How to tell if you have a stress migraine and the best ways to get rid of it

• A stress migraine may start with symptoms like irritability and fatigue that develop into a throbbing headache and nausea or vomiting.
• Stress is thought to be a common migraine trigger because it affects hormones like serotonin and cortisol.
• You can treat a stress migraine by trying over-the-counter pain relievers, prescription medication, and staying hydrated.

Stress isn't just mental. It can manifest physically and cause symptoms such as upset stomach or chest pains. For people who have frequent migraines, stress may be a trigger for a migraine attack.

Since migraines are recurring, it's important that people are aware of their personal triggers so they can avoid future migraine attacks. If stress is a migraine trigger for someone, they may need to make lifestyle changes to try and relieve that stress.

Here's what you need to know about stress migraines as well as how to treat and prevent them.

Stress is a common migraine trigger

Stress is an extremely common migraine trigger. According to the American Migraine Foundation, about 70% of people with migraines say that stress is a trigger for them.

They are most likely to occur in people with a predisposition for migraines - and those with anxiety and mental health conditions are at the highest risk, says Tanya Bilchik, MD, a headache specialist at Yale Medicine.

The stress that causes these migraines may be chronic stress, such as financial stress or juggling family life with a stressful career, or they can be caused by episodes of acute stress, such as an extremely demanding project at work.

"Though what exactly causes migraines hasn't been established, researchers believe they may be caused by changes in the levels of certain chemicals in the brain," says Bilchik.

The chemical serotonin, in particular, is thought to be responsible for stress migraines. Serotonin is a hormone that is responsible for the regulation of mood, which includes anxiety levels. Low serotonin levels are typically associated with low mood and higher anxiety.

Cortisol is another hormone that is associated with stress. High stress results in elevated cortisol levels. There is an inverse relationship between serotonin and cortisol, meaning that cortisol can reduce serotonin production.

Low levels of serotonin are associated with migraines - so it makes sense that increased production of cortisol due to stress and decreased levels of serotonin would result in a migraine.

On top of stress itself, relaxation following a period of high stress is also a possible migraine trigger. Bilchik says this is known as the "let down" effect. Findings in a small 2014 study showed that the "let down" effect of relaxation after stress was actually more likely to trigger a migraine than acute stress itself.

Symptoms of stress migraines

Symptoms of a stress migraine are the same as any other migraine, however, you may notice some other physical symptoms of stress first, such as an upset stomach, muscle tension, and fatigue. You may also feel mentally stressed, uneasy, or anxious.

Then, there are multiple stages of a migraine. The first stage is prodrome, which Bilchik says may begin a few days to a few hours before the migraine. Prodrome symptoms include:

• Irritability
• Fatigue
• Muscle stiffness
• Cravings
• Difficulty concentrating

After prodrome, Bilchik says you may experience an aura, which typically involves visual disturbances. Signs of a migraine aura include:

• Blind spots
• Seeing lines or geometric shapes
• Seeing flashes of light
• Experiencing numbness or tingling

After you experience an aura, then you may experience a full-blown migraine. Bilchik says this may last from a couple of hours up to even 72 hours. She says migraine symptoms include:

• Throbbing headache
• Nausea or vomiting
• Dizziness or lightheadedness
• Sensitivity to light and sounds

Lastly, after the migraine attack will come the postdrome, colloquially referred to as the migraine hangover. Bilchik says symptoms of the postdrome phase include:

• Low-grade headache
• Mood changes
• Fatigue

How to get rid of stress migraines

The methods of treating a stress migraine are the same as treating any other migraine. Bilchik says treatment options include:

• Over-the-counter pain meds such as Advil, Motrin, Tylenol, or Excedrin
• Prescription migraine medication like triptans, gepants, and ditans
• Anti-nausea medication - if you experience nausea and vomiting with your migraine

There are also non-medication related treatments for migraine which can help you feel some more comfort. Bilchik recommends:

• Being in a quiet room with reduced light and noise
• Applying ice to the head and temples
• Increasing hydration

The best way to prevent stress migraines will depend on the frequency of your migraines. If you have more than three to four migraines a month and they don't respond to acute migraine medications, Bilchik says you may need long term preventive medications, which are taken daily or monthly to reduce the frequency, length, and severity of migraines.

She says some examples of these are:

• Anticonvulsants
• Beta-blockers
• Antidepressants
• CGRP receptor antagonists
• Botox

Additionally, you also want to address the migraine trigger of stress. Preventing high levels of stress can stop your migraines from happening in the first place.

Aside from trying to lower your overall stress levels, Bilchik recommends:

• Meditation
• Practicing mindfulness
• Yoga
• Exercise
• Sleeping seven to eight hours a night with a consistent bedtime and wake up time

When to see a doctor

Even if you already have a known diagnosis of migraines, there are several instances when you should see a doctor.

Bilchik recommends seeing a doctor if you experience any of the following:

• Increased migraine frequency, duration, and intensity
• A migraine that won't go away
• When your previously effective medication stops working
• When you are taking medication for migraine more than once a week
• New migraine symptoms
• Neurological symptoms with migraine

Insider's takeaway

Stress, or relief from high stress, are common triggers for migraines. However, with proper stress and migraine management, you can feel better. Be sure to contact your doctor if you experience any of the warning signs that Bilchik mentioned so that you can experience some relief from your migraines.

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