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, and can last anywhere from 4 to 72 hours. They’re often accompanied by other symptoms. For instance, nausea, vomiting, and sensitivity to light are common during a migraine.

Migraines are different than headaches and what causes them aren’t well understood. But there are known triggers, including stress. According to the American Headache Society, about four out of five 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 that they may be caused by changes in the levels of certain chemicals in the brain, such as serotonin. Serotonin helps regulate pain.

In 2014, a 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. They 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, which has also been linked to other illnesses, such as upper respiratory infections, the flu, and an increase in arthritic pain.

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 headache, in what 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 prodome stage. An aura causes vision disturbances, and in some people 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, which 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, Aleve) 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, but 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
  • have attacks that last more than 12 hours
  • don’t get relief from pain-relieving medications
  • experience an aura or numbness for prolonged periods

Preventive medications are taken daily 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:

Prescription anti-inflammatory medications, such as 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 that 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. These include:

  • relaxation exercises, such as yoga and meditation
  • resting in a dark room when you feel a headache coming
  • getting enough sleep, which can be achieved through keeping a consistent bed time each night
  • massage therapy, which can help prevent migraine, reduce cortisol levels, and decrease anxiety, according to a 2006 study
  • exercise, which 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 who can recommend ways to cope with stress.

Migraines from stress can be prevented by taking steps to minimize the stress in your life. Medications and self-care measures can also help you get relief from symptoms and prevent or reduce the frequency of your migraines.