Is stress a Migraine trigger or not?
Monday August 21, 2006
Recently, the National Headache Foundation (NHF) sent out a press release regarding myths about Migraine. One of their myths was, "Stress is not a Migraine trigger." In other words, they're saying that stress is a Migraine trigger.
MAGNUM, the International Headache Society (IHS), and I disagree with that statement. In their International Classification of Headache Disorders, 2nd Edition, the IHS actually moved stress from their list of "triggering factors" to their list of "aggravating factors."
Stress alone doesn't trigger Migraines but it does make us more susceptible to our triggers. An analogy is the best way I know to explain it. When we're stressed, we're more likely to "catch a cold." It's not stress that triggers the cold; it's the cold virus. The stress just made us more vulnerable to the virus. Stress and Migraine have the same kind of relationship. Stress doesn't actually trigger a Migraine, but makes us more susceptible to our triggers.
In a way, I think categorizing stress as a trigger ovesimplifies the role it plays in Migraine. It's my opinion that, in some ways, the role of stress in Migraine is actually more complex than that of a "regular" trigger because it takes minor triggers that are rather impotent by themselves and gives them more power. It takes triggers that are capapble of triggering a Migraine on their own and makes them downright brutal,..
This brings up some excellent questions:
- If stress isn't a trigger, why do we see it listed as a trigger so often?
Good question; one that I've asked too. There are a number of reasons. Reducing stress can help reduce the frequency of Migraines. Some people, including some doctors and even researchers, find it easier to list stress as a trigger than to try to explain the difference between a trigger and an aggravating factor, especially if it's in a short article or brief question and answer venue. Some also reason that triggers and aggravating factors both contribute to the frequency of Migraines, so they don't feel it's urgent to differentiate.
- Why do I continue to differentiate and say that stress is not a trigger but an aggravating or exacerbating factor?
Trigger identification and management is a key part of managing Migraine disease. Since stress by itself doesn't trigger a Migraine, blaming a Migraine attack on stress rather than trying to identify the trigger that combined with the stress can lead to not identifying some of our triggers, especially the milder triggers. Triggers are what Dr. Jan Brandes calls stackable. Another way of putting it is to say that we have a trigger threshold. It's very common to have some triggers that won't trigger a Migraine individually, but if encountered in combination with other triggers or an aggravating factor such as stress, will trigger a Migraine. Identifying as many triggers as possible is important in order that if any can be avoided, we can do so to reduce the frequency of our Migraines.
- So, is the NHF wrong?
I wouldn't say that they're wrong, just that we have a difference in philosophies. That's not always bad, and this isn't a black-and-white issue. As long as questions are asked and a healthy dialogue continues, differences in opinion and philosophy can spark very educational exchanges.
We're discussing the role of stress in Migraine disease on our forum. Join the discussion.
Comments
I have found that my migraines get worse when I am in a long-term stressful situaiton. When I was in a bad marriage or a bad job, my migraines really increased. I didn’t realize that I was clenching my jaw and that my back was very tense.
Just having stress in general does not cause them, but I think continual stress can be a trigger.
Interesting point. I guess I’m lucky because I can always spot my migraine triggers. I’ve noticed that I tend to have more migraines during times that are, looking back, more stressful — busy periods at work, holidays, or during a crisis — but I knew the trigger was eating a trigger food, noise, perfume, or something else I could identify. Now, it makes sense that the stress of the situations makes my triggers stronger during those times.
Thank you!
Miss Terri,
I like what you said about nobody being right or wrong. Why do others like the national headache foundation make things out to be that anyone who says stress isn’t a trigger is wrong?
thank you kindly,
Ray
There is no relationship to stress and migraine. This is the leftover remains of the age when all illness was a mental illness.
The problem with presenting this relationship is that chronically ill people develop stressful lives. We hide our illness, we pretend to be well when we are not, we hope the people we love will not suddenly stop loving us and we are afraid we will lose our jobs. We beg and grovel at the feet of doctors so that they will give the meds we need - then we try to appear normal. That is the issue of stress as it relates to migraine. This is a biological illness that has a strong relationship to ms and other immune disorders. Medicine has been wasting our time with this stress and migraine study. Enough. More research is done on making improved versions of viagra than on the real reason we have pain. I am furious with NHF for this nonsense.