Can Anxiety Cause Headaches?

While temporary anxiousness, stress, and worry are natural reactions to life events, anxiety disorders arise when these feelings don’t go away or worsen. This class of mental health conditions, which affects up to 30% of adults, includes:

• Generalized anxiety disorder (GAD)
• Panic disorder
• Phobia
• Social anxiety disorder
• Separation anxiety disorder 
• Post-traumatic stress disorder (PTSD)

Anxiety disorders provoke a range of emotional and physical symptoms. Acute and chronic headache disorders often accompany them, and these conditions are closely linked. This article provides a quick overview of the symptoms, types, and treatments for anxiety headaches.

How Anxiety Affects the Body

The feelings of fear out of proportion to situations, excessive worry, and the other psychological effects of anxiety disorders are only part of the story. While there are some variations among specific types, anxiety disorders cause a range of immediate physical symptoms:

• Heart palpitations, heavy beating, faster heart rate
• Chest pain
• Sweating
• Headaches
• Dizziness, light-headedness
• Tingling
• Breathing difficulties
• Trembling and shaking
  

Why Anxiety Causes Headaches

While there’s more work to do, researchers have found significant connections between anxiety and headaches.

Those with anxiety disorders, especially generalized anxiety disorder (GAD), are much more likely than others to experience migraine and new daily persistent headache (NDPH). Furthermore, having an anxiety disorder increases the risk of headache problems becoming chronic (flaring up 15 or more times a month).

As to how anxiety disorders and headaches are related, researchers are still working it out, but have been able to draw several connections:

• Genetic predisposition: Migraines, other chronic headaches, depression, and anxiety disorders seem to have a shared genetic component. This implies that you may be born with a predisposition for both anxiety and headaches.   
• Anxiety preceding headaches: Anxiety disorders and migraines have similar symptoms, including irritability and increases in muscle tension. The worry and fear caused by anxiety, sleeping disruptions, and other symptoms can make headaches worse and may work to set headaches off.
• Headaches leading to anxiety: Researchers have found that headache disorders can also precede the onset of anxiety. This implies that behavioral issues can also be the result of the instability and stress of living with an unpredictable condition.  

Symptoms and Types of Anxiety Headaches

Anxiety disorders are primarily associated with two types of headaches: tension and migraine. Each has a distinct set of symptoms and signs, though they can also co-occur. The less common headache type, new daily persistent headache, is also associated with anxiety. Here’s a quick breakdown of these types.

Tension Headaches

The most common type, tension headaches arise when muscles contract and tighten up in the head and scalp. This causes you to feel dull pain or pressure on both sides of the head, usually localized in the scalp, temples, neck, and shoulders. Tension headaches last anywhere from 30 minutes to 7 days.

A range of issues set off this tension, including:

• Stress
• Dehydration
• Anxiety and/or depression
• Head injury
• Poor posture/head position
• Smoking, alcohol, or caffeine use
• Dental issues
• Colds, the flu, or sinus infection
• Eyestrain

Migraine Headaches

Compared to tension headaches, migraine symptoms are typically more debilitating and diverse. A recurrent disorder that more often affects women than men, attacks tend to go through phases, lasting anywhere from four to 72 or more hours.

There are many different types of this headache, and the signs and impact can vary from person to person. Generally, the signs of migraines are:

• A stabbing or pulsating headache of moderate or severe intensity
• Pain is usually only on one side, though it can be on both
• Nausea and vomiting
• Increased sensitivity to lights and sounds  
• Feeling tired
• Restlessness, giddiness, or depression
• Visual disturbances, or auras, causing flashes or zig-zags

Migraines are closely associated with their triggers, which are certain stimuli or health factors that can set off attacks. These can also vary individually and include:

• Certain foods or drinks, especially those with preservatives, artificial sweeteners, or that are pickled and fermented
• Hormonal changes due to menstruation, menopause, or hormone therapy
• Caffeine, which can set off attacks but also alleviate them if you regularly use it
• Bright or flashing lights
• Strong smells or odors
• Alcohol use
• Stress and muscle tension
• Disruptions of sleep or not getting enough rest

New Daily Persistent Headache

A very rare headache disorder, new daily persistent headache (NDPH) is also closely associated with anxiety disorders. In one study, 65% of those with this condition also experienced anxiety disorders. As its name implies, those with the condition suffer daily headaches and other symptoms. The features of NDPH include:

• Sharp, stabbing pain, often on one side of the head
• Flu symptoms when it first sets on
• Nausea and vomiting
• Sensitivity to light and sound
• Worsening of symptoms with physical activity

How to Treat Anxiety Headaches

Managing anxiety headaches often means relying on multiple strategies and working on multiple fronts. It may require taking medications or undergoing therapy, targeting both the anxiety disorder and the headaches themselves.

OTC Pain Medicine

Often the first-line approach to headaches is over-the-counter (OTC) analgesics, or pain medications. For anxiety headaches, these include:

• Motrin, Advil (ibuprofen)
• Aleve, Anaprox DS, Mediproxen (naproxen)
• Tylenol (acetaminophen)
• Excedrin, Butalbital (combination pain medication and caffeine)

Prescribed Medications

Among the approaches to managing anxiety disorders and the associated headaches are several classes of prescribed medications, including:

• Selective serotonin reuptake inhibitors (SSRIs), such as Zoloft (sertraline) and Prozac (fluoxetine)
• Serotonin and norepinephrine reuptake inhibitors (SNRIs)
• Tricyclic antidepressants like Anafranil (clomipramine), among others
• Beta-blockers like Inderal (propranolol) and Tenormin (atenolol)

For difficult migraine or other headache conditions, several classes of prescribed medications can help. Triptans, such as Imitrex (sumatriptan), and ergot alkaloids, like Cafergot (ergotamine), may help after attacks have set on. Furthermore, anticonvulsants and Botox injections are options for preventing migraines or other disorders from setting on.

Talk Therapy and Support Groups

Talk therapy can play a massive role in treating anxiety disorders and the associated headaches. Particularly effective for these conditions is cognitive-behavioral therapy (CBT), in which you and a therapist develop strategies for coping. In one-on-one sessions with a therapist, this entails:

• Learning how your thoughts contribute to your anxiety and pain
• Figuring out ways to change these thought patterns to reduce the intensity of attacks
• Learning how to control unwanted behaviors resulting from the condition
• Developing strategies for facing anxiety-provoking situations

There are also benefits simply to having someone to talk to, and support groups can provide that helpful ear. By sharing your own experiences—and being reminded that others are going through what you are—you’ll find further footing to manage your anxiety.     

Complementary Treatments

Complementary therapies may also help with anxiety and headaches, especially when combined with other therapies. These focus on promoting relaxation and may help ease the frequency and severity of symptoms. Strategies you can try include:

• Meditation and mindfulness
• Yoga
• Massage therapy
• Acupuncture
• Riboflavin (vitamin B12), magnesium, or co-enzyme Q10 supplements

Preventing Anxiety Headaches

There’s a lot you can do to minimize the severity of anxiety headaches or stop them from forming altogether. The keys to prevention are making positive dietary and lifestyle changes, incorporating better sleep, and working to reduce stress.

Diet and Lifestyle Changes

Making healthy changes to your lifestyle and diet is another means of managing the headaches associated with anxiety disorders. Key lifestyle changes to incorporate include:

• Keep a headache diary: Keep a log of when your headaches and other symptoms are happening, what medications you’re taking, what you’re eating and drinking, levels of tension and stress, and any other factors that may influence your condition. The more you know about your headaches and anxiety, the better you’ll be able to treat them.
• Exercise: Regular activity and ensuring your fitness can go a long way in managing anxiety disorders and headache attacks. Aim for a minimum of 150 minutes a week (30 minutes a day, 5 days a week) of light to moderate activity. Start small and scale up as you make progress.
• Manage weight: Higher weight is linked with increased incidence and rates of migraine and other headache disorders. Working to manage weight through diet, exercise, and other means can reduce the frequency of attacks.

Better Sleep Habits

Anxiety disorders are closely linked to sleep disorders and poor sleep quality, which can trigger migraine episodes and tension headaches. Focusing on getting sufficient and good-quality rest is critical for anxiety headache prevention. Here’s what you can do to improve your sleep:

• Go to bed and get up at consistent times
• Get enough sleep (for adults, 7 to 8 hours a night)
• Make the bedroom a screen and work-free zone
• Avoid caffeine, nicotine, or alcohol before bed
• Don’t take naps
• Exercise regularly
• Have a relaxing, regular routine before going to bed (a bath, light stretching, meditation all work)

Stress Management

Since stress can set off headache disorders—and is a constant factor in anxiety disorders—figuring out healthy ways of managing it can also help with prevention. There are several strategies that can help:

• Biofeedback: The aim of biofeedback is to learn your own physiological signs of increasing stress and tension, while also developing relaxation strategies to prevent headaches. Early on, you wear devices that track these signs so that you can get a sense of when stress levels are rising.
• Mindfulness: Regular mindfulness work can also help prevent headaches from starting. The idea is to focus on the present moment, training yourself to become aware of the activity of your mind. These techniques can help with pain acceptance for chronic cases.  
• Visualization: Guided or solo meditation with visualization can also be a means of easing stress. This may involve deep breathing and working on ways to ease muscle tension in the body.

Summary

Anxiety disorders, such as generalized anxiety disorder and post-traumatic stress disorder, are closely linked to headaches. Those experiencing these conditions are much more likely to experience tension headaches, migraines, and new daily persistent headaches, among others. These headaches can increase the burden of anxiety disorders, making their management an aspect of overall care.

Over-the-counter pain killers such as ibuprofen or naproxen may help with the pain, as can prescribed anti-anxiety medications, such as selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants, and others.

Lifestyle modifications, such as ensuring you get enough sleep, eat well, get exercise, and promote relaxation can help prevent attacks. Therapies, such as cognitive-behavioral therapy also play a central role in managing this condition.     

A Word From Verywell

There’s no denying that anxiety disorders can be a terrible burden, affecting both your mental and physical health. The associated headaches only add to that weight. As tough as it can be, it’s important to be proactive and engaged in your own care and to remember that the tools are out there to manage your anxiety.