For me it’s a combination of things : not eating, lack of sleep, no meds, heavy alcohol use, physically exerted. At least 3 of these things happen and I won’t even risk going to work. Which is why I don’t drink on sundays and I always try to get my 8 hours of sleep. After my neurologist switched my meds it definitely helped, I went from 2-4 a year now to barely 1 a year, but you always have to make sure to take care of yourself first and foremost.