Faking It

Headache advocates are taking to social media to express their (justified) outrage about a wikiHow that explains how to fake a migraine. The article, one of many “how to fake” pieces on the website, suggests that, although migraines can be hard to fake, one can approximate it with some squinting and head-touching.1

Obviously, this article is wildly offensive to those of us who have regular migraines, and who desperately need people to believe when we have an attack. One of the main problems facing people with migraine is what I call the “legitimacy deficit.” Even though people know that migraine is a real biological disorder, an individual complaint of migraine remains easy to dismiss as “just a headache.” That’s the problem with pain – it’s invisible, impossible to test with any diagnostic test, and completely subjective. What’s more, pain is difficult to describe. That’s why so many of us say that only people with migraine can understand how bad it can be.

Even doctors are skeptical of people who complain of migraine. Stories abound about people who are turned away from the Emergency Department because a doctor believes that they are merely drug-seeking. And at least one study has shown that a substantial subset of neurologists think that their headache patients either have emotional problems or other motivations to maintain their disability. Even the federal government doesn’t think that migraine is serious—the National Institutes of Health (NIH) provides disturbingly little funding for headache research.

Granted, a wikiHow article is hardly the source of the problem. But it is emblematic of a broader issue – one that all of us need to work on changing. Because the irony is that while some people might think faking migraine is a good idea, the rest of us are trying to hide our very real, very debilitating migraines.

The wikiHow article warns readers that faking a migraine too often can lead to suspicion. Unfortunately, having real migraines too often leads to the same problem. How many of you have put on a brave face, even as your head is exploding?

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