients they may want to have medicine on hand, but that if they know crying constantly triggers a migraine, and they anticipate crying at an event, it may be a good idea to take the medication ahead of time. For me personally, I think that next time I know I will be crying my eyes out, I'll tuck away some Excedrin in my purse!

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