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How can stress cause headaches?

Many things can cause headaches. It is felt that stress overall can make one more vulnerable to getting a headache. High levels of stress can make other triggers for a headache more potent. There are some great studies that show that some relaxation techniques can reduce the number and duration of migraines.

Stress is the most commonly recognized trigger of headaches. Stress can be physical or emotional to cause headaches. Some events causing emotional stress can trigger a migraine headache.

  • Migraine sufferers are highly responsive emotionally, reacting quickly to stress.
  • In times of emotional stress, certain chemicals are released that provoke the vascular changes that cause a migraine headache.
  • Factors related to stress include: anxiety, worry, shock, depression, excitement, and mental fatigue.
  • Chronic and repeated stress will cause daily or almost daily tension-type headache.
  • The headache is generalized (typically in a "hat-band" distribution), and often accompanied by a sleep disturbance.
  • Relief can be found by lowering stress, psychotherapy, biofeedback, behavioral modification, and the use of antidepressant drugs under the watchful eye of a physician. 
Dr. Marni Feuerman, LCSW, MFT
Marriage & Family Therapy

There are three different types of headaches, two of which are not caused primarily by stress, and one that may be:

  • Migraine Headaches: Headaches associated with migraines can be severe and even debilitating, and can last from 4 to 72 hours. These headaches are usually on one side of the head (unilateral), and worsen with daily activities like walking around. There can be nausea or sensitivity to light and sound involved, and sometimes an aura. Some experts state that stress is not a migraine trigger, other headache expert clarify that statement by suggesting that stress alone may not trigger migraines but it does make sufferers more susceptible to other migraine triggers. So, in a way, stress increases migraines, but is not considered a direct cause.

 

  • Secondary Headaches: This is the umbrella under which fall all headaches that are caused by more serious conditions such as brain tumors and strokes. They are also not directly caused by stress. Although, in the same way that stress makes people more susceptible to illness, and those illnesses can cause headaches, stress is indirectly related to secondary headaches.

 

  • Tension Headaches: These headaches, also called “stress headaches”, are experienced periodically by more than one-third of adults. They involve both sides of the head and generally feel tightness in the forehead or back of the neck. They’re not generally debilitating; people with tension headaches can normally go about their regular activities.  These headaches are thought to be directly caused by stress.
Kelly Traver
Internal Medicine

Headaches are a common response to stress. The three most common types of headaches seen in an outpatient primary care setting are muscular tension headaches, migraines, and temporomandibular joint pain. These headaches have different causes, but the underlying initiator is often stress.

Stress can cause muscular tension headaches because the stress reaction (or fight-or-flight response) naturally causes your spine to tighten. Your spine muscles are connected to the muscles and connective tissue of your scalp, so your scalp muscles tighten, too, in stress and this can generate a headache. This kind of headache is often diffuse and described as "tight" or "squeezing."

Migraine headaches work differently. They are caused by blood vessels in the brain that first constrict and then over dilate. Since this increase in pressure is within a fixed area of your skull, you feel pain. Migraines can be precipitated by stress, and they can also be precipitated by beverages and foods such as red wine and processed foods containing certain preservatives such as nitrates. They are also commonly precipitated by hormonal changes before a woman's menstrual cycle or in the perimenopausal period, when hormones fluctuate rapidly.

Temporomandibular joint (TMJ) pain is caused by inflammation in the small joint of the jaw, called the temporomandibular joint. This small joint can become inflamed if a person clenches or grinds his or her teeth at night or if the mouth remains open for long periods of time, such as at the dentist's. Stress can also cause tightening of the TMJ muscle, causing pain. The TMJ joint often refers the pain to the scalp area, causing a headache.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.