Stress and TN 2

Hi. I have TN 2 and, quite likely TN 1 on left side of my face. When I woke up this morning, I could feel the “buzzing” in my upper lip and under my eye, as usual. I’ve been awake for about an hour, and as I was answering work emails (my work is stressful), I noticed the burning increasing. I’ve noted this several times. While I absolutely do not believe that stress causes TN-ridiculous, I am wondering if stress exacerbates it, though. Has anyone noted this for themselves? My boyfriend, girlfriend of 50 years, neurologist, and therapist have all suggested that this might be the case. I’ve noted that my chronic migraine episodes decrease when I am not working for longer than a weekend, like over the summer when I was a teacher. That is data that is collected via my migraine calendar for insurance coverage for the botox every month. My pain is real, but, I just wonder if there is a connection between the pain and stress level. Thanks. I have shown Dr. Red’s article which states that TN pain is NOT all in my head.

Hi Camia,

For me stress is definitely a factor in the pain level and frequency of the attacks. I don't think stress was a factor in causing TN for me. Of course everyone can be different.


Thanks for your thoughts, Scott. I don’t believe stress causes TN. I just am thinking that it can make symptoms worse or more frequent…for me. Having said that, the pain from the TN and chronic migraine, I know for a fact, creates anxiety and stress, again, for me. I think it can all become a vicious circle. There are times where I am feeling quite ok, emotionally, and then I’ll smile, and boom! here comes the pain…go figure! Hope you are having a pain free day.


From what I've observed in 20 years of talking with chronic face pain patients, high levels of stress may be associated with breakthrough pain and a tendency toward depressed mood, in people who already have an ongoing medical problem. I've many times talked with patients who felt that their increased or decreased pain tended to happen as stress increased or decreased generally in their lives. Like depression, there are clearly mechanisms of physical health involved: depression or stress can disturb sleep, leaving you wakeful for long periods at night and tired when rising in the morning. Fatigue builds up various toxic waste byproducts in the bloodstream, and general health may decline in response to such build-ups.

My two Red cents, for whatever they're worth.


Also when my shoulders get tight or tense that can cause break thru pain and when the pain hits that causes me to to tense up in the shoulders. There again is that vicious circle for me.
Camia said:

Thanks for your thoughts, Scott. I don't believe stress causes TN. I just am thinking that it can make symptoms worse or more frequent...for me. Having said that, the pain from the TN and chronic migraine, I know for a fact, creates anxiety and stress, again, for me. I think it can all become a vicious circle. There are times where I am feeling quite ok, emotionally, and then I'll smile, and boom! here comes the pain...go figure! Hope you are having a pain free day.

Stress does not generally influence my pain levels, but can work in other ways:

- As with Scott, stress gets into my neck, and my neck and TN have a nice little connection.

- stress makes me mre tired and I am not as strict with trgger control. For instance, if I am exhausted, I often don't have the headspace (or patience) to deal with my dictaphone, which I should always do with backlit screens such as my phone. So I will quikly write a text and add exessively to the trigger load. (And are you sure backlit screens/light sources are not an issue for you, Camia...? I note that you were doing e-mails)

- being in pain when I am under a lot of pressure can makeme streesed, and hence overfocusing on more pain - making me feel every little sensation or flutter.

Hi Tineline
I never thought of baclighting. I frequently email, or type the legal meeting notes as I facilitate stressful meeting in my job. I know my eyes get really tired and it can be a migraine trigger. I figured the stress of these meetings where there is tension and emotion and legal perfection to maintain were triggers for both issues for me. Glasses don’t help. Unfortunately, I can’t dictate notes written during ac3 hour meeting.wish I could!

Sorry to hear that. You can test yourself over a weekend or holiday by being very strict with use of phone (no texting, facebook or pictures), computer, tv, card readers, self-service machines etc. If you can identify a trigger this way, you may qualify for disability support, for instance for dictation software. If you take notes by shorthand, you can then simply read them to your computer. even better: if you can exclude it, you don't have to worry.

In any case: if your meetings are a/c'ed, or your office is, I just discovered how much help a thin snood is.Even if it clashes somewhat with work attire. It is important to implement strategies in the workplace as early as possible, to be able to keep working. Unfortunately, that is not a given with this condition. Hoowever, to beable to put strategies in place, you should really keep an eye on those triggers and maybea pproach your manager?

For years I denied that stress affected my TN, but have found that it does trigger an attack or make an existing attack worse. Doesn't cause TN, but definitely exacerbates it for me. Today making a stressful decision has had my face burning and hurting.

I have denied that as well. I always felt that if a pain or illness were stress related or made worse by stress, that it was my fault. People will ask if I was stressed when the attack came on, and if I say yes, they respond, “oh yeah, that’s it then.” I am forced to ask what they mean, that because I have some stressful situation, then, that’s the answer, I caused the pain myself? Possibly a warped view, but I do get tired of doctors and some well-meaning people dismissing the pain because stress made it worse or brought on an attack. But, if one has TN, and it is a structural defect, how does stress make that worse? Been wondering about that for awhile.

Thanks for the ideas, Tineline. I’ll consider testing myself. I’m going on a trip on friday, lots of fresh air, no tv, cell, hopefully will get my classwork done, so very minimal use of computer. Little stress. All will hopefully add up to even more respite from pain.

About Stress: While I believe a case can be made that in some people, some of the time, stress can become an irritant or a precipitating factor in already existing pain conditions, I categorically oppose the silly notion that stress or anxiety "cause" pain. For people dealing with treatment issues involving having been told that their pain is caused by stress, I highly recommend a book by Angela Kennedy: "Authors of Our Own Misfortune? Problems with Psychogenic Explanations for Physical Disease." The following is my review of the book on Amazon.


Angela Kennedy has assembled a major body of well-referenced research in "Authors of our own Misfortune? The Problems With Psychogenic Explanations for Physical Illnesses". The book is difficult in two ways. Kennedy writes as a social scientist and researcher. Her intended audience is primarily medical doctors, psychiatrists and psychologists who assign diagnoses of psychosomatic disorder to patients seen in their practices. Non-professional readers may find her long paragraphs and 8-line sentences to be hard slogging. In language and style, the book is nearly inaccessible to any but the most persistent of college educated non-physician readers.

This being said, a second and deeper sense of difficulty applies in this book. Kennedy directly challenges both medical doctors and mental health professionals to examine and revise their assumptions about a range of important issues pertaining to so-called "psychogenic" medical symptoms. These are by definition, symptoms of physical disorder or disease that are presumed to be "caused" by the mental state or thinking of the patient. The term "assumed" is highly central here. Kennedy is also challenging professional doctors who may be in emotional denial that what they practice in "psychosomatic" medicine is a dangerous and destructive mythology rather than a consistent or constructive healing art.

Kennedy effectively demolishes an entire branch of current psychiatric practice as codified in the 5th and previous editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association. She demonstrates compellingly that there is no basis in science for such diagnoses as "Somatic Symptom Disorder", "Functional Neurological Symptom Disorder (Conversion Disorder)", "Hypochondriasis," or "Munchhausen Syndrome by Proxy". She also sets forth evidence that several presently controversial medical disorders are far better explained as poorly understood medical illness, than they are treated as outgrowths of any emotional or psychogenic process. These medical disorders include Fibromyalgia, Myalgic Encephalomyelitis /Chronic Fatigue Syndrome (ME/CFS), and Irritable Bowel Syndrome (IBS).

Kennedy demonstrates predictable and unnecessary harms that grow from misdiagnosing medical disorders as mental disease entities. Chief among these is the denial of effective medical assessment and treatment to millions of people who are instead written off as "head cases" and then disregarded as reliable reporters of their own medical symptoms and conditions. The careless or frustrated discharge of "difficult" patients who have subtle or unusual medical problems can and already has led to patient deaths. Likewise, among mental health professionals charged with caring for psychosomatic patients, there are no truly effective modalities of treatment. None.

If you are a mental health professional, then you should read this book and ask yourself how many of your patients have been harmed by the fallacies it reveals. If you are a patient who has been referred by a medical doctor for mental health evaluation, or who has been diagnosed with so-called psychogenic symptoms, then you should buy this book and give it to the practitioner who diagnosed you. You may even want to add a note on the flyleaf: "if you can't do better than this, then it's time you looked for an honest line of work!"

Fair Disclosure: I approached this book with a predisposition to accept its premises. I read it to verify that sufficient research was quoted to support those premises. As a social networking site moderator for over 5,000 chronic face pain patients, I have met many who were written off as head cases because their medical doctors didn't recognize what was causing their pain. I have separately published on the connections between psychogenic diagnoses and patient suicides. See "Psychogenic Pain and Iatrogenic Suicide" on the Global Summit for Diagnostic Alternatives of the Association for Humanistic Psychology.

Thus I may have a bias of my own: having seen the damage done to medical patients with rare disorders by psychosomatic medicine, I am convinced that this branch of psychiatry is a complete crock! Practitioners of this mythology should be confronted with the harms they do, and if necessary barred from treating patients until they have been reeducated.

Thank you for the text. I swing back and forth between writing my pain off as stress related because of what therapists, doctors, friends, loved ones have suggested, given my “type A” personality and anxiety, aND aDamen refusal aND indignation at that notion. Ive evendors dEnid myself medical care bease i beleven that i was juse stresses out, aND alost dued aa a result of this self-induced neglect. I’ve had chronic pain since age 2.

When not in pain, my whole attitude is happier, flexible, engaged. When in pain, I am anxious, irritable, and the longer it lasts, the more hopeless i become, and often I think about suicide. Significantly reduced pain last 2 days. Life is good again. I feel, and appear like 2 very different people. I still believe that my anxiety and depression are caused by my pain. I guess I’m influenced by others, still.

Well, it sounds like just the time for a quiet weekend away! You cannot believe how envious I am.
For some people, TN does appear to worsen with stress. I have had so many strange symptoms due to stress over the years (severe dizzyness, headaches, etc) that I don't blame a GP for making the connection. And it seems like you are not yet sure, so maybe you should try to put own some stressbusting strategies and see what happens. And migraine is, after all stress induced, no? Might not harm. :-)
However, I do feel that we shouldn't discredit stress as a factor in TN - who knows what it does to blood prssure and other vessel-things. Most importantly, TN is individual, and we don't want to tell people "You don't fit the pattern, so that cannot be a factor." I know we don't enjoy to not be trusted - possibly the biggest stress of all for us TN-patients.
Watch your own triggers, know that they can change dramatically, by all means share - but be open to other ways of having TN. Us who have tried to argue ATN to a small town neuro may know what that's like, no?

I understand what you are saying, Tineline. Makes a lot if sense. I’ll see how it goes on vacation. Sinus is the biggest trigger for my migraines. Sometimes triggers my TN. Maybe stress makes blood pump harder or faster in vessels, I don’t know. However, I do know that sometimeshe stress can seem to start the tingling. And I’ve been super relaxed or sleeping and pow, here it comes full force! So, I look at it as it is there, and real, and when I’m at my wit’s end, I have all of you. Hope you are pain free, today.

No doubt! Stress is the most likely perciptating factor …rest and sleep is so important