Psychological Disturbances

Did you know psychological disturbances such as anxiety, depression or general stress can cause tension type headaches? But why?

We may think it may be because stress tightens our muscles, but our current view suggests more than that. Stress interacts with the brain’s pain-regulation systems, making our nervous system more sensitive.

Read more here: (Leistad et al., 2006) - Stress-Induced Pain and Muscle Activity in Patients with Migraine and Tension-Type Headache (TTH)

This mechanism is called central sensitisation. When we become stressed, our body responds by activating the nervous system which increases in inflammation. 

Read more here: (Klyne et al., 2026) - Understanding the relationship between sleep, psychological and musculoskeletal health from a neuroimmune perspective

This increases the sensitivity in brain regions involving how threatening or intense something feels. This means a mild muscle discomfort that is normally disregarded, may feel like a headache.

Also, these stressors can impact other behavioral factors such as skipping meals, clenching jaws, and poor sleep quality. Which can then lead to a headache. Check out the ‘sleep’ video for more information. 

Here are some management techniques you can try! 

1. Slow and relaxed deep breathing 

This can increase the parasympathetic activity to allow the body to rest and recover. Sit upright and comfortably with the shoulders relaxed, breathe slowly in through the nose, allowing the abdomen to expand, then exhale slowly. 

Read more here: (Hopper et al., 2019) - Effectiveness of diaphragmatic breathing for reducing physiological and psychological stress in adults: a quantitative systematic review

2. Progressive muscle relaxation 

People with tension type headaches often have increased awareness of muscle tension. Tense a muscle for 5 seconds, release for 10 seconds and repeat for other muscle groups.

Read more here: (Gopichandran et al., 2024) - Effectiveness of Progressive Muscle Relaxation (PMR) and Deep Breathing Exercise on Pain, Disability, and Sleep Among Patients With Chronic Tension-Type Headache: A Randomised Control Trial (RCT)

3.  Exercise 

This is the most evidence based. Find an activity that you enjoy. This could be walking, swimming, pilates or just going to the gym. 

Read more here: (Krøll et al., 2021) - The effects of aerobic exercise for persons with migraine and co-existing tension-type headache and neck pain. A randomised controlled clinical trial (RCT)

Read more here: (Zhao et al., 2026) - Comparative effects of exercise modalities on depression, anxiety, and stress in university students: a systematic review and network meta-analysis of randomized controlled trials

But remember, if you feel like you need extra help, you can always reach out to other health professionals. They are always here to help!