Common Stressors
Your migraine threshold: the bucket idea
Triggers rarely act alone. They add up, and an attack happens when the total overflows.
5 min read · 3 research sources · Based on the Mastering Migraine courses by Dr. Adam Harcourt
Picture your nervous system as a bucket. Every stressor adds a little water: a short night of sleep, a skipped lunch, a stressful meeting, a hormonal shift, a stiff neck, bright fluorescent lights. Most days the bucket holds. On the day it overflows, a migraine starts.
This simple picture explains a lot of what puzzles people about migraine:
- Why the same trigger does not always cause an attack. Wine on a relaxed vacation may be fine, while the same glass during a stressful, sleep-deprived week is not. The brain’s excitability naturally rises and falls, and it is more vulnerable to triggers at its peak 1.
- Why it often seems to come out of nowhere. The last drop gets the blame, but the bucket had been filling for days.
- Why reducing several small factors works. You do not need to remove every trigger. Lowering the overall level gives you room to spare.
What science calls the “bucket”
Researchers describe the body’s total stress burden as allostatic load: the cumulative wear from repeated or unresolved stressors on the brain and body 2. A higher allostatic load has been linked to migraine and its progression 3.
The body’s stress system can be overloaded in three basic ways 2:
- Too many hits: frequent stressful events that wear down the ability to adapt.
- No off switch: a stress response that does not settle down afterward.
- No response: an inadequate reaction when a stressor appears, often after long-term overload.
Triggers versus early warning signs
Some “triggers” may actually be early symptoms of an attack that has already started. Craving sweets, yawning or feeling tired can all be part of the premonitory phase 1. Keeping a diary helps sort out which is which.
What fills the bucket
The rest of this section walks through the most common contributors, grouped by the four areas Dr. Harcourt evaluates, plus everyday lifestyle factors:
- Lifestyle: stress, sleep, meals and blood sugar, caffeine, environment
- Nutritional: food sensitivities, diet quality and weight, nutrient gaps
- Hormonal: the menstrual cycle, life stages, birth control, hormones in men
- Musculoskeletal: neck, jaw and muscles
- Neurological: eyes and balance, the autonomic system, concussion, medication overuse
How full is your bucket this week? Tap the stressors that apply to you and watch the bucket fill, then add the habits that lower it.
See how the bucket can grow in The Mastering Migraine framework.
This article is educational and does not replace a personal evaluation. Talk with your clinician before making changes to medications, supplements or diet.
Research cited on this page
- Goadsby PJ, Holland PR, Martins-Oliveira M, et al. Pathophysiology of Migraine: A Disorder of Sensory Processing. Physiol Rev. 2017;97(2):553-622. PubMed 28179394 · DOI
- Guilliams TG. The Role of Stress and the HPA Axis in Chronic Disease Management. Point Institute. 2015. Source
- Calabrò C, Di Tillo E, Pensato U, et al. Migraine chronification as an allostatic disorder: a proof-of-concept study. Neurol Sci. 2024;45(6):2775-2782. PubMed 38261154 · DOI
Mastering Migraine is an educational resource and is not a substitute for individualized medical care. Always talk with your own doctor before changing medications, starting supplements, or beginning a new treatment.
