Anxiety Headache

What Is an Anxiety Headache?

Anxiety headaches happen along with a feeling of anxiety. Having a headache may make you anxious. Or a headache can be a physical symptom of your anxiety.

Doctors believe the two can be linked, but they don’t understand exactly how.

It may have to do with how the brain works. The cells in your brain that control mood, sleep, and pain use a chemical called serotonin to send messages to each other. When people get migraines, these cells get much more active than normal. That changes your serotonin levels, which may lead to anxiety.

As doctors learn more about how headaches and anxiety affect each other, they can offer better treatments for both. Make sure to tell your doctor about both conditions so you can get the care you need.

Anxiety Headache Causes

Does anxiety cause headaches, or is it the other way around? The answer's not so simple.

Headaches are a common symptom of different types of anxiety, like generalized anxiety disorder (GAD). That's a condition where you constantly worry and find it really hard to control your anxiety. Headaches are one of the signs doctors look for when they check for GAD.

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Often, though, it's not clear how to tease apart cause and effect when it comes to anxiety and headaches. It may be that if you're someone who's more likely to get one of those problems, your chances go up that you'll get the other. For example:

  • Some folks have a history of migraines before they have GAD or other anxiety issues. Others have anxiety first and develop migraines later.
  • People with migraines are more likely to have anxiety and depression. When you have all three, it usually starts with anxiety, then migraines kick in, and then depression shows up.
  • For people who don't typically get as many headaches, anxiety increases the odds of getting them more often.

Things that may contribute to anxiety headaches include:

  • Stress
  • High sensitivity to pain
  • Muscle tension
  • Lack of sleep
  • Low serotonin levels
  • General anxiety disorder

Types of Anxiety Headaches

Doctors don't have a separate name for a stress or anxiety headache. But the most common types of headaches all have a link to anxiety.

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Tension headaches. Almost everyone gets one at some point. When you hear people say they have a headache, it's usually this kind. Typically they're not too painful.

Tension doesn't mean stress in this case, but refers to how the headache feels, which may be like a tight band around your head. It can be triggered by anxiety, but it's not clear why this happens.

Migraines. These are more severe headaches that can cause painful pounding or throbbing. They can last for hours or even days. Besides pain, migraines can also make you vomit and feel sensitive to light and noise. They're very common in people who have anxiety disorders.

Cluster headaches. They aren't as common as the other two. They're very intense and tend to give you a burning or piercing pain, usually behind the eyes.

They're called cluster headaches because of how they happen. You might get them a few times a day for a few weeks or months, and then they just go away. They may not come back for months or years.

People with cluster headaches are more likely to have anxiety -- typically in the months of downtime between bouts of headaches. Doctors aren't sure how cluster headaches and anxiety are connected or which one causes the other.

Anxiety Headache Symptoms

Your pain and other signs may differ, depending on which type of anxiety headache you have.

Tension headaches:

  • Mild or moderate pain on either side of your head
  • Pain can last hours or days
  • Headache doesn’t get worse with physical activity

Migraine headaches:

  • Sharp and intense throbbing pain
  • Often happens with nausea and sensitivity to light
  • Pain may be just on one side, and may be focused on the eye, the back of the head, and other areas
  • Headache can last a day or longer

Cluster headaches:

  • Extremely severe pain
  • Each attack can last 15 minutes to several hours. You can get multiple attacks a day.
  • Watery eyes
  • Runny nose
  • Sweaty face

Treatment for Anxiety Headaches

The first thing to do, if you haven't already, is talk to your doctor. They’ll likely ask about your symptoms and health history. Try to give as much detail about your symptoms as you can.

Your doctor may suggest:

Medicine. Some drugs for anxiety, such as anxiolytics, tricyclic antidepressants, and monoamine oxidase inhibitors (MAOIs), can also treat headaches. If they don't work for you, you may need more than one drug.

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You'll have regular checkups to see how well the medicine works for you and to make sure your headaches don't get any worse.

Therapy. You might also get different types of therapy to help with anxiety issues. Cognitive behavioral therapy (CBT) has been shown to be particularly effective for people with anxiety and migraines. It helps you become more aware of your thoughts and behaviors so you can change them to lessen your worry and anxiety. You can often see results within a few months.

Pain relievers. You can start with over-the-counter medications such as aspirin, ibuprofen, or naproxen. Prescription drugs called triptans may help if you have both migraines and tension headaches.

Muscle relaxants.Tizanidine (Zanaflex) may help prevent some tension headaches.

Alternative remedies

Certain non-medication treatments may help, too.

Biofeedback. You use a machine that relays electrical signals to help you control your muscle movements and breathing to help you relax.

Heating pads. Putting them on your shoulders and neck may help ease tension and keep the headache away.

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Acupuncture. Studies suggest that this needle-based therapy can cut the number of headache days as well as make them hurt less.

Often, a combination of therapy and drugs is better than just taking medicine. No matter what treatments you choose, it's important to get care for both headaches and anxiety.

Anxiety Headache Prevention

Lifestyle changes and paying attention to your headache triggers can help avoid them off before they start.

  • Manage your stress.
  • Track your triggers.
  • Do exercises that get your heart beating fast.
  • Get enough sleep.
  • Practice good posture.
WebMD Medical Reference Reviewed by Smitha Bhandari, MD on July 28, 2020

Sources

SOURCES:

Anxiety and Depression Society of America: "Headaches," "Generalized Anxiety Disorder," "Therapy."

The University of Iowa: "Cluster headaches associated with anxiety disorders, memory deficits."

Cleveland Clinic: "Migraine Headaches," "Stress and Headaches," "Overview of Headaches in Adults."

American Migraine Foundation: "Anxiety and Depression."

Mayo Clinic: "Tension Headaches."

National Health Service (UK): "Tension-type Headaches."

Penn State Health Milton S. Hershey Medical Center: “Headaches -- tension.”

Harvard Health Publishing: “4 ways to tame tension headaches,” “Tension Headache,” “What type of headache do you have?”

Cochrane Database of Systematic Reviews (Online): “Acupuncture for tension-type headaches.”

Michigan Medicine: “Tension headaches.”

StatPearls: “Cluster Headache.”

Functional Neurology: “What is cluster headache? Fact sheet for patients and their families. A publication to mark Cluster Headache Day 2016.”

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