Migraine complicates the relationship between specific disease and
legitimation. Migraine has a well-established diagnosis, a subspecialty in medicine that is devoted to its treatment, brain imaging that illustrates a migraine in process, pharmacological interventions, research that links certain forms of migraine to genetic mutations, insurance companies and policy makers that recognize its existence (albeit to a limited degree), and a pharmaceutical industry that already markets some drugs to treat it and which is trying to develop more. And while researchers have not yet articulated a specific cause of migraine, they have developed a neurobiological model to explain much of the migraine process. Moreover, migraine differs from most of the contested illnesses that have been studied in that it has been defined as a medical diagnosis for hundreds, if not thousands, of years. Yet these advances have so far not been sufficient to validate the experiences of those with migraine, nor to bring resources to
the study and treatment of migraine.

Legitimation, therefore, must depend on something more than the discovery of biomedical pathology. Legitimation also has a moral dimension. In other words, for a disease to be fully legitimated, the people who have it must be viewed as deserving of care and resources.

Joanna Kempner in Not Tonight

Migraine’s legitimacy deficit makes it much harder to live with because the people around you see it as some combination of

  1. your fault
  2. not hard
  3. not real

And so I am not deserving of care and support.