How I Navigate Anxiety and Migraine

For many people, migraine and anxiety coexist. Here’s how I manage anxiety while living with chronic migraine.

For me, anxiety and migraine have always been closely connected, and it turns out that I’m not the only one.

Did you know that studies have shown that people who live with migraine are more likely to also live with anxiety? Not only are anxiety and stress triggers for migraine attacks, but living with migraine can predispose you to having certain anxiety disorders.

According to the American Migraine Foundation, around 50–60% of people living with migraine, also live with anxiety.

An older 2012 study found that around 5–17% of migraine patients experience panic attacks. For those with chronic migraine or with migraine with aura, this number increased to 25–30%.

Another study, published in 2021, revealed that the more migraine days people experienced per month, the more prone they were to anxiety and depression.

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So what’s the anxiety and migraine connection?

For me, one big reason my anxiety is heightened by living with chronic migraine is because I’m often anxious about having an attack.

This is something that many in the chronic illness and disability community call “flare-up anxiety.” After all, once you know how bad your symptoms or your migraine attacks can be, it’s understandable to be anxious about them happening again.

In 2022 a team of researchers found that increased sensitivity to pain signals and conditioned fear around these pain signals was a significant cause of anxiety for those with migraine.

Those researchers also identified several biological reasons as to why those who live with migraine may be more predisposed to anxiety. First, they found that some people with migraine experienced reduced levels of serotonin or 5HT receptors in the brain.

They also found that a genetic mutation, the COMT Val allele, was present in some people with migraine. This allele affects connectivity within the brain. People who have this genetic mutation, have a hypothalamus that has less inhibitory control over certain brain areas responsible for anxiety.

What’s more, anxiety and mood changes can also be symptoms of an active migraine attack. These symptoms can occur either as part of the prodrome (in the hours and days before an attack), during an attack, or in the postdrome (after the active attack has subsided).

However, research has also found that treating stress and anxiety can help reduce migraine frequency and symptom severity. This means that treatments that address anxiety may help you better manage migraine.

How I cope with migraine and anxiety

Everyone is different, and what works for one person in terms of managing their anxiety with migraine may not work for another. There’s a wide variety of things that you can try.

Here are some of the more widely recommended strategies I’ve come across when dealing with migraine and anxiety.

Lifestyle changes

Many lifestyle modifications can help you make sure your body is best equipped to manage stress and anxiety. Making changes like limiting caffeine intake, staying hydrated, and practicing good sleep hygiene can help set yourself up for success by helping to avoid migraine episodes and reducing your daily stress levels.

Getting in some gentle exercise when your pain levels allow for it or trying breathing, meditation, or mindfulness practices can help as well.

Acupuncture

Acupuncture remains one of the only treatments that was ever effective for reducing the severity and frequency of my migraine attacks. It also made me feel calmer.

Research suggests that it can reduce the symptoms of generalized anxiety disorder.

Medications

Talk with your doctor about medications that may benefit both migraine management and anxiety reduction.

Medications like amitriptyline (a tricyclic antidepressant) and propranolol (a beta-blocker) may be options for some people who experience both migraine and anxiety.

You may also want to talk with your doctor about trying medications specifically made to treat anxiety. These medications include antidepressants like SSRIs or SNRIs.

Your doctor will be able to assess which medications are best for you and make sure they don’t interact with drugs you’re already taking for migraine.

Therapy

Trying psychological therapies like cognitive behavioral therapy (CBT) may help you develop tools to manage the thought processes and anxiety around migraine attacks and in your day-to-day life.

What has worked for me

For me, I try to combat my anxious racing thoughts with other positive thoughts. For example, I remind myself that I have survived all of my worst migraine attacks before. They were horrible, and I didn’t think I would get through it, but I did. I tell myself that I can get through another attack if it comes.

I lean into my tried-and-true migraine coping strategies. This looks different for everyone; for some it may mean taking paracetamol and lying down in a dark room. For me, it’s a combination of taking caffeine, prescribed triptans, tiger balm, and ice packs.

Making sure I have all the ingredients of my migraine treatment recipe on hand, no matter where I am, allows me to feel a bit more in control.

Finally, I continue to investigate and pursue new preventive treatment options. Reminding myself that there are options I haven’t explored helps me to remember that I still have treatments I can try.

The takeaway

Migraine and anxiety frequently occur together and can make managing each condition more complicated.

Several strategies, medications, and therapies can help you cope with anxiety and migraine. If you’re finding it difficult to manage migraine, anxiety, or a combination of both, it’s important to talk with your doctor or neurologist. They’ll be able to offer advice and treatments to help you find the support and relief you need.

Remember that you’re doing your best to live with this difficult disease and that neither your anxiety nor your migraine is your fault.

Even when it feels overwhelming, remember all the times you’ve felt that way before. Remind yourself that you did survive it. Remember to breathe, and take everything one day at a time.