You may experience migraine attacks if you live with an anxiety disorder. And you could experience anxiety symptoms if you have migraine. Other factors may play a role.

Stress has made you reluctant to go to work every morning, and now you’re starting to feel the tell-tale, throbbing head pain associated with an anxiety migraine attack.

Migraine episodes are often debilitating and involve pulsing head pain that can last between hours and days. This, often, may lead to more intense anxiety symptoms.

While the exact link between migraine and anxiety isn’t fully understood, the relationship has been established.

Migraine attacks aren’t a formal symptom of anxiety but some people living with anxiety disorders may experience them. It doesn’t mean anxiety directly causes migraine attacks.

Headaches and migraine episodes are common among people living with anxiety disorders, particularly generalized anxiety disorder and panic disorder. In fact, anxiety may lead you to experience different physical symptoms.

But experiencing migraine attacks doesn’t always mean you’re living with anxiety or, if you do, that this is the cause. You can both experience anxiety and don’t ever have a migraine episode, and also have migraine attacks without ever experiencing anxiety.

What if you only experience migraine attacks when anxious?

The physical symptoms of anxiety, like rapid heartbeat and a rush in adrenaline, may cause migraine attacks.

Anxiety and stress are recognized as factors that can contribute to migraine episodes. Psychological stress is actually cited as one of the most prominent contributors to headaches, in general.

In 2017, a systematic review found that excessive worry and tension likely play a role in migraine episodes.

This link may be due to stress hormones like cortisol, which may cause a number of vascular changes in the brain that could lead to inflammation and head pain.

Emotional states related to stress and anxiety may also induce muscular tension, which in turn could make a migraine episode more intense.

A 2021 systematic review of anxiety-migraine comorbidity noted that migraine attacks often improve when symptoms of anxiety are treated.

While this doesn’t establish that anxiety causes migraine attacks directly, it suggests there may be similar biological factors underlying both.

Anxiety migraine vs. tension headache

Both anxiety-related migraine and tension headaches can result from stress.

Tension headaches tend to occur in the “hat band” area of the head and range from mild to moderate pain.

Like with migraine, you may experience sensitivity to light or sound (but not both) during a tension headache.

Unlike migraine, tension headaches may not be debilitating, can be managed primarily with over-the-counter medications, and aren’t accompanied by vomiting.

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It’s unclear if living with migraine is a direct cause of anxiety. The two conditions may share physiological processes, which means that having one may increase your chances of experiencing the other one.

Anxiety, by definition, is a persistent worry and apprehension even in the absence of a stressor. You can feel anxiety for many reasons — it doesn’t mean you’re living with an anxiety disorder.

If you live with periodic migraine episodes, you may experience anticipatory anxiety about these attacks.

Migraine can be a painful and debilitating condition, and episodes may come with little to no warning. Migraine may also make you extremely sensitive to light and sound, or upset your stomach enough that you need to vomit.

This may make you feel anxious about going to events, driving, sitting in classrooms or offices, or attending social gatherings.

Statistics show that approximately 20% of people living with episodic migraine (less than 14 migraine attacks per month) and 30 to 50% of people living with chronic migraine (15 migraine attacks or more per month) also experience anxiety.

Migraine attacks are complex, and while anxiety may be a primary contributing factor and effect, genetics, hormones, diet, eyestrain, and sleep cycles can all play a role.

You may not be able to stop an anxiety migraine, but you might be able to prevent them from happening as frequently in the future.

Anxiety treatment

Research suggests treating anxiety may improve migraine attacks.

Anxiety disorders are often treated through psychotherapy approaches, such as:

Your health team may also include anti-anxiety medications in your treatment plan. Benzodiazepines and beta-blockers may help relieve some of the more impairing anxiety symptoms. This, in turn, can lessen the chance of experiencing migraine attacks.

Stress management

If anxiety headaches are related to emotional and mental stress, finding ways to relieve that tension may help.

You can manage the effects of stress through:

Migraine treatment

If you believe migraine attacks are the main source of your anxiety symptoms, migraine treatment may help.

Mild migraine attacks are managed with over-the-counter medications like ibuprofen. Chronic migraine may require prescription-strength intervention.

Triptans and ergot derivatives are migraine medications that work by balancing brain chemicals associated with episodes. They’re intended to be taken as soon as you feel a migraine coming on in order to provide you with the best chance of preventing intense symptoms.

In some cases, migraine attacks can be prevented through the daily use of prescriptions such as:

Not all migraine attacks will respond to daily medications. Only a health professional can provide you with an adequate plan for your situation.

For some people, anxiety and migraine come hand in hand.

While it’s unclear if migraine attacks can cause anxiety symptoms, and vice versa, evidence suggests these conditions may share similar physiological pathways in the brain.

Stress management, medications, and psychotherapy may be able to help diminish the impact anxiety migraine attacks have on your life.