How Migraines Can Lead to Post-Traumatic Stress Disorder

Man with migraine sitting at a desk.
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Post-traumatic stress disorder is a psychiatric condition that arises after a traumatic event, like a car accident, death of a loved one, or abusive relationship. A person with post-traumatic stress disorder (PTSD) is overcome with emotions of helplessness and fear, often reliving the traumatic event in their minds over and over again. They often avoid things or people that remind them of the event.

The Link Between PTSD and Migraines

What's interesting is that post-traumatic stress disorder is more common in people who suffer from migraines than people who do not get migraines. Also, PTSD may trigger migraine development in those who did not previously suffer from them. In addition, people with migraines may be more likely to develop PTSD when exposed to traumatic events.

The exact reasons why this connection exists is unclear, but experts think there may be a biological basis. For instance, research has shown that the neurotransmitters serotonin and norepinephrine are lower in people with PTSD and in migraineurs.

In addition, a dysfunction in the hypothalamic-pituitary-adrenal axis (HPA axis) may also explain the link between PTSD and migraines. The HPA axis refers to the structures (the hypothalamus and pituitary gland being in the brain and the adrenal glands sitting on top of your kidneys) that regulate the stress response, which involves the release of the stress hormone cortisol.

Finally, a person's immune system may contribute to the connection between PTSD and migraines. Scientists have found that people with PTSD have elevated blood levels of cytokines. These cytokines are proteins that trigger inflammation in the body, and this inflammation has been linked to migraine formation.

Men With Migraines Are More Likely to Have PTSD

Men with migraines are at a greater risk of developing PTSD after a traumatic event than women. This is an interesting finding, but experts are not quite sure why this is true. They suspect that genetic differences between males and females and differences in how men and women respond to stress, in terms of hormone release, may play a role.

Treatment of PTSD and Migraines

While PTSD is often treated with selective serotonin reuptake inhibitors, or SSRIs, these are really not effective in preventing migraines. Instead, experts recommend treatment with either the atypical antidepressant Elavil (amitriptyline) or the serotonin-norepinephrine reuptake inhibitor Effexor (venlafaxine). In addition to medication, cognitive-behavioral therapy is also usually used to reduce migraines and symptoms of PTSD.

What Does This Mean for Me?

Both PTSD and migraines are disabling medical conditions alone, and suffering from them both can be even more debilitating. That being said, there are therapies to help both, and treating one may even help the other. So don't be discouraged—and don't fret if you have migraines. While your chance of developing PTSD when exposed to a traumatic event is higher than someone who does not have headaches, it's certainly not a guarantee.

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Article Sources
  • Peterlin BL, Najjar SS & Tietjen GE. Post-traumatic stress disorder and migraine: Epidemiology, sex differences, and potential mechanisms. Headache. 2011;51(6):860-68.