Migraine and Anxiety: How Are They Linked?
Anxiety and migraine are old friends. When you have migraine, you can’t help worrying: Is my manager going to be upset that I’m missing work again? What does this symptom mean? What happens if I run out of medication this month? Is this attack going to be a really bad one? Will I ever feel normal again? For some people, these migraine-related worries may grow and become an anxiety disorder.
It’s important to note that migraine is a neurological disorder, not (as some think) a psychological condition. However, there seems to be a relationship between migraine and anxiety disorders, scientists have found. Researchers who conducted a review of 178 studies found that epidemiological studies “suggest that patients with migraine – especially those with chronic migraine (CM) and migraine with aura – are at increased risk for major depression, anxiety, or suicidal behavior when compared to subjects without migraine.”[i]
So, does migraine cause anxiety? Or does anxiety cause migraine?
This is a question researchers haven’t been able to answer definitively. Many suggest that the relationship is bidirectional — migraine may increase the likelihood of anxiety, and anxiety, in turn, can exacerbate migraine.
“Notably, the prevalence of anxiety increases with migraine frequency, suggesting a ‘dose-response’ effect; the comorbidity between migraine and anxiety disorders is also enhanced by the presence of medication overuse and concurrent depression,” the researchers above wrote in The Journal of Headache and Pain.[ii]
While scientists are trying to illuminate the complex relationship between migraine and anxiety, people living with both conditions are simply trying to manage them. “Anxiety is not just worry and fear, it’s also avoidance that prevents us from doing the things we need and want to do,” migraineur Jennifer writes for Migraine Strong. “It shackles us to our couches pleading for us to avoid everything that creates those worrying thoughts. Sometimes even keeping us from doing the things we love.”
Which anxiety disorders are most often associated with migraine?
There are five main types of anxiety disorders: Generalized Anxiety Disorder (GAD), Obsessive-Compulsive Disorder (OCD), panic disorder, Post-Traumatic Stress Disorder (PTSD), and social phobia.[iii]
Many studies have found that people with GAD and panic disorder, in particular, are likely to experience migraines or other types of headaches, according to the Anxiety and Depression Association of America.[iv]
People who have Generalized Anxiety Disorder worry a lot about everyday things, have trouble controlling their worries, and know they worry more than they should. Other symptoms include feeling restless, tired and/or irritable; having a hard time concentrating; and having trouble sleeping, among other symptoms.
People who have panic disorder experience sudden, repeated panic attacks. These are characterized by overwhelming anxiety and fear, as well as feelings of being out of control or impending doom. Physical symptoms of a panic attack can include a racing heart, sweating, chills, trembling, breathing problems, weakness or dizziness, tingly or numb hands, chest pain, stomach pain, and nausea.
If you think you may have an anxiety disorder, talk to your healthcare provider about the best ways to treat it. Many people find success with cognitive behavioral therapy (CBT), a form of psychotherapy that teaches new ways of thinking and reacting to situations that cause your anxiety.[v] If your anxiety is related to fear or worry about migraine attacks, you may want to try preventative migraine treatments that can lessen the frequency and severity of attacks.
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**The information in this article is not intended to be a substitute for professional medical advice.
[i] Dresler, T., Caratozzolo, S., Guldolf, K. et al. Understanding the nature of psychiatric comorbidity in migraine: a systematic review focused on interactions and treatment implications. J Headache Pain 20, 51 (2019). https://doi.org/10.1186/s10194-019-0988-x
[ii] Dresler, T., Caratozzolo, S., Guldolf, K. et al. Understanding the nature of psychiatric comorbidity in migraine: a systematic review focused on interactions and treatment implications. J Headache Pain 20, 51 (2019). https://doi.org/10.1186/s10194-019-0988-x