A migraine causes throbbing, pulsing pain, on one or both sides of your head. The pain is most often felt around the temples or behind one eye. Pain can last anywhere from 4 to 72 hours.

Other symptoms often accompany migraines. For instance, nausea, vomiting, and sensitivity to light are common during a migraine.

Migraines are different than headaches. What causes them isn’t well-understood. But there are known triggers, including stress.

According to the American Headache Society, about 4 out of 5 people with migraines report stress as a trigger. Relaxation following a period of high stress has also been identified as a possible migraine trigger.

So, what’s the connection between stress and migraines? We explain the research, symptoms, and coping strategies to get you feeling better, sooner.

Though what exactly causes migraines hasn’t been established, researchers believe they may be caused by changes in the levels of certain chemicals in the brain, such as serotonin. Serotonin helps regulate pain.

A 2014 study found that people with migraines who experienced a reduction in stress from one day to the next were significantly more likely to have a migraine the next day.

Researchers believe that relaxation after high levels of stress was an even more significant trigger for migraine than the stress itself. This is referred to as the “let-down” effect. Some suggest this effect is linked to other conditions, such as getting a cold or flu.

You’ll likely first notice symptoms of stress before the symptoms of a migraine. Common symptoms of stress include:

  • upset stomach
  • muscle tension
  • irritability
  • fatigue
  • chest pain
  • rapid heart rate
  • sadness and depression
  • lack of sex drive

The symptoms of a migraine can begin a day or two before the actual migraine. This is called the prodrome stage. The symptoms of this stage may include:

  • fatigue
  • food cravings
  • mood changes
  • neck stiffness
  • constipation
  • frequent yawning

Some people experience migraine with aura, which occurs after the prodrome stage. An aura causes vision disturbances. In some people, it can also cause problems with sensation, speech, and movement, such as:

  • seeing flashing lights, bright spots, or shapes
  • tingling in the face, arms, or legs
  • difficulty speaking
  • temporary loss of vision

When the pain of the headache begins, it’s referred to as the attack phase. Symptoms of the attack phase can last from a few hours to a few days, if left untreated. The severity of symptoms varies from person to person.

Symptoms may include:

  • sensitivity to sound and light
  • increased sensitivity to smells and touch
  • throbbing head pain on one or both sides of your head, in your temples, or in the front or back
  • nausea
  • vomiting
  • dizziness
  • feeling faint or lightheaded

The final phase is called the postdrome phase. It can cause mood changes that range from euphoria and feeling very happy to feeling tired and worn out. You may also have a dull headache. These symptoms usually last for about 24 hours.

Migraine treatments include medications to relieve your symptoms and prevent future attacks. If stress is causing your migraines, finding ways to reduce your stress levels can help prevent future attacks.

Medications

Medications to relieve migraine pain include:

  • over-the-counter (OTC) pain relievers, such as ibuprofen (Advil, Motrin) or acetaminophen (Tylenol)
  • OTC migraine medications that combine acetaminophen, aspirin, and caffeine, such as Excedrin Migraine
  • triptans, such as sumatriptan (Imitrex), almotriptan (Axert), and rizatriptan (Maxalt)
  • ergots, which combine ergotamine and caffeine, such as Cafergot and Migergot
  • opioids, such as codeine

You may also be given anti-nausea medication if you experience nausea and vomiting with a migraine.

Corticosteroids are sometimes used with other medications to treat severe migraines. However, these aren’t recommended for frequent use because of side effects.

You may be a candidate for preventive medications if:

  • You experience at least four severe attacks a month.
  • You have attacks that last more than 12 hours.
  • You don’t get relief from pain-relieving medications.
  • You experience an aura or numbness for prolonged periods.

Preventive medications are taken daily or monthly to reduce the frequency, length, and severity of your migraines.

If stress is a known trigger for your migraines, your doctor may recommend taking the medication only during times of high stress, such as leading up to a stressful work week or event.

Preventive medications include:

  • beta-blockers, such as propranolol
  • calcium channel blockers, such as verapamil (Calan, Verelan)
  • antidepressants, such as amitriptyline or venlafaxine (Effexor XR)
  • CGRP receptor antagonists, such as erenumab-aooe (Aimovig)

Prescription anti-inflammatory medications, such as naproxen (Naprosyn), can also help prevent migraines and reduce symptoms.

However, anti-inflammatories have been found to increase the risk of gastrointestinal bleeding and ulcers as well as heart attacks. Frequent use isn’t recommended.

Other treatment options

There are a few things you can do to lower the risk of a migraine from stress. These things may also help relieve the symptoms caused by both stress and migraines. Consider the following:

  • Incorporate relaxation exercises into your daily routine, such as yoga and meditation.
  • Rest in a dark room when you feel a migraine coming.
  • Get enough sleep, which can be achieved through keeping a consistent bed time each night.
  • Try massage therapy. It can help prevent migraines, reduce cortisol levels, and decrease anxiety, according to a 2006 study.
  • Exercise more days than not. It can lower stress levels and may help prevent let-down migraines after a period of stress.

If you’re having trouble dealing with stress and find that stress is a trigger for your migraines, speak to your doctor. They can recommend ways to cope with stress.

If stress is a trigger for your migraines, work to reduce or eliminate the source of your stress. Medications and self-care measures can also help you get relief from symptoms and prevent or reduce the frequency of your migraines.