The Relationship Between Migraines and Generalized Anxiety Disorder

Generalized anxiety disorder and migraines may overlap.
Getty / Arman Zhenikeyev

A 2017 Canadian population health survey published in the journal Headache showed that 6 percent of individuals with migraines had experienced generalized anxiety disorder (GAD) in the past 12 months, compared with only 2.1 percent of those without migraines. This study suggests a connection between migraines and GAD, confirming the findings of previous research.

What Is a Migraine?

If you've ever had a migraine, you know that it often starts with an aura or visual symptoms like flashing lights.

You might see zig-zag patterns or experience a blind spot. The migraine itself usually involves severe pain on one or both sides of the head around the temples or behind the eyes or ears.

Migraines can cause nausea, vomiting, and sensitivity to light or sound. They may last for a few hours up to several days. People with chronic migraines have them 15 or more days per month. It's easy to see how having migraines regularly would interfere with your daily life.

How Do Migraines and GAD Relate?

Individuals with generalized anxiety disorder can't control their worrying, and fear things that are not likely to happen. They are known as worry warts, always expecting disaster.

People with GAD may be more likely to develop migraines, and those with migraines may also be at risk for GAD. People with both generalized anxiety disorder and migraines are also at increased risk for having major depression.

 People with both migraines and GAD also tend to have increased awareness of their symptoms, and headaches tend to be more severe in people with the disorder.

Migraines and GAD may share some symptoms, making it difficult to know which symptom is caused by which issue. Both may involve sleep problems, appetite changes, becoming easily upset, trouble concentrating, low energy, and dizziness.

Research has shown that among people with migraines, those who also have GAD are more likely to have low income, no close confidant, and to be male. In addition, for people with both generalized anxiety disorder and migraines, when their anxiety is acting up, migraines are more likely to occur.

We still don't know exactly how these two conditions are related, but it is believed that both may involve sensitivity to changes in the brain and body. Individuals with both problems tend to have greater disability and in turn, higher medical costs.

How Are Migraines With GAD Treated?

Treatment for migraines and GAD when present together may involve a single treatment method or multiple treatments. Medications for both generalized anxiety disorder and migraines include certain antidepressants, particularly the tricyclics like amitriptyline. It's believed that these medications change how the brain sends messages.

Cognitive-behavioral therapy (CBT) may also be used to manage anxious thoughts and feelings. CBT involves safe and gradual exposure to feared situations. CBT is thought to be more effective for anxiety in the long term compared to medication. However, a combination of medication and CBT has also been recommended.

People who have both generalized anxiety disorder and migraines may be less likely to follow directions for medication and therapy, and they may also be at risk for relapse. As a result, it is important that doctors recognize overlapping anxiety with migraines, and ensure treatment is being followed as planned.

In particular, treating migraines without addressing underlying anxiety can lead to problems. Instead, addressing each condition through one or more treatment methods is necessary.

How to Cope With Migraines When You Have GAD

  • Get enough sleep. Anxiety may interfere with your sleep, which can make you more prone to migraines. Migraines may also interfere with sleep, which can make anxiety worse. Receiving treatment for both conditions should help you to catch enough sleep at night.
  • Reduce stress. Stress may be a trigger for migraines. Try to reduce stress in your life, as it should also help you manage your symptoms of GAD.
  • Manage pain. Ask your doctor how to manage the pain of migraines. Chronic pain may worsen your anxiety if left unchecked.
  • Be healthy. Eat a balanced diet, drink enough water and exercise. Simple, basic healthy habits will at least ensure that you are not contributing to your anxiety or migraines through poor choices such as sugar and caffeine.
  • Look for distractions. This can help with both migraines and GAD. When you are in pain or feeling anxious, look for people, things, or situations that will help distract you from your feelings.

A Word From Verywell

If you live with chronic migraines and generalized anxiety disorder, it can be hard to get ahead of your pain and anxiety. Be sure to keep in touch with your doctor about treatment to help your symptoms. Treating the whole person including both issues simultaneously will give you the most benefit.

Sources:

Anxiety and Depression Association of America. Headaches.

American Migraine Foundation. Anxiety and Depression.

Culpepper L. Generalized anxiety disorder and medical illness. J Clin Psychiatry. 2009;70 Suppl 2:20-24.

Fuller-Thomson E, Jayanthikumar J, Agbeyaka SK. Untangling the Association Between Migraine, Pain, and Anxiety: Examining Migraine and Generalized Anxiety Disorders in a Canadian Population Based Study. Headache. 2017;57(3):375-390. doi:10.1111/head.13010.

Mercante JPP, Peres MFP, Bernik MA. Primary headaches in patients with generalized anxiety disorder. J Headache Pain. 2011;12(3):331-338. doi:10.1007/s10194-010-0290-4.

Continue Reading