Chronic migraine, which affects an estimated 1 to 2 percent of people around the world, is sometimes rooted in stress or lack of sleep. It’s diagnosed when you have 15 or more headache days per month and can be disabling with major emotional effects.

While chronic migraine has a physical neurologic root cause, adding talk therapy to a chronic migraine treatment plan has been shown to help some people manage the condition.

Talk therapy, also known as psychotherapy, can be used to lower stress levels and manage depression, anxiety, or insomnia. It involves talking with a licensed professional to better understand and react to stress, pain, and even your own feelings and beliefs.

For many people with headache disorders, a combination of medications and complementary treatments, such as therapy, leads to the best results in terms of reducing headaches.

Talk therapy can help you manage the mental health impacts of chronic migraine and may reduce the number of migraine attacks for some.

According to the American Migraine Foundation (AMF), 30 to 60 percent of people with migraine have fewer headaches after starting relaxation, biofeedback, or cognitive behavioral therapy (CBT).

For people who use relaxation therapy or biofeedback therapy specifically, the AMF has reported they see a 45 to 60 percent reduction in headache frequency and severity.

Benefits of therapy

Talk therapy can have a number of benefits, including preventive measures. It can help you:

  • manage pain response to chronic migraine
  • reduce the stress associated with the condition
  • change your mental outlook
  • improve sleep
  • learn relaxation techniques to help prevent migraine onset

Risk factors for chronic migraine include depression, anxiety, and stressful life events, so prioritizing mental health care is essential for those diagnosed with the condition.

Since stress can bring on a migraine attack and vice versa, learning how to manage stress is an important strategy that talk therapy can help you practice.

Migraine symptoms can leave you bedridden or unable to complete activities. These symptoms include:

  • moderate to severe head pain
  • throbbing pain
  • nausea and vomiting
  • dizziness
  • sensitivity to light, sound, and smells
  • disturbances to visual, motor, or other sensory function, called auras

Such severe symptoms can have a major impact on mental health, especially when chronic migraine lowers your quality of life.

This may contribute to an estimate from the AMF that states people with migraine are five times more likely to develop depression than those without migraine.

People diagnosed with chronic migraine may also experience symptoms of anxiety, like excessive worry, fear, or irritability. Some individuals might worry about when the next migraine attack could happen, or feel helpless over their symptoms.

Others may feel frustrated over the impact chronic migraine has on their lives.

Sometimes, feelings of depression can mimic common migraine symptoms, including:

  • insomnia
  • loss of appetite
  • general discomfort

A lack of control over the condition can also contribute to feelings of depression. This can include:

  • fatigue
  • loss of interest in previously enjoyed activities
  • changes in sleep or eating habits
  • feelings of sadness or hopelessness

Remember that you’re not alone and resources are available to you.

If you or someone you know is considering suicide or self-harm, please seek support.

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There are a number of therapy types that may help with chronic migraine. While some people use medication to alleviate the mental health impacts of the condition, others might benefit from therapy alone or a combination of the two. No single approach works for everyone.

Cognitive behavioral therapy

CBT can be useful for those looking to manage stress or change responses that may be contributing to feelings of anxiety and depression.

This common form of talk therapy works by helping you become aware of negative thinking. It also helps you understand how your thoughts and beliefs translate to your behavior.

CBT was shown to benefit people with migraine in one small 2019 study and more research is currently ongoing for migraine-specific CBT.

During CBT, you work alongside therapists to learn how to view difficult situations with more clarity, which can help you to respond in more effective ways.

Relaxation therapy

Some people use relaxation therapy for chronic migraine, which can have similar benefits to CBT. Relaxation therapy works by directly addressing stress, one of the key triggers for migraine symptoms.

Relaxation therapy involves calming the nervous system with meditative and calming exercises like deep breathing or guided visual imagery.

It can be done alongside a trained therapist in an office, which is helpful when you’re just getting started, or on your own with the help of smartphone apps or online videos.

Biofeedback therapy

During biofeedback therapy, you’re connected to machines that measure various involuntary physiological responses, such as skin temperature or muscle tension. You’ll be given information about the changes that are happening and may look at a computer screen or receive visual cues to see the physical measurements of stress.

This can help you understand and change your reaction to stress, or alert you to begin a preventive strategy, such as hand warming, says the AMF.

According to the National Headache Foundation, people with chronic migraine may see the following benefits from biofeedback therapy:

  • fewer migraine attacks
  • more stability in the nervous system between attacks
  • a greater sense of control over migraine

Biofeedback therapy usually takes place in physical therapy clinics, medical centers, and hospitals.

Speak with your primary doctor

The first step toward getting started with therapy is to speak with a primary care physician. It’s important to share your needs, concerns, and symptoms to identify a potential treatment plan. A primary care physician can also help refer you to a therapist they trust.

Be sure to speak up and advocate for a referral if you think therapy would help you manage migraine symptoms.

You should consider your goals for therapy as well, such as lowering anxiety or learning relaxation strategies. This can help you and your primary doctor determine which therapy is right for your needs. It may be best to find a therapist who has special experience working with people with chronic pain.

Consider costs

Before starting therapy, check if it’s covered by your health insurance or company benefits and try to select a psychologist or other mental health provider in your network.

You can also reach out to local hospitals for assistance in finding a provider.

For lower-cost options, consider finding a therapist who’s training at a center or university. They work under the close supervision of licensed mental health professionals.

There are also online therapy options available that may be less expensive than traditional therapy.

Talk therapy won’t get rid of chronic migraine, but it can help manage the mental health impacts of the condition and may reduce the number and severity of migraine attacks for some people. It can be useful in addressing stress, depression, or anxiety in general.

To learn more about the benefits of talk therapy, speak with your primary care physician. They can help you determine what kind of therapy may benefit your overall chronic migraine care regimen.