Migraine Caused by Stress

Stress and Relaxation: How Much of Each Is Good for Those Affected by Headaches and Migraines? Why is it important to actively address stress? Find out everything you need to know here.

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Last updated: February 6, 2024

The Link Between Stress and Migraines

Hans Selye, the “father of stress research,” discovered a paradox 80 years ago: stress activates physiological systems that both protect and harm the body. Could this dual effect of stress also lead to migraines?

To investigate this, researchers Peter Sterling and Joseph Eyer introduced a concept 30 years ago that still shapes modern stress research. They sought to understand how the body maintains a physical and mental balance amid alternating periods of stress and relaxation.

Sterling and Eyer proposed an analogy to homeostasis, calling it allostasis. This concept was later expanded by renowned stress researcher Bruce McEwen and applied to migraines.

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Stress and Migraines: Homeostasis & Allostasis

Homeostasis describes how the body regulates its temperature and maintains it at a relatively constant 36°C despite changing environmental conditions. In contrast, allostasis explains how human behavior is regulated and how, for example, the appropriate readiness to act is developed in a problem situation.

Homeostasis refers exclusively to the biological states of the body—for instance, body temperature, blood pressure, or the electrical membrane potential of an individual cell. Allostasis, on the other hand, takes mental aspects into account in addition to all these physiological states. This is because the brain—or rather, the person—must first perceive stress as such. And this is where the crux lies. This perception is not solely influenced by physiological factors but also by individual experiences and personal behavior.

How Stress Wears Down the Brain in Migraines

An example: Whether you respond to a problem with an increased heart rate and blood pressure depends on allostasis, not just homeostasis. This includes physiological and behavioral responses.

Over time, repeated stress can lead to adaptations that either protect or harm the body. Chronic overburdening damages the body, a phenomenon Bruce McEwen refers to as allostatic load.

What Contributes to Brain Wear and Tear?

Over time, allostatic load in migraine accumulates not only due to recurring pain attacks. Many other factors come into play. The flashes of light, visual and perceptual disturbances triggered by the migraine wave (known as cortical spreading depression) during a migraine aura increase allostatic load just as much as disruptions in sleep patterns or hypersensitivity to light, smell, and noise during the prodrome phase.

Allostatic load gradually alters brain structures through various neuronal mediators, hormones, and—as we now know—the immune system. As a result, resilience decreases, and the migraine brain approaches a tipping point.

You may have heard that a body of water or the climate can “tip over.” But the brain? Yes, that too! In fact, many complex systems have such tipping points. Three renowned researchers in aquatic ecology, climate science, and complex systems, together with three headache experts, have developed a tipping point model for migraine. When we talk about a “tipping point in the brain,” we mean that, driven by allostatic load, the state shifts quite suddenly from a pain-free period into the headache phase of a migraine attack.

However, I want to put the word “suddenly” into perspective. The pain of an attack sets in rather abruptly. However, the attack itself often announces itself long beforehand. Before this tipping point is reached, significant fluctuations occur throughout the body. This is precisely what the model explains. These fluctuations affect physiological, hormonal, and emotional changes and manifest in various warning signs for those affected. In this phase of low resilience, one is particularly sensitive to triggers.

Bruce McEwen has now demonstrated something alarming: with an increasing number of attacks, the hippocampus shrinks, leading to dysregulation in conjunction with other brain regions. This suggests that the brain becomes increasingly prone to “tipping over.” The hippocampus is a central hub of the limbic system and plays a key role in processing stress—and not only that. It is also involved in the emotional perception of pain, which can create a vicious cycle.

What Helps with Stress-Induced Migraines?

The critical question is whether these processes can be reversed.

Should stress be avoided altogether? Many guides claim that excessive stress exacerbates migraines. However, avoiding stress entirely is likely counterproductive.

According to Bruce McEwen, both too much and too little stress are harmful. He cites the Yerkes-Dodson Law, which states that too little stress leads to low arousal and lack of motivation, which can also be detrimental. The “sweet spot” lies in the middle.

McEwen recommends three practical approaches:

Regular physical exercise
Mindfulness-Based Stress Reduction (MBSR)
Seeking support from family, friends, and colleagues to maintain emotional balance

Instead of passively avoiding stress, the key is to actively address it. Techniques like relaxation exercises and moderate aerobic exercise can help. Clinical studies show that such therapies can reduce migraine attack frequency and intensity by up to 45%.

Conclusion

Stress is the most common trigger of migraine attacks. However, it is often not the stress itself that is the relevant influencing factor, but the change in the stress level – i.e. from relaxation to stress or from stress to relaxation. Reducing this difference in level through therapy methods such as progressive muscle relaxation therefore makes perfect sense and is part of non-drug therapy.

Sources

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Gruber, H.-J. et al. (2010): Hyperinsulinaemia in Migraineurs Is Associated with Nitric Oxide Stress. In: Cephalalgia30 (5), S. 593–98. https://doi.org/10.1111/j.1468-2982.2009.02012.x.
Siva, Z.O. et al. (2018): Determinants of Glucose Metabolism and the Role of NPY in the Progression of Insulin Resistance in Chronic Migraine. In: Cephalalgia38 (11), S. 1773–81. https://doi.org/10.1177/0333102417748928.
Yilmaz, N. et al. (2011): Impaired Oxidative Balance and Association of Blood Glucose, Insulin and HOMA-IR Index in Migraine. In: Biochem. Med., 21, S. 145–151.
Del Moro, L. et al. (2022): Migraine, Brain Glucose Metabolism and the „Neuroenergetic“ Hypothesis: A Scoping Review. In: J Pain., 23(8), S. 1294-1317. doi: 10.1016/j.jpain.2022.02.006.
Bongiovanni, D. et al. (2021): Effectiveness of Ketogenic Diet in Treatment of Patients with Refractory Chronic Migraine. In: Neurol Sci, doi:10.1007/s10072-021-05078-5.
Evcili, G. et al. (2018): Early and long period follow-up results of low glycemic index diet for migraine prophylaxis. In: Agri.30(1), S. 8-11. doi: 10.5505/agri.2017.62443.
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About the Author

Dr. rer. nat. Markus A. Dahlem

Dr. Markus Dahlem was co-founder and CEO of Newsenselab, the start-up behind M-sense. He has been researching the development of migraines for more than 25 years. As a physicist, he is fundamentally interested in whether mathematical calculations can contribute to the basic understanding of diseases.