Stress and Headaches: What Can You Do?

Stress and Headaches: What Can You Do? 

Stress is one of the strongest triggers for both tension-type headaches and migraines. The problem is that stress is not a variable you can measure objectively. What feels overwhelming to one person might feel manageable to someone else. People also differ in how they deal with stress. This matters because it affects how likely you are to get a headache due to stress.

The good news is that research shows that people who find life very stressful can learn better ways to cope with stress. And when stress management improves, the frequency and intensity of headaches can improve too.

What does stress do to us?

Stress doesn’t just stay in your head. It affects your whole body and mind in many ways, potentially causing gastrointestinal issues, cardiovascular reactions, anxiety attacks, poor sleep, and – as mentioned – bringing on headaches.

A key player in all this is cortisol, a substance naturally produced in our adrenal glands (specifically, the adrenal cortex). Cortisol is often called 'the stress hormone'. Whenever your body interprets a situation as threatening – for whatever reason – cortisol levels rise quickly. Possible scenarios that might cause your cortisol levels to skyrocket include emotional crises, extreme pressure, feeling overwhelmed, intense environmental stimuli, and real physical danger.

Why do we actually have a stress response?

Our stress response is as ancient as the human race. Thousands of years ago, cortisol helped humans to survive. In dangerous situations, it prepared the body to fight or run away quickly (the famous “fight or flight” response). That instinct is still with us, but the world around us has changed. In modern life, the stress we face comes from a different set of challenges and calls for a different response. The cortisol the body produces stays elevated because the response it was designed for (fight or flight) is not appropriate to the situation. Over time, this can leave the body in a permanently overstimulated state of imbalance that affects the mind and body.

Cortisol, migraine and headaches

Research shows that people with migraine already have higher baseline cortisol levels. Even at rest, their blood cortisol levels may already be elevated compared to people who do not get migraines. Genetic factors probably play a role here. As a result, when stress occurs, cortisol can rise above a critical threshold more quickly. This can trigger a migraine attack.

Tension-type headaches – the most common type – are also highly stress-reactive, meaning that stress is a major trigger of tension-type headaches. The close connection between stress and headaches helps explain why, in a world full of stress and permanently high cortisol levels, headaches are so very prevalent.

What does science say about stress management?

Researchers identified the connection between stress and headaches early on and have long studied how stress management can help people with headaches. Hundreds of scientific teams around the world are developing and testing strategies to improve how individuals cope with stress in order to relieve or prevent headaches.

One such approach is mindfulness-based stress reduction (MBSR). It was developed in the 1970s by US molecular biologist Jon Kabat-Zinn. Kabat-Zinn conducted extensive research on the connections between physical processes and mental activity. His ‘mindfulness-based stress reduction’ approach advocates developing calmness and inner balance through the deliberate focus and direction of attention. He proposes a combination of different types of meditation, elements of yoga, and additional exercises, all of which are practised daily over a period of eight weeks. Today, this approach is offered to patients in several hundred hospitals across the United States and, in Germany, has been adopted by specialised psychosomatic clinics.

Is there evidence that MBSR helps with headaches?

A review of ten studies found that MBSR can reduce both pain intensity and the frequency of attacks in people with migraine and tension-type headaches. Statistical analysis found the reduction to be significant. Another positive effect – often observed with non-medication approaches like this – is that participants reported an increase in their sense of self-efficacy. Self-efficacy is the extent to which patients believe they can influence their symptoms through their own actions. In other words, people practising MBSR felt more confident that their own efforts could make a real difference in their symptoms.

However, from a scientific point of view, the authors of the review paper identified a limitation: the different studies used very different methods and approaches, which makes it more difficult to draw firm and reliable conclusions. This issue is more common in newer research on this topic than in traditional medication-centered studies. It is an indication that this is a relatively new research field that still needs to develop the common standards required to produce robust scientific evidence.

Breathing techniques to combat stress

Breathing training is another way to cope better with stress. Specific breathing exercises can improve the oxygen supply to the body. This helps prevent 'oxygen debt', which can occur when the oxygen supplied to the body by breathing is less than the amount your body needs – typically after a strenuous workout.

Mindful, 'correct' breathing also benefits the immune system, as research shows. Breathing training can also lower blood pressure. It slows the resting pulse and heart rate. Psychologically, breathing exercises can reduce perceived stress, and less perceived stress can meaningfully reduce headache attacks. Essentially: breathing exercises that improve your stress levels can help with headache prevention.

Migraines and daily routine: why regularity matters

Research repeatedly shows that sudden changes in daily routine are a common trigger of migraine attacks. For people living with migraine, unexpected events or a disrupted routine can act as powerful stressors.

Especially for people prone to migraines, keeping a consistent daily routine with a regular, predictable structure is very important. Taking steps to stabilise the day can noticeably reduce the burden of headaches. Helpful strategies include eating meals at regular times (see here), keeping a consistent sleep schedule (see this article), taking regular breaks during the day, and planning relaxation periods intentionally. For individuals susceptible to migraine, regularity reduces stress – and less stress means more effective prevention of headache attacks.

Published: February 2026