It’s NOT “Just Stress”

Normally I don’t dedicate an entire post on an article in the news.  Often I will post them to Twitter or Facebook (so keep an eye on those if you want more news!).

However, if there ever was an article that you should sit down and read, this is the one.

We have talked about stress and migraine for years.  I hope I’ve gotten across this fact:

Stress does not cause migraine

Stressed out!

Ok, so stress does not cause migraine disease.  Hopefully that’s clear, because many people under extreme stress never develop migraine, while others who are not under unusual stress do.

All right then – does stress trigger migraine attacks?

Well, that is a matter of opinion.  We can say with certainty that stress does not trigger every migraine attack.

This is a typical conversation I have with people…

James: So what did your doctor say?
Friend: She said that it was a migraine, brought on by stress.
James: I see.  Well, stress may be involved, but chances are there’s something else going on.  What else did your doctor say?
Friend: Well, she gave me these pills…

Stress is a very convenient way to act like you know what’s going on.  But doctors need to ask more questions to really get to the bottom on things.

“It’s stress” usually means to the patient “Don’t look for another cause – you’re probably just not coping well”.  Guess what – it’s probably not stress, and if we can get that into our heads we will find better treatment QUICKER.

Does it sound like I’m ranting?

I respect doctors.  And I do understand that stress may be involved.  And even when a doctor says that, they may have some very excellent treatments to recommend, and they may not be writing off other possible factors.

But I do think it’s very easy for doctors to send the wrong message.  And the same for patients.

The author of the article also wrote this in her personal blog:

But it’s not just doctors who are to blame.  Some patients dismiss their symptoms as stress too and to be fair iit’s[sic] easy to see how doctors can be thrown off the scent of what is really wrong.  Jade Smith – another patient I’ve interviewed for the piece above – admits she put all her symptoms down to stress – even though she was in constant pain from head to toe.  The problem was that she was going through a stressful time at work so stress seemed to be the obvious cause of all her ills.  Later though when her symptoms of depression lifted she was still left in pain.  When she mentioned it to her doctor he diagnosed fibromyalgia.

Now, let’s get to the article.

I highly recommend you read the whole thing yourself, but I am going to give you some highlights.

The article starts with the story of Victoria Saxton, who was told she had headaches from muscle tension from the stress of studying.  As you may guess, there was another factor.  Other similar stories follow.

Here are some key points the article brought out:

  • The “stress” diagnosis often keeps patients from discovering the real (and often dangerous) issue.
  • Patients in pain often show signs of stress – because they’re in pain!
  • Patients in pain also show signs of stress for biological/neurological reasons.  There are physical connections between pain and stress.

This from neurologist Dr Giles Elrington, director of the National Migraine Centre:

If I had a pound for every patient I see who is told their headache is down to stress, I’d be a rich man.  Saying headaches are just down to stress won’t do.  While stress, or the let-down period after stress, can trigger migraine attacks, it occurs in only 10 per cent of cases.  The reality is that there are lots of other triggers, including dehydration, skipping meals, lack of sleep, disruptions to the body clock, poor posture and hormone changes — yet these are often overlooked.

There are some other excellent points that the article makes, but I’ll let you read it for yourself.

Yes, I’m stressed – stressed because patients are going through years of treatments that aren’t working, or are simply focusing on the wrong things, because somebody told the patient that the problem was “stress”.

Are you convinced stress is involved?  Fine.  Try saying,“It’s stress and…” and see if you can fill in the blank.  Chances are there’s another trigger or cause.

Enough introduction – here’s the article:
The doctor says you’re just stressed. But could it be more sinister?

Now excuse me, I’m going to write to the author of this article (Jo Waters) to say “Thank you”.

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3 comments… add one
  • winny Oct 10, 2012

    James: Have had the same thing happen to me with a cancer diagnosis. Not only was I stressed but I was deemed (literally) hysterically wanting a hysterectomy because I calmly and clearly stated something was “wrong” becuase of many many issues. I was told that I needed to take a “vacation” from gyno doctors for a couple of years. In 2 years I was in the kind of shape you could not mistake my problems. Just because of hubris, and a doctor making a split second assessment of my being the minute he saw me. There is a study (I will try and find the link in PubMed) that a significant % of the doctors decide what is wrong with their patients within the first 15 seconds of walking into the exam room with the patient. Needs to be some retraining going on in my opinion in all practice types. A great article from across the pond (from me anyway!!)

  • Alvin Arnold Oct 12, 2012

    It is very common to us that we blame stress if we experience something in our body or we have some difficulties. I would rather say that it is a 50-50 change that stress is the cause because sometimes or most of the time, even we are not stressed, it will occur. Stress is somewhat a mental disorder, and that is the reason why most of the time, stress could affect our daily activities.

  • Stephanie Oct 12, 2012

    I had to comment on this. I have a stressful job (attorney). My greatest fear is that I would get a headache in the middle of trial. Never happens. I have gotten them in the least stressful times (on Christmas morning as a kid, I mean seriously). I had one neurologist tell me once that sometimes the migraine will come in a “let down” period after a stressful event. I always thought that to be interesting. There is very little rhyme or rythem to my headaces. But stress has never been the culprit.

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