Don't Stress Me Out

Teri Robert, another fellow migraineur and prolific blogger, recently wrote that she disagrees with both MAGNUM and the International Headache Foundation about stress being a migraine trigger. Both MAGNUM and the IHF say that it isn’t, but Teri’s point is (and I’m probably summarizing and oversimplifying here) that it probably is a “meta” trigger: it takes other triggers and makes you more susceptible to them.

Her articles always give me a lot to think about, and this one was no different. So I started thinking about stress, and the question, “Does stress give me a migraine?” For me, I think the answer is no.

But answers are never simple with me, are they?

There’s a morbid joke that says “It isn’t the fall that kills you. It’s the sudden stop at the end.” That’s stress and migraine for me. It’s not the stress that causes the migraine, instead, it’s the relaxation at the end of the stressful period that does.

This is another one of migraines’ cruel jokes—something called the “letdown migraine” or the “letdown headache.” There we are all week at work, busting our humps to get the job done, working at a hundred and twenty percent of capacity. When the weekend finally comes, we can start to unwind. We finally have some peace and quiet. And that’s when it strikes.

I’m not sure what causes this. Maybe the stress at work keeps our cranial blood vessels constricted, and when we get a chance to relax, they dilate and start playing havoc with our trigeminal nerve. Or maybe the relaxation time starts messing with our serotonin levels or something. Regardless of the cause, for those of us that suffer from this particular type of migraine on a regular basis, it kind of sucks!

Luckily for me, the letdown headaches aren’t a given. I would say they only happen maybe 25 percent of the time—and usually only when the week has been particularly hectic (and the weekend is particularly quiet). Given that, I guess I can rely on my Midrin or Maxalt to get me through the rough spots. My only other choice would be to deliberately introduce more stress into my life on the weekends, and that just seems ridiculous.

Talk about your migraine triggers in the message boards.