Migraine vs. Anxiety: How to Tell the Difference

Migraine vs. Anxiety: How to Tell the Difference (And Why It Matters): If you’ve ever found yourself asking, “Is this a migraine or is this anxiety?”—you’re not alone. For many women, especially those with chronic migraine conditions like vestibular migraines, the line between migraine symptoms and anxiety symptoms can feel blurry. Both can involve dizziness, nausea, sensitivity to light or sound, and intense fatigue. And both can be made worse by stress and nervous system dysregulation.

So how do you know what you’re really dealing with—and how do you treat it effectively?

Let’s dive into the key similarities, the major differences, and the healing strategies that address both conditions at the root.

Why Migraine and Anxiety Often Get Confused

Both migraine and anxiety disorders affect the nervous system. They can create a cascade of physical and emotional symptoms that overlap:

• Dizziness and vertigo
• Tight chest or neck pain
• Nausea or gastrointestinal discomfort
• Panic-like sensations or fear
• Sensitivity to noise and light
• Brain fog or cognitive fatigue

If you live with chronic migraines, your baseline stress levels may already be elevated. Over time, your body can become “stuck” in a sympathetic (fight-or-flight) state. This state can trigger migraines and anxiety attacks—sometimes at the same time.

Symptom Overlap: What They Have in Common

Because of this overlap, it’s no surprise that many people are misdiagnosed or unsure of what to treat first.

7 Ways to Tell If It’s Migraine or Anxiety

1. Head Pain Is Not Always Present in Anxiety

While migraines often involve throbbing, one-sided head pain, many vestibular migraines involve no head pain at all. But if you feel no head pressure or tension and the episode feels more fear-driven, it could point to anxiety.

2. Anxiety Is Triggered by Thoughts; Migraines by Sensory Triggers

Anxiety often starts with a fearful thought or anticipation, such as worrying about an upcoming event. Migraines are more likely to be triggered by external stimuli, like lights, smells, foods, or lack of sleep.

3. Check the Timeline

Anxiety episodes may build up gradually or come on quickly in response to stress. Migraines often have a predictable timeline:

• Prodrome → Aura → Headache → Postdrome

If you can identify that cycle, it’s likely migraine.

4. Visual Auras Are More Migraine-Specific

Seeing zig-zag lines, light flashes, or blind spots before symptoms start? That’s a classic migraine aura, not anxiety.

5. Muscle Tension Feels Different

Tightness in the neck or shoulders is common in both. But if the tightness radiates up toward your scalp or jaw, especially on one side, it may signal a migraine in progress.

6. Heart Rate Clues

Rapid heartbeat can happen in both cases. But with anxiety, it often comes with shallow breathing and a sense of panic. With migraines, especially vestibular ones, it’s more likely to be from autonomic nervous system imbalance.

7. Relief Methods Work Differently

• Breathwork or grounding exercises often ease anxiety within 10–20 minutes.
• Migraines usually require rest, darkness, hydration, or medication and take longer to resolve.

What If It’s Both?

Sometimes it is both.

Anxiety can trigger migraines, and migraine attacks can increase cortisol and adrenaline, making you feel anxious or panicked. This is especially common in the prodrome or postdrome phases of a migraine, when the nervous system is hyper-sensitive.

If you find yourself stuck in this loop, it’s time to focus on nervous system regulation—not just symptom management.

Natural Ways to Support Both Anxiety and Migraine

Here are some daily practices that support your vagus nerve, reduce inflammation, and calm the overactive brain-body connection:

🧘‍♀️ 1. Somatic Grounding

Try 5-4-3-2-1 grounding or body scanning to bring your attention away from fear and into the body.

🌀 2. Vagus Nerve Stimulation

• Cold exposure (splash cold water or use a cold pack)
• Gargling or humming
• Deep belly breathing (long exhale)

🌿 3. Anti-Inflammatory Diet

Limit processed foods, seed oils, sugar, and alcohol. Focus on whole, colorful foods and omega-3s.

🌙 4. Sleep Hygiene

Inconsistent sleep is a double trigger for both migraine and anxiety. Try:

• Blue light blockers after 7 PM
• No caffeine after 2 PM
• Magnesium glycinate at night

☕ 5. Caffeine Awareness

Too much caffeine can fuel both migraines and panic. Experiment with reducing gradually or switching to low-caffeine herbal options like tulsi or rooibos.

📓 6. Track Patterns

Use a symptom tracker to document:

• Onset triggers
• Timing
• Emotional state
• Relief strategies

Over time, you’ll start to see patterns and gain clarity.

When to Seek Help

If your anxiety or migraines are interfering with daily life, it’s okay to seek professional help. You may benefit from:

• A neurologist (for diagnosis or meds)
• A functional medicine practitioner (for root causes)
• A somatic therapist (for nervous system healing)
• A migraine-specific coach (for holistic strategies)

Final Thoughts

You don’t have to live in confusion or fear, wondering if your next dizzy spell is anxiety or another migraine. With the right tools, patterns, and support, you can start to reclaim control—and calm.

Remember: Both migraines and anxiety are signals from your body—not failures. When you begin listening with curiosity, not fear, you’ll start to heal.