Migraine and stress

By: Dr Sophie White, Clinical Psychologist, Headache Group, National Hospital for Neurology & Neurosurgery, University College London Hospitals NHS Foundation Trust

11th February 2021

As a psychologist in headache services, I often talk to people about stress. We know that stress is one of the most common triggers for migraine attacks and you may notice this either during or after a stressful time. However, we also know that a tricky cycle occurs: living with migraine is stressful, then this stress acts as the trigger for the next attack. The good news is that this means we can find different ways to break the cycle, to manage some of those extra triggers and to improve your overall sense of well-being.

Whether we like it or not, our bodies are designed to respond to stress so this will always happen to some extent. Once upon a time, we had to be able to act quickly if a lion was coming towards us. Luckily I don’t see many lions when I’m off to the supermarket or to catch a train…. but our brains continue to react in the same way to any threat.

What we find stressful is very personal, whether big or small, or even if it’s a seemingly good thing like moving house. Scientists understand stress as the balance between the situation and how we can cope. This helps us to understand that it is okay to find things stressful for you: nothing is too small or ‘silly’ as it’s about your own personal balance.

OK, so what am I going to do about it?

Often the first stop in resolving these difficulties is to take some time to think and understand your own patterns. What are the kinds of situations that make you feel stressed? Do these things feel motivating or demanding? How do you know when you’re stressed? Sometimes we don’t even notice we’re stressed until our bodies tell us so (e.g. getting mouth ulcers, increase in headaches), or perhaps even when people tell us that we are being irritable.

Next, you can think about whether there is anything you can practically do about the things that are causing stress. You might need to get a little creative here to keep thinking about any options that might be right for you. Do you need any assistance from anyone in this? It’s important to recognise that we might not be able to get rid of everything that is causing us stress, especially if those things are out of our control.

Equally, if we focus on getting rid of all things that cause us stress, then we might also miss out on the things that make life meaningful for us. For example, if certain members of your family can leave you feeling stressed, then one way would be to avoid all family gatherings: but this then has an impact on your time with others. Instead, it can be helpful to focus on ways to cope with inevitable stress.

What can help me to cope?

Finally, you can take time to think about the coping strategies that may help with how you feel. Looking after yourself is an important part of finding a way to keep going with the demands that are placed on you, but you may recognise that it is easy to forget to take the time to do these things. It is important to remember that these are things to implement every day to manage the effects of stress, rather than only using them once you are at breaking point.

Have a think, what are the things that normally help you when you are finding life difficult? Are all these things helpful for you in the long-run, or are they creating any additional difficulties? Do you need to give yourself a visual reminder of what these things are? We all have different ways of coping. This includes physical things like sitting in your favourite chair, using relaxation exercises or mindfulness, going for a walk, being outside, stretching, or eating healthy food. Some people prefer to use more social strategies, like talking to a person or pet, being around people they love, or having a hug.

You may benefit from taking time to do creative activities or hobbies, having time alone, creating a good routine, connecting to your faith, or journaling. In the current climate, it can feel hard when the things we’d normally do to cope are restricted. However, the point of having various strategies is to recognise that there is always something else that you can do. In a DIY toolbox or a make-up bag, we do not use everything all at the same time: some days we need one thing, other days we need another. It is okay to take the time for you to do what you need.

Ultimately you might notice that this is feeling too much to do on your own and that is okay too. You can read more about to how to get access to more help in my previous blog post.