Migraine and Anxiety
Everybody on earth has some degree of stress or anxiety. They might not be able to talk about it or identify it but anxiety is part of the universal human condition. Persons may say that their boss is a “pain in the neck,” for instance, a symptom common with the muscle tension part of Generalized Anxiety Disorder (GAD) which includes tension in the neck and shoulders. The boss is the problem but the patient gets the pain—in his neck. This is a backward way of a patient saying they are stressed, especially by their boss who may be demanding and strict. Half of persons with insomnia have GAD, the most common cause of sleeplessness. Some people think that have Alzheimer’s dementia because they can never remember things well, yet they test well cognitively and really just have poor concentration, another cardinal GAD symptom. Mental tension means “time pressure” or the feeling of having to work under the pressure of the clock to get a project done. Such a person may feel he doesn't have time for lunch and so he misses a meal and gets a "hungry headache." All these scenarios describe anxiety and below is the check list to make a diagnosis.
Diagnostic and Statistical Manual of Mental Disorders (DSM) 5 Criteria for GAD
Excessive anxiety and worry
Difficult to control
Symptoms occur for more days than not for six months
Significant distress or social impairment
At least three ancillary symptoms
Muscle tension-in neck, shoulders, jaw, or teeth, grinding or bruxism
Focus of anxiety/worry is not another disorder (for example, panic disorder)
Not part of a mood disorder, psychotic disorder, or pervasive developmental disorder
Not substance related
GAD and Migraine are 40% comorbid.
See the article "APA guidelines for treatment" on medical management of GAD.