Are my emotions giving me migraines?

Want to fly, run your own business or climb Everest? Anything is possible with a virtual reality simulator. Immersive experiences have never been such fun. So, who’s up for experiencing a migraine? Cue Excedrin’s migraine trip, your chance to feel as debilitated, disorientated and distressed as someone who really has the condition. Excedrin makes painkillers (hence its interest in this area) and its representation of the flashing lights and blurry, shifting landscape looks accurate. If only they could bang you on the head and give you the painful throbbing that migraine sufferers feel. At two points in the company’s short online video, a friend or lover turns to a person with migraine and says: “I’m so sorry I doubted you.” So what is it about migraine that makes people feel it’s not real, that its an excuse to bunk off work?

This week, the New York Times covered migraines in its weekly misconception series by stating: “Women’s emotions do not cause their migraines.”

Migraines, argued the writer, Joanna Klein, were due to abnormal brain activity and not to emotional disturbances. Yet, as recently as 2012, research linked migraine to neuroticism (a medical term for emotional instability). People with migraine (myself included) will themselves link attacks to stress or emotional upset. So are emotions really unrelated? And if you could live stress-free, would you be migraine-free, too?

The solution

The Mayo Clinic in the US is a centre of excellence and D Todd Schwedt is a professor of neurology there who thinks neuroticism is an outdated and unhelpful term. “Migraine,” he says, “is a neurological disorder and not a maladaptive response to stress.” There is a strong genetic predisposition: up to 70% of sufferers have family members who are also affected. The mechanism is not fully understood but includes electrical changes in nerve cells spread over the brain: the brain functions abnormally during an attack.

There are books devoted to discussing the pathology of migraine. Triggers for attacks include hormonal changes (during menstruation), lack of sleep, red wine, missing meals, bright lights and – yes – stress. But as Schwedt says: “If someone without migraine is exposed to high stress levels, they don’t develop a migraine.” Don’t get triggers confused with causation. People who have migraines have different thresholds for triggering the electrical changes and the release of chemicals that cause symptoms such as flashing lights, nausea or throbbing pain.

There are medical treatments, such as Triptans, that can stop migraines progressing if taken quickly. It’s hard to avoid triggers: who leads a stress-free life or gets enough sleep? But remember that someone without the brain abnormality can have a load of stress and never get a migraine – except through virtual reality.