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Could your fear of migraines be the very thing triggering them?
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Today we uncover 5 sneaky ways anxiety might be fueling your next attack and what to do
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Welcome to Migraine Heroes, a podcast for people living with chronic migraines with
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years of pain, misunderstanding and lack of answers.
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I'm Diane Ducarme.
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I've helped more than a thousand people reduce the burden of migraines and feel more in control.
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My mission in life?
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To help a million people.
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Each episode brings you grounded insight into what your body might be asking for and what
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Just to keep you fully supported, this podcast is educational.
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For diagnosis or medication, always work with your doctor.
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Now take a breath and let's dive in.
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In this episode, you will learn how migraine-related anxiety rewires your brain and keeps you stuck
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in a cycle of attacks.
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The five subtle everyday habits anxiety creates that may be unknowingly priming your next
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migraine, and a calming in-the-moment practice to soothe your nervous system and reduce the
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likelihood of another attack.
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Before we start, I really want to acknowledge something important.
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If you live in pain, like real pain, especially if you've had a migraine attack so severe
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it sent you to the emergency room, or made you think you were having a stroke, or caused
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you to lose your speech, feel half-paralyzed, or simply endure pain that feels absolutely
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unbearable, of course you're going to fear it.
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That fear makes complete sense.
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It's no different from how a woman who's been through a traumatic first labor might feel
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approaching a second one.
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Your body remembers.
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Your nervous system remembers.
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And there is absolutely no judgment here for anxiety.
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That anxiety is warranted.
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It exists because you know what's coming.
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You know the storm, and you know how violent and consuming it can be.
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And on top of that, you're often navigating all of this alone, trying to act like everything's
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fine, trying to keep social commitments that feel impossible, trying to be taken seriously
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in a world that still doesn't truly understand migraine.
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Life keeps moving.
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Expectations stay the same.
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And meanwhile, you're managing something invisible, unpredictable, and deeply, deeply disruptive.
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So if you feel anxious, hypervigilant, or on edge waiting for the next attack, I want
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to hear this clearly.
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That response is normal.
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It's understandable.
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And so today isn't about judging that anxiety.
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It's about understanding it.
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Because while that fear once served a purpose, over time, it can stop being your protector
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and start becoming your enemy.
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And by understanding how that happens, intellectually, gently, you can begin to approach things differently
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But with more clarity, more agency.
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And so you can hold yourself with the same care you'd offer someone you love.
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So what is migraine anxiety?
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Migraine anxiety, or what some researchers now refer to as a pre-attack anxiety or anticipatory
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anxiety, is a physiological state in which individuals experience chronic worry or fear
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about the onset of a migraine.
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And it's actually not just in your head.
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It is the biologically reinforced loop that I want to talk to you about today.
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So how big is the problem?
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In a study published in Headache, the journal of head and face pain, over 58% of chronic
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migraine sufferers reported significant anxiety directly related to migraine attacks.
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And among those with more than 15 headache days per month, that number rose sharply.
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That's more than half of people living in a state of heightened fear even before the
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Here's where it gets fascinating and actually serious.
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Chronic anxiety about migraines can alter brain function and pain processing, especially
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in the amylda and insula, two brain regions deeply involved in emotional regulation and
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A study from the Journal of Neurology, Neurosurgery and Psychiatry showed increased activation
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in these regions in migraineurs who reported high anxiety levels.
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This leads to what scientists call central sensitization.
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Your brain becomes more sensitive to stimuli that wouldn't bother someone else.
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The lights feel brighter, the noise gets louder, the stress hits harder.
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So what does this all lead to?
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There are four or five sneaky ways that anxiety is going to trigger migraine attack.
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The first way is hypervigilance to early symptoms.
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You feel a tiny twinge and your brain says, it's coming.
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This fear triggers stress hormones like cortisol and adrenaline, increasing inflammation and
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vasodilation, which are two key migraine mechanisms.
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The second way is poor sleep from worry.
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Sleep disturbance, especially REM sleep disruption, is both a cause and a consequence of anxiety.
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Poor sleep is a massive migraine trigger, as confirmed by a 2022 review in the Frontiers
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The third way is avoidance of social settings.
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You can cancel plans to play it safe, which is going to increase feelings of isolation
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and is going to reinforce your brain's threat response and the cycle is going to tighten.
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The fourth way is over-monitoring of triggers, so constantly checking, scanning for triggers
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like food, light, posture, weather, and keeping your brain in a state of alert and fear, raising
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baseline stress levels.
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And the fifth way is negative thought loops.
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Repeated thoughts like, I can't handle another migraine, activate the same pain centers as
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Yes, your thoughts can light up your pain circuits.
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And so here's the kicker.
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Even if a migraine does not come, the anxiety is still going to set the physiological groundwork
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Now, let's move east for a minute.
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In Asian philosophy, anxiety is not treated as a problem to be fixed, but as a state of
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misalignment with the present moment.
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It arises when the mind moves faster than life itself.
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When attention leaves what is, and leaves what might happen, the self is pulled out
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of the rhythm with reality.
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Taoist thought teaches that life unfolds in cycles and seasons, each moment carrying its
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And anxiety appears when we attempt to outrun those cycles, when we try to control outcomes,
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when we experience pain, or mentally rehearse the future.
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The mind tightens, effort increases, and resistance replaces flow.
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Suffering in this view doesn't come from what happens, it comes from struggling against
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the way things unfold.
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So in the East, anxiety isn't an enemy, but it isn't a guide either.
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It's a signal that the mind has stepped out of the present and is carrying more than this
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Peace, therefore, isn't achieved by suppressing anxiety, but by returning to immediacy, to
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breath, sensation, and now.
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And when the mind stops trying to live tomorrow, today, anxiety naturally loosens.
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I know this can sound very strange, a strange idea, and you might be thinking, how on earth
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could being in the present moment be an antidote to anything, especially pain?
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And I get that reaction, but I remember one moment very clearly, we were on one of our
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group calls, one spread across New Zealand, Australia, and then the US and Canada.
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And one of the women, she was actually based in New Zealand, in the North Island, she said
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something that completely stopped me.
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She said, I don't fear the pain anymore, I still have the pain, and then over time that
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pain subsided, but the fear of the pain is gone.
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So in that moment, she was in that group call expressing that the fear of the pain was gone,
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and over time we worked and successfully removed the pain as well.
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But that distinction fascinated me.
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And what she had learned, something that Dulty, one of our health practitioners and actually
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former clients, teaches us beautifully, she is a trauma expert, wasn't how to eliminate pain,
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but how to experience pain with safety, how to expect it without breathing, how to meet
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And the practice that she advised her to do was simple, was to anchor yourself with something
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that feels safe and observe what's unfolding without judgment.
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Not trying to escape it, not narrating it, just noticing it.
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So letting the pain come, and when it comes, think, it's expected, and just observe it
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and leave it to the side.
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And from a philosophical Asian perspective, this is quite profound.
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The pain is no longer layered with resistance, fear, or anticipation.
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It's no longer multiplied by the mind.
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And when that happens, something remarkable follows.
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The nervous system can finally soften.
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The body can return to rest and digest.
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And that is the state in which healing, or at least regulation, becomes possible.
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That's why I love having Dulty in the team.
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She's a blessing in the sky.
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This is why that notion matters so much to us at Migrant Heroes,
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it creates the condition for the body to help itself.
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It's not about forcing calm or pretending things are fine.
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It's about removing the extra suffering that comes from fighting what's already here.
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It makes me think of another woman, Priya Rama.
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Absolutely remarkable.
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She's an artist who paints her pain.
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She paints her migraines with aura.
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And what struck me when I met her wasn't the art itself, but how she related to the experience.
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When a migraine came, she wouldn't panic or brace against it.
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She would observe it, contemplate it without judgment.
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And then she translated it into color, shape, and movement.
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And I have two of her paintings in my desk, in my room, next to me.
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And there was something luminous about her, a beautiful glow.
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And to be clear, I'm not saying that anyone should live in pain or accept suffering or
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start drawing their migraines.
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That's not the point at all.
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The point is what her relationship to sensation allowed and revealed.
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And by removing judgment, by welcoming sensation instead of fighting it, she allowed her body
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to return to balance more quickly.
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There was no extra layer of fear, no resistance amplifying the experience, just awareness,
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And philosophically, that matters deeply because the absence of judgment creates safety.
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And safety is what allows the body to soften, recalibrate, and recover.
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I hope that makes sense.
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It's subtle and it's counterintuitive,
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but it's one of the most powerful ideas that the East offers us.
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When we stop adding struggle to sensation, the system finds its way back to balance faster.
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And remember, every small step you take moves you closer to freedom.
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You are powerful, you are resilient, and you are no longer alone.
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Keep rising, Migraine Hero.
