Why Your Migraines Keep Coming Back: What's Actually Happening in Your Brain
By Dr. Brenna Erickson, DC
READ TIME: 9 MINUTES Part 1 of 3 — Part 2: What's Driving Your Migraines | [Part 3: What Migraine Care Can Actually Look Like]
Dark Clouds roll in over an American Midwestern summer corn field, the tall stalks blowing in the wind.
Maybe you've learned to sleep with an ice pack within reach. Maybe you know exactly which corner of which room has the least light when it gets bad, and you've gotten frighteningly good at excusing yourself from things — dinners, meetings, your kid's recital — without having to explain why. Maybe you carry your medication in every bag you own, and you've developed a private calculus for when to take it, when to wait, when you've already waited too long. Maybe you've stopped telling people how often it happens because you're tired of the look, the one that's half sympathy and half something you can't quite name.
And maybe, somewhere underneath the management and the adaptation, you've quietly concluded that this is just how your life is going to be.
If any of that landed: this is for you.
You are not stuck. You are under-informed. And there is a significant difference.
I want to tell you what migraines really are, why the way we talk about them in conventional medicine leaves most people worse off than they need to be, and what it takes to build a nervous system that generates fewer, shorter, and less severe attacks. Not because you found the right medication. Because you changed the conditions your nervous system is living in.
That's what this series is about. And I'll tell you upfront: this is not another post telling you to drink water, reduce stress, and track your triggers. If you've been doing that for years and it hasn't been enough, you already know it's not the full picture.
This is the full picture.
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What Migraines Actually Are
The biology matters here, and most people have never had it explained clearly.
Migraine is not “just” a headache. It's a neurological event, a whole-brain, whole-body phenomenon that happens to sometimes involve head pain. It originates not in your head but in your hypothalamus.
The hypothalamus is your brain's master regulator. It governs sleep-wake cycles, hunger and thirst, body temperature, hormonal signaling, stress response, and pain sensitivity. The part of your brain whose entire job is to keep your internal environment stable in the face of a constantly changing world.
In migraine-prone brains, the hypothalamus is hyperreactive. It responds to threat, whether that threat is a missed meal, a disrupted sleep cycle, a hormonal fluctuation, a weather change, or a week of accumulated stress, by triggering a cascade. The trigeminal nerve activates, inflammation spreads through the blood vessels around the brain, and the result is the light sensitivity, nausea, cognitive shutdown, and pain that migraine sufferers know intimately. In some people, this cascade starts with aura, the visual disturbances or sensory changes that arrive before the pain, which is the brain's electrical activity spreading in a wave before the headache begins.
This hyperreactivity is indeed genetic. The threshold for triggering that cascade is lower in some brains than others. But the threshold is not fixed. It moves up and down based on the conditions your nervous system is living in at any given moment.
That is the entire premise of what I do.
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The Problem With "It's Genetic"
When a neurologist tells you your migraines are genetic, they are telling you the truth. What they often fail to tell you, because the Western medical model isn't built around this question, is what that means for your life beyond prescription management.
The genetic framing, delivered without context, creates a kind of quiet resignation. You receive a diagnosis that names something immutable about you, your DNA, your neurology, your inheritance, and the implicit message is that treatment means symptom control, not root cause work. You learn to abort attacks. You learn to identify triggers. You learn to have a plan for the bad days.
What you are rarely taught is how to change the biological terrain that makes your nervous system so reactive in the first place.
This isn't a failure of your neurologist's intelligence, or how much they care for their patients. It's a structural gap in how Western medicine approaches chronic, complex conditions. Medication for acute attacks has its place, and I'm not asking you to throw out your triptans. Used early in the attack window, before the cascade is fully established, they can be effective. But aborting attacks is not the same as reducing how often your nervous system generates them. Management is one goal. Changing the terrain is another.
That is where my functional medicine lens comes in.
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No Two Migraine Brains Are the Same
Something gets flattened every time we talk about migraine as though it's a single condition: migraine exists on a spectrum, no two patients are the same.
Something I hear constantly from new patients, in some version or another: "I've tried everything, and nothing works. I don't know if I'm just a difficult case, or if I'm doing something wrong, or if there's something wrong with me."
There is nothing wrong with you. You've probably been treated with approaches designed for a generic migraine patient, and you are not a generic migraine patient. “Average” is a mathematical construction rather than a personal failure.
Migraine exists on a spectrum that is wider than most people realize, and the lived experience varies just as dramatically. There's episodic migraine, a handful of attacks per month, relatively predictable, often responsive to medication. There's chronic migraine, 15 or more headache days per month, where the boundary between attack and baseline starts to erode, where you stop remembering what it felt like to not be managing something. There's migraine with aura, where the attack announces itself with visual disturbances or sensory changes before the pain arrives. There's vestibular migraine, where the primary experience is vertigo and balance disruption rather than head pain, and patients have frequently been through multiple specialist workups and told nothing is wrong. There's the migraine that shows up as cognitive shutdown without a headache at all, which is almost never recognized for what it is. And there's the migraine that dismantles someone for three days while their employer, their partner, their children watch and quietly wonder why they can't just push through.
All of it is real. None of it is an exaggeration. And the person who's been told they "don't look that sick" has heard something that is both unkind and clinically uninformed.
What this means for my work: there is no universal migraine protocol. There is careful assessment, pattern recognition, and an individualized plan built around your specific nervous system, your specific contributors, your specific life. What I can give you here is the map.
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The Framework: Threshold Theory
To understand why migraine responds to the approach I'm describing, you need one concept — and once you have it, everything else makes sense.
Every migraine-prone nervous system has a threshold: the level of accumulated physiological stress at which the hypothalamus tips into an attack. That threshold is genetically influenced — some brains are set lower than others. But it is not fixed. It rises and falls continuously based on what your nervous system is carrying.
Think of your migraine threshold as a container. When your overall load is low — when sleep is good, blood sugar is stable, hormones are balanced, gut is functioning, stress is manageable — that container has room. Your nervous system can absorb disruption without cascading. When your load is high, the container is nearly full, and the smallest additional stressor causes it to tip over, and everything it has been carrying spills out, touching everything.
This is why your triggers are inconsistent and maddening. Wine triggered a migraine last month but not this month. Your period brought an attack in January but not February. Those things didn't change. Your threshold was different. The container was sitting at a different level.
This is also why chasing and eliminating individual triggers is an incomplete strategy. You can avoid every trigger on the list and still have daily migraines if your underlying load is high enough. The more powerful approach, the one that changes the trajectory, is to systematically lower your overall load so your threshold rises and your nervous system has more room before it tips.
That means looking at everything contributing to the load. And that's what Part 2 of this blog series will cover.
What's Next
Part 2 of this series maps the systems I investigate in every new migraine patient — sleep, hormones, blood sugar, gut health, mitochondrial function, toxic burden, and several more that rarely get looked at together. Understanding which of these are active in your particular picture is the beginning of a very different conversation about your migraines.
Part 3 describes what integrative migraine care at Stockheart looks like in practice, the tools, the modalities, the process of building a plan that's built around you.
If you'd rather talk through your picture before reading further, a consultation at Stockheart is the place to start. It's a conversation, not a commitment — and you'll leave with a clearer sense of what's driving your pattern and what it would take to change it.
→ Request a consultation at Stockheart
And if you're in the middle of a rough stretch right now and need something practical today, the Oh Sheet Migraine Emergency Kit is a free resource I built for the window between "I feel a little off" and "I'm in full migraine." Evidence-informed, practical, and always free.
Stockheart Whole Health is an integrative clinic in Minneapolis offering chiropractic, acupuncture, massage therapy, and nutritional support. We specialize in whole-person care for people navigating complex, whole-body transitions.
Brenna Erickson DC
Dr. Brenna Erickson practices at Stockheart Whole Health in Minneapolis, offering chiropractic care, DNFT, cranial adjusting, and functional medicine for people with chronic and complex migraine. Stockheart's integrative team also includes acupuncture and massage therapy. To explore care, request a consultation here.
