Migraine tears usually refer to one of two things: the involuntary watering of the eyes that can occur during a migraine attack, or the emotional tearfulness and mood shifts that often occur before, during, or after one.
Migraine Tears, the Physical Kind
Watery eyes during a migraine attack fall under a category of symptoms doctors call cranial autonomic symptoms, often abbreviated as CAS. These are involuntary reactions on the same side of the face as the headache, including eye redness, eyelid swelling, nasal congestion, and tearing.
A 2022 cross-sectional study conducted in a tertiary care neurology department found that among 119 migraine patients, cranial autonomic symptoms occurred in nearly 64% of cases, with lacrimation (the medical term for tearing) reported by nearly 45% of participants, making it the most common autonomic symptom in that group.
A similar 2021 study found that tearing was the second most common cranial autonomic symptom overall, just behind eye redness, and appeared in about 21% of episodic migraine cases and a higher share of chronic migraine cases.
Why This Happens: The Trigeminal Autonomic Reflex
The eye-watering isn’t random. It traces back to a specific neurological pathway called the trigeminal autonomic reflex. A 2022 review explains that this reflex connects the trigeminal nerve, which carries pain signals from the face, to the parasympathetic nervous system, the branch responsible for involuntary functions such as tear production.
During a migraine attack, activation of trigeminal pain pathways can spill over into this parasympathetic circuit, triggering tearing, congestion, and eyelid changes as side effects of the same nerve activity that causes the headache itself.
This is also why the symptom tends to show up on the same side as the pain. A study of 200 migraine patients found that tearing and other autonomic symptoms were more likely to occur on the same side as the headache than to appear symmetrically on both sides, reinforcing the idea that these symptoms share a direct neurological link with the pain rather than being a separate, unrelated reaction.
Are Migraine Tears the Same as Cluster Headache Tearing?
Tearing during head pain is actually the defining feature of an entirely different, though related, condition called cluster headache. The key difference is degree and diagnostic role.
In cluster headache, cranial autonomic symptoms such as tearing are required for diagnosis and tend to be severe and unilateral. In migraine, these same symptoms can occur, but they’re not required for a diagnosis and tend to be milder.
A 2022 review focused specifically on distinguishing between the two conditions notes that migraine patients have a lower prevalence of every autonomic symptom item compared with cluster headache patients, even though the two conditions can look similar on the surface.
That same review points out that migraine with autonomic symptoms tends to involve more severe, frequent, and longer attacks compared to migraine without these symptoms, along with higher rates of light sensitivity, sound sensitivity, and skin sensitivity during attacks.
How Common Is This Symptom, Overall?
Estimates for how often tearing and related autonomic symptoms show up in migraine vary across studies, generally landing somewhere in a wide but consistent range.
A 2022 review of the topic notes that across different studies, cranial autonomic symptoms have been reported anywhere from 26% to 80% of migraine patients, a range that likely reflects differences in how studies define and ask about these symptoms rather than a true inconsistency in how common the experience actually is.
A 2022 prospective study at a tertiary headache center offers a useful data point in the middle of that range: just over half, 52.4%, of the 164 migraine patients studied reported at least one cranial autonomic symptom, with symptom frequency correlating with a measure called central sensitization — essentially, how sensitized the nervous system has become to pain and other stimuli over time.
That same study found that patients with three or more autonomic symptoms had significantly higher central sensitization scores than those without any, suggesting these tearing episodes may be one visible marker of a broader pattern of nervous system sensitivity that develops in some people with migraine.
Migraine Tears, the Emotional Kind
Migraine is increasingly understood as a condition that affects emotional regulation, not just pain perception, and tearfulness is one of the more commonly reported emotional symptoms tied to the different phases of an attack.
A large 2023 international survey examined pre- and post-headache symptoms across six countries and found that emotional and cognitive symptoms were common companions to the headache phase itself, occurring alongside more familiar physical symptoms like neck pain and light sensitivity in the periods surrounding the actual pain.
Mood-related symptoms, including low mood and tearfulness, are frequently reported during both the prodrome, the warning phase before pain begins, and the postdrome, the recovery period after the headache resolves.
Why Migraine Affects Mood This Way
The likely explanation ties back to shared brain chemistry. Serotonin, dopamine, and norepinephrine are neurotransmitters involved in both pain regulation and mood regulation, and migraine attacks are associated with fluctuations in these same chemical systems. When these systems shift during a migraine attack, emotional symptoms and physical pain symptoms can move together, which helps explain why tearfulness, irritability, or a flat, drained mood so often accompany the headache itself rather than existing as a separate, unrelated issue.
This overlap is also reflected in the well-documented relationship between migraine and mood disorders more broadly. A large Swedish national cohort study following people from 2015 through 2023 found that people with migraine had a substantially higher rate of subsequently developing depression or anxiety compared to those without migraine, with an adjusted hazard ratio of 1.78 in the main comparison group.
Importantly, this kind of population-level association describes a pattern across large groups of people, not a certainty for any one individual, and it doesn’t mean every migraine attack will come with emotional symptoms or that tearfulness during an attack signals a separate mental health condition.
Can Crying Actually Trigger a Migraine?
Beyond migraine causing tearfulness, some people report that crying itself, especially intense or prolonged crying, seems to bring on a migraine attack afterward.
One proposed explanation involves what’s sometimes called a letdown headache: as the body decompresses from an intense emotional or stress response, the physiological shift involved in that release may trigger head pain in people prone to migraine.
Crying also causes physical changes inside the nose, including swelling of structures called turbinates, as well as sinus pressure changes that can plausibly contribute to a headache in someone already prone to migraine.
Shifts around menstruation or menopause can make some people both more prone to crying and more prone to migraine attacks around the same time, which can make the relationship look more direct than it actually is in any single instance.
When Tearfulness Is Part of the Bigger Emotional Picture
“Migraine tears” can mean something different depending on which phase of the attack a person is in. During the prodrome, tearfulness often shows up alongside irritability and food cravings, sometimes hours before any pain begins. During the headache phase itself, anxiety and a strong desire to escape light, sound, or other stimulation tend to dominate the emotional picture. In the postdrome, sometimes informally called a “migraine hangover,” many people describe feeling foggy, drained, and unusually prone to tears, even after the physical pain has fully resolved.
Recognizing which phase a particular bout of tearfulness belongs to can be clarifying rather than worrying. A wave of unexplained tearfulness the evening before a headache starts isn’t a sign of an unrelated emotional crisis — it may simply be an early signal that an attack is on its way, much like food cravings or neck stiffness. Tracking mood alongside physical migraine symptoms over time, rather than treating them as two separate categories, tends to give both patients and doctors a clearer, more complete picture for treatment planning.
Do Migraine Tears Mean Something Is Wrong With Your Eyes?
For most people, no. Physical tearing during a migraine attack is a neurological reflex tied to trigeminal nerve activation, not a sign of an eye infection, an allergy, or any structural eye problem. It typically resolves on its own once the migraine attack passes and doesn’t require separate treatment for the eyes themselves.
That said, a few situations are worth flagging to a doctor rather than assuming they’re simply part of a typical migraine pattern.
Tearing accompanied by severe eye pain, sudden vision changes, or symptoms that don’t improve once the headache resolves deserves a closer look, since these could point to a different underlying cause occurring alongside a headache rather than because of it.
Similarly, if tearing and related autonomic symptoms are extremely severe, strictly one-sided, and clustered into short, intensely painful episodes, that pattern is worth discussing with a doctor to rule out cluster headache, which benefits from a different treatment approach than typical migraine.
What Helps With Migraine-Related Tearing and Emotional Symptoms
Treatment for cranial autonomic symptoms like tearing generally follows the same path as treatment for migraine overall, rather than requiring a separate approach.
A 2022 review notes that certain migraine treatments, including triptans and onabotulinumtoxin, commonly known by the brand name Botox when used for chronic migraine, have shown particular effectiveness for patients who experience these autonomic symptoms alongside their headache pain.
A separate 2022 study on newer migraine medications called CGRP monoclonal antibodies similarly found that these treatments improved autonomic symptoms in real-world patients alongside their broader migraine symptoms.
Do Migraine Tears Look the Same in Everyone?
Not quite. Research suggests meaningful variation by age and headache pattern.
A 2022 review notes that in children specifically, the most common autonomic symptoms tend to differ somewhat from the adult pattern, with aural fullness, facial flushing, and conjunctival injection appearing more frequently in younger patients. This is a useful reminder that migraine, including its autonomic symptoms, doesn’t present the same way across all age groups, and a symptom pattern that looks unfamiliar compared to what’s typically described for adults isn’t necessarily cause for concern in a child or teenager.
There’s also variation tied to how sensitized a person’s nervous system has become over time. The 2022 tertiary headache center study referenced earlier found a clear relationship between the number of cranial autonomic symptoms someone experiences and their overall central sensitization score, a measure of how reactive the nervous system has become to various stimuli. People with more frequent or severe migraine attacks over time may be more likely to develop a wider range of autonomic symptoms, including tearing, as their nervous system becomes more sensitized. This doesn’t mean tearing is a sign that migraine is “getting worse” in a way that should cause alarm; it simply reflects a documented relationship between attack frequency and symptom breadth that researchers continue to study.
The Overlap Between the Physical and Emotional Kinds
Someone can experience both physical, involuntary eye tearing tied to trigeminal nerve activation and emotional tearfulness tied to shifting neurotransmitter levels during the very same migraine episode, sometimes without being able to clearly distinguish which is driving which in the moment.
This overlap makes sense given how interconnected the underlying biology is. The same neurological systems responsible for processing pain, regulating tear production, and modulating mood are closely linked in the brain, and a migraine attack activates several of these systems simultaneously rather than triggering just one isolated symptom.
For someone experiencing a migraine attack, this can mean crying without being entirely sure whether it’s due to physical eye irritation, an emotional wave, or some combination of both — and understanding that both are legitimate, well-documented parts of the same underlying condition can make that confusing experience easier to make sense of in the moment.
For the emotional side of migraine tears, management tends to work best when it addresses both the underlying migraine and any mood symptoms directly, rather than treating tearfulness or irritability as background noise to simply push through.
Since migraine and mood disorders share overlapping biology, some treatments that help manage migraine frequency may also ease accompanying emotional symptoms, though anyone experiencing persistent depression or anxiety alongside migraine should raise both concerns directly with a doctor rather than assuming one will automatically resolve the other.
A Comforting Note for Anyone Feeling Uneasy About This
If you’ve noticed your eyes watering during a migraine, or found yourself unexpectedly tearful before, during, or after an attack, that experience is well-documented and common, and not a sign that something is seriously wrong with your body or your emotions.
If mood symptoms around your migraines feel like more than an occasional wave of tearfulness, particularly if low mood, anxiety, or emotional exhaustion linger well beyond the physical recovery period, that’s worth bringing up with a doctor. Not because anything is wrong with you for feeling that way, but because a fuller picture of what you’re experiencing gives you and your care team more to work with in finding a treatment plan that actually addresses everything going on, not just the head pain.
Frequently Asked Questions
Is it normal for one eye to water more than the other during a migraine?
Yes. Cranial autonomic symptoms like tearing typically occur on the same side as the headache pain, so one-sided tearing during a migraine attack is a well-documented and expected pattern rather than something unusual.
Can migraine tears happen without any head pain?
It’s less common, but tearing and other autonomic symptoms are occasionally reported alongside migraine aura or other migraine-related sensations even when head pain is mild or absent. If eye-watering occurs on its own without a clear migraine pattern, it’s reasonable to have it evaluated separately to rule out other causes.
How long does migraine-related eye watering usually last?
It typically follows the timeline of the migraine attack itself, easing as the headache resolves. Since migraine attacks can last anywhere from several hours to a few days, tearing may come and go throughout that window rather than persisting constantly.
Is crying during a migraine a sign of depression?
Not necessarily. Tearfulness during a migraine attack is often tied to the same neurological and chemical shifts causing the headache itself, rather than being a marker of a separate mood disorder. That said, if low mood or emotional symptoms persist well beyond the migraine attack, mentioning it to a doctor is a reasonable step, since migraine and depression can occur together.
Should I be worried if my eyes water every single time I get a migraine?
A consistent pattern like this generally isn’t a cause for concern on its own, since it reflects a well-documented, common aspect of the migraine experience for many people. If the tearing is ever accompanied by severe eye pain or vision changes, or feels different from your usual pattern, that’s worth mentioning to a doctor.
Can treating my migraines also reduce the eye-watering and tearfulness?
Often, yes. Because these symptoms are tied to the same underlying migraine mechanisms as the headache pain, effective migraine treatment frequently reduces accompanying symptoms like tearing and mood changes as well, rather than requiring a completely separate approach.
What’s the difference between migraine tears and cluster headache tears?
Cluster headache involves tearing and related symptoms as a required, usually severe, and strictly one-sided feature of the condition, often paired with intensely painful, short attacks. Migraine can include similar symptoms, but they’re typically milder, not required for diagnosis, and part of a broader symptom picture that includes longer-lasting head pain along with nausea and sensitivity to light or sound.