The Link Between PTSD and Migraine Explained

Migraine is a neurological condition characterized by severe head pain, nausea, sensitivity to light and sound, and more. Post-traumatic stress disorder (PTSD) is a mental health condition that occurs after someone has experienced a traumatic event.

While research is still limited, there seems to be a connection between migraine and PTSD. People with PTSD seem to be more likely to have migraine headaches, while people with migraine may have an increased risk of developing PTSD. Both conditions can cause disability, so it’s important to know the signs and how to manage each.

“There is a significant association between migraine and PTSD,” says MaryAnn Mays, MD, a neurologist and headache specialist at Cleveland Clinic. “Studies suggest that people with PTSD are more likely to experience migraine than the general population.”

Dr. Mays also says that PTSD likely worsens migraine symptoms, and vice versa.

People with PTSD tend to have higher scores on questionnaires about migraine’s impact on a person, says Ryan Serdenes, DO, a psychiatrist at Temple University Hospital in Philadelphia and an assistant professor of clinical psychiatry at Temple’s Lewis Katz School of Medicine.

“Overall, the relationship between both conditions is complex and likely bidirectional,” Dr. Serdenes says, meaning that each condition may influence your chance of developing the other.

Statistics on PTSD, Migraine, and Other Headache Disorders

Do Headaches Lead to PTSD?

“Headaches themselves do not directly lead to PTSD, but can contribute to the overall burden of PTSD symptoms and exacerbate the condition,” says Mays.

“However, chronic migraine can lead to psychological distress, anxiety, or depression, which may mimic some PTSD symptoms,” she says.

Serdenes says that “generally speaking, PTSD is characterized by either a direct or indirect exposure to trauma,” so headaches or migraine cannot directly lead to PTSD.

It’s not entirely clear why some people with PTSD have an increased risk of developing migraine, but researchers have a few theories.

Childhood Trauma

“Adverse childhood experiences were identified as a risk factor to developing a primary headache disorder as an adult,” Serdenes says. He adds that physical, sexual, and emotional abuse in childhood have been linked to an increased risk of migraine.

Traumatic Brain Injury

According to Mays, people with mild traumatic brain injury (TBI) who develop post-traumatic headaches are more likely to report PTSD symptoms. This suggests that there’s a relationship between headache severity and PTSD.

Stress and Extreme Emotions as a Trigger

Mays says that marginalized populations such as refugees, migrants, and sexual and gender minorities also face higher rates of PTSD and chronic headaches. This is “due to systemic stressors such as racism, economic hardship, and barriers to healthcare.”

Both PTSD and migraine are treated with medication, therapy, and lifestyle changes. Treating just one condition will improve both conditions, so treating both should improve your overall quality of life.

Medications

There isn’t currently one medication used to treat people who have both PTSD and migraine, so your doctors may recommend migraine medication and PTSD medication separately.

The serotonin-norepinephrine reuptake inhibitor (SNRI) venlafaxine, and the tricyclic antidepressant amitriptyline, have been used off-label for treating both PTSD and migraine, so a doctor may recommend one of these first.

Therapy

• Cognitive behavioral therapy (CBT)
• Acceptance and commitment therapy (ACT)
• Mindfulness-based stress reduction (MBSR)

Other Treatments

Because gammaCore is so new, you may need to ask your doctor if insurance will cover it.

Self-Care and Lifestyle Changes

It’s important to take care of your overall mental and physical health when you’re managing both conditions.

You can:

• Relieve stress with practices like deep breathing or journaling.
• Exercise.
• Track symptoms of both conditions.
• Eat nutritious foods.
• Get adequate sleep and keep a consistent sleep schedule.
• Stay hydrated.
• Seek support when your treatments aren’t working well enough.

Anytime you have new symptoms of migraine, you should reach out to a doctor for complete medical evaluation, says Serdenes.

Mays says that you should see a doctor if:

• New migraine episodes or headaches develop, especially if they’re happening often or are severe
• Headaches or migraine symptoms are interfering with your sleep or daily functioning
• Over-the-counter (OTC) medications aren’t working anymore, or medication overuse becomes a concern
• Your PTSD symptoms start to get worse alongside the headaches

If you believe you may have migraine or PTSD, reach out to a healthcare professional. They can help figure out what’s causing your symptoms and get you the support you need.

• Migraine and PTSD are connected, though experts still have a lot to learn about the link.
• People who have migraine are more likely to develop PTSD, and at the same time, people with PTSD have an increased chance of developing migraine.
• Genes, traumatic brain injury, stress, and brain chemicals may all be part of why many people are diagnosed with both PTSD and migraine.
• Your doctor may recommend treating migraine and PTSD separately, or certain medications may be used off-label to treat both.