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How My Autism Diagnosis Helps Me Manage My Migraine

Medically Reviewed By Meredith Goodwin, MD, FAAFP
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I have always felt different. The world always felt way too loud, intrusive, and uncomfortable. I chalked my differences up to just being quirky and having an ultra-sensitive migraine brain. Having migraine meant being overstimulated by the environment in which I lived. The same is true for individuals with neurodevelopmental disorders. 

Last year, I underwent neuropsychological testing. Navigating life had become much more challenging with increased sensory issues, the inability to concentrate or focus on tasks, being overstimulated constantly, and social and communication challenges. I needed to understand whether I was experiencing these symptoms as a result of decades-long migraine disease or if my feelings and issues were related to being neurodivergent. The word “neurodivergent” refers to people whose brain variations influence how their brain functions.

After an extensive clinical interview and several psychological tests, I received a diagnosis of autism spectrum disorder (ASD) level one, once known as Asperger syndrome. Level one is the mildest form of autism. It is also known as being “high-functioning” on the spectrum. This gave me much perspective on how challenging it has been for me to navigate the world since adolescence. Now that I know what is going on with my brain, I can finally manage the intricacies of being neurodivergent.

Understanding autism

Autism is a neurological condition that impairs communication, social interaction, and behavior. It is characterized by a wide range of symptoms and is classified as a spectrum condition, which means that people with autism might have varied levels of disability. 

Autism affects 1 in 45 adults in the United States. The signs and symptoms of autism spectrum disorder in adults encompass the hallmarks of ASD – repetitive and restrictive behaviors and challenges with social communication skills. ASD level 1 can cause a wide range of social, emotional, and behavioral issues. Adults with ASD level 1 typically exhibit difficulties with social contact, a limited range of interests, and repetitive behaviors or mannerisms. 

I have constantly struggled with verbal communication in social situations and social anxiety and have needed to stick to specific patterns or schedules so as not to become overwhelmed. If my daily routine is disrupted in any way, I feel incredible anxiety and become increasingly overstimulated.

Masking: what is it?

ASD is more commonly diagnosed Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source in males than females. Women and girls without intellectual disabilities (ID) or language difficulties may struggle to obtain an autism diagnosis, receive one later in life, or receive a misdiagnosis. The reason why ASD in women and girls can go undiagnosed could be due to how they express their autism, compensating for and masking their autistic characteristics to better fit into society.

“Masking” or camouflaging autistic traits in social circumstances is thought to be a typical coping mechanism for individuals with autism spectrum disorders. This can look like forcing eye contact even if it feels uncomfortable, holding back self-stimulating behaviors, or creating “scripts” for conversations or social situations.

Self-stimulating (known as “stimming”) behaviors include hand-flapping, rocking, and pacing back and forth. After my diagnosis, I realized that I utilized many different stimming behaviors to help with emotional regulation. One of my comforts is smelling my scarf, which helps calm my anxiety and sensory overload. I also engage in rocking and pacing or shaking my leg when I become emotionally overwhelmed.

I realized while going through the interview for the neuropsychological test that I have been masking my autistic behaviors for decades. Masking for so long has resulted in increased depression, anxiety, and overall burnout. Having answers has been tremendously helpful. However, I now have to learn how to work through those challenges I was so successful in hiding for so long.

The link between autism spectrum disorders and migraine

According to research, people with autism have a higher prevalence of migraine than those without autism. Approximately 20 to 50% of individuals on the autism spectrum suffer from migraine or frequent headaches. This prevalence rate is far higher than that of the overall population.

The exact causes of the higher prevalence of migraine in autism are not fully understood. However, sensory sensitivities, neurological problems, and hereditary links may contribute to this increased occurrence. 

When investigating the link between autism and migraine, sensory processing issues, anxiety, and inflammation are common areas where ASD and migraine appear to overlap. A recent study suggests that autism spectrum disorder is an independent risk factor for migraine. Results indicate that children and adolescents on the spectrum were more likely to develop migraine later in life.

While I had no idea that I was on the spectrum until recently, I can look back on my adolescence and see where ASD and migraine overlapped. Hypersensitivity to sensory stimuli like bright lights, loud noises, strong odors, and certain textures was a frequent experience for me as a child, especially in school. I spent much time in the nurse’s office with sensory-induced migraine attacks or severe stomach aches and nausea

People with autism may be more sensitive to those same stimuli, which can potentially trigger migraine or make an existing attack worse. Social interactions and the anxiety they induced indeed exacerbated my migraine symptoms when I was younger, and they continue to do so as an adult.

Increased pain sensitivity is an important feature of sensory processing difficulties that may link migraine to autism. An increased sensitivity to pain, or a lower pain threshold, seems to be shared by those on the spectrum and people living with migraine.

Managing migraine and autism

Learning how to manage migraine and autism has been a learning curve for me. Thankfully, some of the therapies used to treat both migraine and autism are ones I already utilize. With the combination of medication, cognitive behavioral therapy (CBT), trigger and sensory management, and the use of relaxation techniques, I have better control over both conditions.

It is still a learning experience figuring out all the intricacies of being autistic while also living with migraine disease. Although being level one on the spectrum requires less therapeutic support, there are still challenges I face in managing the disorder. The biggest challenge is the burnout from masking for so long. 

Now that I am aware of what it is I am experiencing, I am dealing with increased anxiety, especially in social situations. In order to manage anxiety and other emotional issues, I have increased how often I engage in cognitive behavioral therapy to help with coping strategies. I must use the tools I have acquired over the years to my advantage to manage both migraine and autism effectively.

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  1. Karimi L, et al. (2021). The migraine-anxiety comorbidity among migraineurs: A systematic review. https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2020.613372/full 
  2. Lee, T.-Y., et al. (2021). Risk of migraine development among children and adolescents with autism spectrum disorder: A nationwide longitudinal study. https://www.sciencedirect.com/science/article/abs/pii/S1750946721001550 
  3. Loftus Y. (2023). Autism and migraines: Is there a connection? https://www.autismparentingmagazine.com/autism-migraines/ 
  4. Moller R. (2023). Autism and migraines/headaches explained. https://www.abtaba.com/blog/autism-and-migraines 
  5. Napolitano A, et al. (2022). Sex differences in autism spectrum disorder: Diagnostic, neurobiological, and behavioral features. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9136002/ 
  6. Signs of autism in adults. (n.d.). https://www.autismspeaks.org/signs-autism-adults 
  7. Vetri L. (2020). Autism and Migraine: An Unexplored Association? https://www.mdpi.com/2076-3425/10/9/615

Medical Reviewer: Meredith Goodwin, MD, FAAFP
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