Understanding the Bucket Theory and Its Impact on Migraine Attacks

The Bucket Theory is a concept frequently used by those who live with migraine to understand how various factors combine to trigger migraine attacks. It offers a clear and relatable way to explain why some days are more challenging than others, even when it seems like nothing significant has changed.

By visualizing these triggers and stressors as filling up a bucket, this theory helps us comprehend how the cumulative effect of daily life can lead to an attack.

While understanding the Bucket Theory is valuable to managing migraine attacks, it’s important to note that migraine is a neurological disease with a mind of its own. We have done nothing to cause our attacks. If you accidentally eat a trigger food or don’t get enough sleep, that is not your fault and you didn’t cause your attack. It’s simply our brains hyper-responsive reaction to those situations.

Migraine attacks will also occur for reasons we won’t be able to comprehend or figure out. It’s likely that some attacks happen on a cellular level that has not yet been identified. There are many genes associated with migraine and many factors involved in how the cascade of neurological events happen.

** While Migraine Strong writes about the latest in migraine treatments, this is not medical advice. We are patient educators and all information you read should be discussed with your doctor.

The Bucket Theory explained

Let’s start with the basics of the Bucket Theory. Each day, you wake up with a bucket that is partially filled with things that can annoy your migraine brain. This bucket doesn’t start empty because it already contains some unavoidable factors—things you have no control over, such as hormonal fluctuations, existing stress levels, or weather conditions. These elements alone might fill up one-third or even two-thirds of your bucket before the day has even begun.

Imagine your bucket is already about half full of water from the things you can’t avoid. Then we start adding in other triggers like allergies, smells, foods and drinks. Each thing we add takes up space or volume in the bucket. Every factor has a different volume attached to it based on how much of a trigger it is for you.

As you drop these triggers into your bucket, the amount of water it displaces is how it will affect your head. This also dictates the overall load it has on tripping the migraine trigger mechanism for the day.

For example, raw onion may have the volume of a rock the size of your fist, whereas a bit of lime juice has the volume of a pebble. If we eat or encounter too many rocks in any given day, the bucket overflows and an attack will ensue.

The challenge of inconsistent triggers

One of the most challenging aspects of living with migraine is the inconsistency of triggers. You might find that certain triggers don’t always cause an attack, leading to frustration and confusion. For instance, you might eat raw onion one day with no adverse effects, but the same food could trigger a migraine attack the next time you eat it. Why does this happen?

The answer lies in the dynamic nature of the factors filling your bucket. Life is rarely static, and each day brings different levels of stress, sleep quality, physical activity, and exposure to environmental factors. Because of this variability, your bucket’s starting level is almost always different.

If your bucket is already nearly full due to high stress or lack of sleep, even a small trigger like a glass of wine or a piece of chocolate could be enough to cause it to overflow, leading to a migraine attack. On a day when you’re well-rested and stress-free, that same trigger might not have any noticeable effect because your bucket has more room to accommodate it.

This is where the confusion about food triggers gets, well…more confusing. If it’s a trigger only sometimes, how can we possibly ever know when a food will trigger a migraine attack?

Understanding your personal migraine triggers

This variability highlights the importance of understanding your personal triggers and how they interact with your daily life. It’s not just about identifying which foods or activities might trigger an attack, but also about recognizing how these triggers combine with other factors to affect your overall threshold for migraine attacks.

For example, I have been trying to reintroduce yogurt into my diet. I try it every year because I really like to eat it and it’s a good source of protein. I have been doing pretty well with non-Greek yogurts. Yesterday, I ate the last container in my fridge and a migraine attack started about 90 minutes later. Was it the yogurt? Possibly, but we had a volatile weather day with lots of storms. Objectively, the weather played a much bigger role in that attack which was likely cooking in my brain when I ate the yogurt.

What is the tyranny of the triggers?

It’s easy to become consumed by what is called the ‘tyranny of the triggers’. This is when you feel like every time you do something (eat, drink, exercise, go shopping or out with friends) it triggers an attack. Your life continues to shrink as you remove every potential trigger possibility from your daily living. You end up having a small list of ‘safe’ foods and activities.

When everything is a trigger, you likely need to revisit your preventive medication regimen with your doctor. If you don’t have a headache specialist, our article on how to find a headache specialist or other options available might help.

The blame game often comes into play in these circumstances as well. For example, if only I hadn’t eaten the yogurt, I wouldn’t have gotten the attack yesterday. Realistically I had the attack because I have migraine, a neurological disease. Trigger management can only take us so far. It’s not our fault. Our Treatment Pie can help you lower your trigger bucket level through a combination of approaches.

Hormonal changes: perimenopause and menopause

Perimenopause

For women, hormonal fluctuations play a significant role in migraine attacks, and the transition into perimenopause and menopause can be a particularly challenging time. During perimenopause, estrogen levels become more erratic, filling up your bucket daily and causing increased sensitivity to other triggers and a higher likelihood of migraine attacks. This is because estrogen has a stabilizing effect on the female brain, and when its levels fluctuate, it can lead to increased neuronal excitability, which is a key factor in triggering migraine attacks.

Imagine your bucket during perimenopause—hormonal changes alone could fill it up significantly, even before other triggers are added. This makes it much easier for your bucket to overflow with even minor additional triggers. As a result, you may experience more frequent and severe migraine attacks during this stage of life. (4)

Menopause

During menopause, as estrogen levels decline more steadily, some women may experience a reduction in migraine attacks. The brain may eventually adjust to the lower, more stable hormone levels, leading to fewer attacks. However, this isn’t the case for everyone. Some women continue to experience frequent attacks, possibly due to other factors like stress, sleep disturbances, or the cumulative effects of aging. (4)

Understanding the role of hormones in filling your bucket is crucial during these transitions. By recognizing how these hormonal changes affect your overall threshold for migraine, you can take steps to manage other triggers more effectively. For example, during times of high hormonal fluctuation, it might be helpful to be extra vigilant about avoiding known food triggers or managing stress through techniques like meditation or regular exercise.

Identifying and managing migraine triggers

Given the complexity of migraine triggers, one of the most effective strategies for managing migraine is to identify and reduce your exposure to these triggers. A migraine-oriented elimination diet is one approach that can be particularly useful in this regard. This type of diet involves systematically removing and then gradually reintroducing potential trigger foods to determine which ones may be contributing to your attacks.

While an elimination diet can be challenging to follow, it provides valuable insights into your personal triggers. By identifying the foods that consistently cause your bucket to fill up, you can make more informed choices about what to eat and when, potentially reducing the frequency and severity of your attacks. (1) Our private Facebook group is a great place to get support if an elimination diet is on your agenda.

It’s important to note that not all doctors fully support elimination diets, primarily because they can be difficult to maintain and may not always identify every trigger. However, there is evidence that comprehensive dietary changes can be effective in preventing migraine attacks and other headache disorders. (2) For many people, the process of identifying food triggers and taking control of their diet is an empowering step in managing their condition.

When to avoid a migraine elimination diet

A cautionary note: elimination diets are not recommended for those who have disordered eating or have been treated for an eating disorder in the past. If you easily get stuck in thinking process where you divide things into a ‘good or bad’ category, an elimination diet might not be helpful and could lead to very restrictive eating. In these cases, focusing on other types of lifestyle changes (stress management, hydration, sleep routines etc.) would be more effective.

Managing non-food triggers

In addition to dietary changes, managing non-food triggers is equally important. This is where the concept of the “treatment pie” comes into play. The treatment pie is a holistic approach that includes various strategies for reducing your overall trigger load.

These strategies might include taking migraine-specific supplements (3), preventive medications, practicing regular movement or exercise, and incorporating stress-reduction techniques like meditation or deep breathing exercises.

By addressing all the different slices of the treatment pie, you can work towards achieving a baseline where even significant triggers, such as weather changes or hormonal fluctuations, have less impact on your bucket.

This holistic approach requires patience and consistency, but over time, it can lead to a significant reduction in the frequency and intensity of your migraine attacks.

Managing stress and relaxation techniques

Stress is one of the most significant triggers for migraine attacks, and it’s also one of the most challenging to manage. Both ongoing stress and stress letdown—the period of relaxation following a stressful event—can contribute to filling up your bucket. Therefore, learning effective stress management techniques is crucial for reducing your overall trigger load.

There are many different ways to manage stress, and what works best will vary from person to person. Some people find that regular physical exercise is an excellent way to reduce stress and prevent migraine attacks. Others might benefit more from therapy, relaxation techniques such as meditation, deep breathing exercises, or yoga.

Guided meditations, which are widely available on platforms like YouTube, can be particularly helpful for managing stress and reducing the likelihood of a migraine attack. These meditations often focus on relaxation, pain management, and improving sleep quality—three key factors that can help keep your bucket from overflowing.

Apps like Calm also offer a variety of meditation sessions, including Body Scans and Emergency Calm sessions, which can provide immediate relief in stressful situations.

Studying bucket theory and its affect on individuals

The Bucket Theory is one of the reasons that medical studies about food triggers feel a little off for those of us that experience their effects on our migraine attacks. Trying to level the confounding individual factors like stress, hormones, weather and sleep while delivering doses of potential trigger foods to the study participants is nearly impossible.

Guacamole may be well tolerated on a day when a person is well-rested, the weather is perfect and their difficult boss is on vacation. However, guacamole may overflow the bucket on a stormy day, with pressing deadlines, after a sleepless night.

Hopefully this article has given you some clarity on how triggers can affect our daily bucket level. For more discussions on these and other migraine topics, join our private Facebook group.

References:

1. https://pubmed.ncbi.nlm.nih.gov/27699780/
2. https://pubmed.ncbi.nlm.nih.gov/27699772/
3. https://pubmed.ncbi.nlm.nih.gov/19454881/
4. https://swhr.org/menopause-perimenopause-and-migraine/

This article has been revised and refreshed since its original publication date.