There are a variety of triggers for the millions of migraine sufferers in the world but stress is one of the biggest.
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According to the American Headache Society, 80% of migraine sufferers report that stress is a trigger. And the American Migraine Foundation reports that between 50 and 70% of migraine sufferers have “a significant association between their daily stress level and their daily migraine activity.”
Right now, there are plenty of reasons to be more stressed than usual as we continue to shelter in place and await the end of the ongoing coronavirus outbreak. That, and the many ancillary issues that come with it, can certainly increase not just stress, but other interconnected triggers for migraines, making them more frequent.
To get a better understanding of how the current situation could be negatively impacting migraine sufferers and how they can better manage those triggers during this tough time, we spoke with neurologist Emad Estemalik, MD.
Understanding the triggers
“We know there are a lot of variables and factors that play a role in terms of either patients having a higher frequency or even a more specific or more severe migraines,” says Dr. Estemalik. Environmental factors, weather changes and even certain diet changes can all play a role.
But stress can have magnifying effects on the migraines that sufferers experience. According to Dr. Estemalik, stress can aggravate the frequency at which migraines occur. “If someone gets three to five headache days a month, under more stress like we’re living with right now, that can go up to 10 to 15 days a month,” he says.
Stress can also induce other physiologic mechanisms, Dr. Estemalik says, like sleep issues, certain mood symptoms, depression and anxiety. “It’s multiple factors,” he says. “Headaches, stress, depression, anxiety and sleep, they’re all interrelated.”
For instance, times of increased stress can magnify anxiety symptoms. “You find yourself unable to concentrate and your mind is racing all over the place,” he says. “You feel other anxiety symptoms and you have more worry and fear than usual and it puts you in a vicious cycle with increased stress levels and headaches, as well.”
That doesn’t mean you can’t manage that anxiety and stress. But, first, it’s important to note what triggers may be in place for you, especially right now.
Recognizing the triggers
One major component that Dr. Estemalik is seeing when it comes to increased stress levels in migraine patients right now is how much information people are seeking out on the coronavirus outbreak and how much time they’re spending in their search.
“It’s good to do your own research and get a proper understanding of what’s going on,” he notes, “but imagine you’re doing that for hours during the day because now you’re stuck at home. There are so many opinions and you’re jumping from one thing to another and you’re consumed with an indefinite flood of information.”
Social media plays a similar role, he adds, providing even more input. “While a lot of that information is correct,” he says, “there’s other information that’s not scientifically sound.” And it’s this overload that can trigger anxiety and stress and, yes, migraines.
“You’re getting so much information, your mind is racing and you’re trying to understand what’s correct, what’s not, what guidelines to follow and whether or not we have a vaccine. Again, it’s this indefinite influx of material that can be a main driver of stress, especially if you include watching the news on TV, too.”
Managing stress (and everything else)
Trying to manage stress, anxiety and all the other factors is a tall task, especially in the middle of a pandemic. But it’s not impossible and setting simple ground rules and boundaries for yourself can help alleviate all of those feelings that feed into the stress that can bring on migraines.
Curbing that flood of information is a big start. “Because there’s usually not a major change of information about what’s going on between the morning and the evening, limit your reading about this subject to 20 minutes a day,” Dr. Estemalik suggests.
“Get the numbers and see how your city and state are doing and move on to something more useful in reducing your stress levels.”
Among other ways to cope, he says, are spending time outside, meditating and reading. “Read information that can be more satisfying to your mind and your soul in general,” he says. General health issues are also important. Whether it’s going for walks, doing yoga or something else that you can do safely, exercise is important to helping alleviate stress.
It’s also important to keep an eye on your diet. “For a lot of people, when your stress level increases, that translates to, unfortunately, snacking or eating more.”
Boundaries are also important, he adds, like setting a time of day when you’ll stop checking the internet for more news and not reading your phone or laptop in bed. “Maybe after 6 pm, no more checking social media or Googling coronavirus news. You can clear your mind for a few hours before going to bed because otherwise your mind’s not shutting off.”
Ultimately, these (and other) ways of coping can be easily applied at home and have a cascading effect, reducing stress and even your headaches. “If you can try to reduce your triggers,” Dr. Estemalik says, “it can have an enormous benefit on the other symptoms as well.”