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Stress: The Most Common Migraine Trigger

Reviewed by: HU Medical Review Board | Last reviewed: October 2020

The link between stress and migraine is complicated. Doctors know that stress in all its forms is the most common trigger reported by people with migraine. Studies consistently find that 7 out of 10 people feel that stress is their No. 1 migraine trigger.1-4

What is stress?

Stress can come in many forms, both positive and negative, such as:3

  • Worry about new job responsibilities due to a promotion
  • Excitement about an upcoming vacation
  • A traffic jam that makes you late for an appointment
  • Divorce or other family conflict

During stressful moments, the brain releases chemicals as the body prepares for “fight or flight.” These chemicals cause a range of brain and body changes, including muscle tension and dilation of blood vessels. For a person with migraine, these reactions to stress can trigger a painful migraine.

As a reaction to stress, a person may make changes to their routine such as missing regular meals, sleep, or exercise. These are all common migraine triggers that can make stress and migraine feel like an endless cycle.2,3

What is the "let-down" period?

For some people who battle migraines, the attack starts after the stressful event has passed, during what is called the “let-down period.” This occurs after a period of high stress or pressure ends, and the person relaxes. These migraines often happen on the weekend or at the beginning of vacation when the whirr of activity has slowed.3

Why is stress management so important?

It is impossible to eliminate all the stress in your life, but sometimes it is possible to manage many of the things that create the most stress and tension in your life. It is important to try and reduce stress because long-term stress can lead to chronic migraine. Studies have suggested that long periods of stress can cause occasional headaches to become more frequent and chronic.4

How can listing stressors help?

First, make a list of the things you know cause you stress and worry. From there, you can try different ways to manage your stress. For example, you may need to get up 15 minutes earlier to avoid stressing out about being late for work. Or, you may need to learn to say no to some extra activities that you enjoy but prevent you from getting enough rest.

What stress management techniques can be used?

You can also learn several techniques to change how you respond to stress. These include:3,4

  • Biofeedback
  • Meditation
  • Relaxation therapy
  • Cognitive behavioral therapy

Try the Biofeedback Certification International Alliance to find a psychologist certified in biofeedback techniques.

How can a change in habits help?

Daily habits such as regular exercise and maintaining a consistent sleep schedule can also help your body maintain its strength and make stress less likely to trigger a migraine.4

How can treating other health conditions help?

Other health conditions can cause significant stress, which triggers migraine attacks in people susceptible to migraine. The most common examples include post-traumatic stress syndrome, depression, anxiety, insomnia, and physical or sexual abuse. This makes it important to find a treatment that helps reduce the symptoms and stress of these other conditions.4

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