February 20, 2014
News Review From Harvard Medical School -- Stress Level Tied to Number of Headaches
Yes, it's true -- more stress is linked with more headaches. That's the conclusion of a study that surveyed more than 5,100 adults. Four times a year for 2 years, they were asked to rate their levels of stress on a scale of 1 to 100. They also were asked about the number of headaches they had each month. Rising stress was linked with an increase in the number of headaches. Researchers wanted to make sure that some factor other than stress did not lead to the increase in headaches. So they adjusted the numbers to account for other factors linked with headaches, such as drinking and smoking. A 10-point increase on the stress scale (1 to 100) was linked with a 6.3% increase in the number of tension headaches. Migraines increased 4.3% for each 10-point increase in stress. The increase was 4% for those with both types of headaches. Study results were presented at a conference of the American Academy of Neurology. HealthDay News wrote about it February 19.
By Robert H. Shmerling, M.D.
Harvard Medical School
What Is the Doctor's Reaction?
Stress is a complicated thing.
We usually think of it as a problem, something we should try to minimize in our lives.
Yet stress can come with benefits. Our bodies have evolved to respond quickly to life-threatening stress. For example, when we face danger, adrenaline is released into the bloodstream. This leads to an increase in heart rate, blood pressure and blood flow to our muscles. It's part of the "fight or flight" response.
Even in less dire circumstances, it some people appear to thrive on stress. They seem to perform better under stress than without it. Think of the athlete who rises to the occasion when the game is on the line. And I know I get more done when I have deadlines, even though deadlines are a source of stress.
But when it comes to health and disease, stress is usually considered a cause or contributor for a host of ailments, including insomnia and depression. It has even been linked to heart disease and cancer.
A new study looks at the common notion that stress contributes to headaches. And it seems that it does.
Researchers surveyed more than 5,100 adults about their stress levels (rated from 0 to 100) and frequency of headaches over 2 years. Here are some of the results:
- Headaches were common. Nearly one-third of those surveyed had tension headaches. About 14% had migraines. Another 28% had a combination of different types of headaches.
- Stress levels were highest for those with migraine headaches.
- Increases in stress were linked with a higher number of headaches. For example, researchers found a 4% to 6% increase in headache frequency for every 10-point increase in self-reported stress levels.
This means that some people could have several more headaches each month due to stress. If a severe headache occurs at just the wrong time -- a big exam at school or a big sales meeting at work -- the impact of stress may be underestimated by just counting up the number of headaches.
It's important to note that this study relied on self-reports about stress and headaches. People might not remember accurately how often they had headaches. And headaches might cause stress (rather than the other way around), especially if they come often. Still, the findings are intriguing. And they provide support for a link between headaches and feeling stressed.
What Changes Can I Make Now?
If you have headaches, this study suggests that reducing stress -- or coping with stress better -- might reduce how often your headaches occur.
Consider making the following changes to reduce your stress or improve your response to it:
- Eat well, get plenty of sleep and exercise regularly.
- Avoid alcohol, drugs and excessive caffeine.
- Try meditation techniques that focus on breathing and muscle relaxation.
- Avoid overextending yourself. When asked to take on more responsibility at home or at work, give yourself permission to say no.
- Remove yourself from the stressful situation for a while. Stop reading your e-mail, turn off the news report and go for a walk.
- Confide in others. Talk about whatever is bothering you with your spouse, a trusted friend or a family member. For some, it may be helpful to talk with a member of the clergy or your primary care doctor about what stresses you and how to deal with it.
- Get help from a professional. If your stress is making it difficult to function or impairing your quality of life despite your efforts to deal with it, see a counselor or therapist.
There is no one "right way" to reduce stress. One or more of these may work for you but not for others. It may take some time (and practice) to figure out what helps you most.
What Can I Expect Looking to the Future?
One reason that stress seems so complicated is that there is more than one type of stress. Clearly, a threat of bodily harm is different from public speaking. Yet, to some degree, the body's response can be similar.
If the findings of this new research are confirmed, the next steps will be to determine whether:
- Some types of stress matter more than others in contributing to headaches and other health problems
- Reducing stress can help to make headaches less severe and occur less often
- Certain strategies to reduce or cope with stress work better than others
Feeling highly stressed all the time is probably not good for your health. But some stress may be good for you. For most of us, it's impossible to remove all stress -- and that may be a good thing.