From Red Carpets to American Love Song: Britt Middleton on Migraine, Representation, and Romance

 

Welcome to Chronically Peachy, a podcast co-hosted by Sophia Fang, founder of Peachy Day, and Bernadette of @ChronicAccounts. This space exists for honest conversations that keep it real and peachy about living alongside migraine. 

We share unfiltered stories, break down migraine hot topics, and uplift community conversations with neurologists, experts, and advocates. If you’re looking for validation, accessible info, or just two friends who genuinely get it, you’re in the right place!

In this episode, we sit down with Britt Middleton, novelist, journalist, poet, and person with migraine, to talk about what it actually looks like to build a creative career while living with a chronic neurological condition. Britt's debut novel, American Love Song, came out May 19th, and it features something rarely seen in romance fiction: a main character who has migraine, a love interest who helps care for her during an attack, and a story that doesn't look away from what chronic illness does to a person's sense of self.

Migraine in the middle of a high-pressure journalism career

Britt spent years interviewing major names, Bradley Cooper, Bill Hader, the cast of Crazy Rich Asians, for outlets like BET, Popsugar, Refinery29, and Nylon. On camera, under studio lights, on tight deadlines with no room to reschedule.

She described a specific moment that stayed with her. She was interviewing John Cena for a film premiere in New York. He was generous and warm throughout. He almost certainly had no idea she was on the verge of vomiting. Twenty professional lights were rigged up. Cameras and microphones attached. The interview was five minutes, then she had to turn around a piece the same day, more screen time, more transcribing, more strain on a brain already at its limit.

What happened after the interview became, unexpectedly, the seed for her book. At the movie premiere that evening, she got sick in front of a few thousand people. She said it without embarrassment, because that's migraine. You can hold it together when you have to, and then sometimes you can't, and there's nothing to be done about it except keep going.

"It illustrates the unpredictability of chronic illness and migraine. People can't always see what you're going through — until they do.".

What is it like to live with migraine for 20 years without a diagnosis for 15 of them

Britt has been living with migraine for roughly twenty years. For most of that time, she didn't have a name for it.

Growing up in the nineties, Britt was the kid who kept telling her mom she had a headache. She took Tylenol. She got glasses to rule out eye strain. She had MRIs. The words for what she was experiencing existed. Medicine just hadn't passed them on to anyone in her life. She wasn't diagnosed until her early thirties. That's fifteen years of reaching for whatever was available: Excedrin, over-the-counter anything, while having up to twenty migraine days a month. Fifteen years of learning to live around pain without understanding what the pain was.

"I had to learn to live with the pain for a long time, which really is not ideal."

The diagnosis changed things. Consistent relief, though, didn't come until two or three years ago. For anyone listening who is still in the gap between diagnosis and actually feeling better, Britt sees you. That gap is real and it can stretch on for a long time.

What does it take to finally get a migraine diagnosis

Work became impossible to ignore. Britt was missing enormous chunks of the month, unable to look at screens, unable to drive, fighting constant nausea. When medication at onset still wasn't enough to keep her functional, she finally saw a neurologist and got the diagnosis that had been missing for years. What followed was something unexpected: relief. Understanding that migraine is complex, still not fully understood, and not caused by anything she'd done wrong meant she could stop chasing blame and start building a life that worked for her brain.

That reframe matters clinically, too. As Bernadette puts it, missing a childhood diagnosis doesn't just mean missing treatment, it often means the disease progresses. You spend years chasing symptoms instead of treating the underlying condition, and by the time you get answers, you're already more severe than you needed to be.

The lifestyle change that led to a novel

A few years ago, Britt was in a high-stress corporate role, sick most of the time, and running on empty. Many of her migraine were stress-triggered. She took a leave of absence, and in that time she asked herself a question she hadn't made space for before: was she going to keep chasing symptoms, or was she going to make a real change?

She left the job. She decided to become an author, something she had promised herself as a kid she'd do someday, at forty, once everything else was settled. She started writing in July 2023, sitting at a restaurant at Walt Disney World with her fiancé, and the book comes out this May.

She was clear that this wasn't a story about chronic illness making someone too weak to handle a demanding career. It was a story about finding the environment that brings out the best in you rather than one that keeps making you sick.

"You know what it feels like to ignore the most vital parts of yourself. And that's not sustainable."

In America especially, productivity and job title are deeply embedded in identity. Unlearning that, getting to the actual question of what you need as a human being in this body, is real work. Not everyone gets there. But many people in the migraine community will recognize exactly what Britt described.

What's different about how Britt writes

Writing, it turns out, is not a migraine-friendly occupation on paper. Long hours at a screen, cognitive strain, light exposure, all of it maps directly onto migraine triggers. Britt has had to build her own relationship with the process.

She doesn't write every day. She uses blue light glasses, prescribed, when she's at the computer. When she can, she writes in a notebook to reduce screen time. She tracks the basics: water, sleep, and food, knowing that the mental load of sustained creative work can manifest as physical pain if she isn't careful.

She also talked about accommodations more broadly: whether in school or in a workplace, figuring out what structures can protect you is part of navigating chronic illness with any kind of sustainability. It doesn't mean the illness wins. It means you've learned how to work with your brain instead of against it.

American Love Song and what it puts on the page

Britt's debut novel centers on Brinton, a 27-year-old Black journalist in New York working at a major music publication. Brinton has migraine. She also lives with anxiety and depression. And in the book, her love interest helps her through a migraine attack, administering Sumatriptan, staying present, caring for her in a way that Britt drew directly from her own relationship with her fiancé of fourteen years.

That scene exists because Britt hadn't seen it anywhere else. She was hungry for a story that showed what love and trust can look like when at least one person in a relationship lives with chronic illness, not as a burden or a plot device, but as part of a full, real life.

Bernadette mentioned Seven Days in June by Tia Williams, a novel that opens with the protagonist having a migraine attack, as a rare example of this kind of representation. But even there, the relationship aspect of caregiving for someone with migraine wasn't at the center. Britt's book goes there specifically.

"I wanted to create the thing I was hungry for."

The book also explores what it means to be the only Black woman in the room, in editorial meetings, on red carpets, in professional spaces that were never designed with her in mind. Brinton navigates being dismissed, being tokenized, being made to feel like an outlier in rooms she has every right to be in. That experience is drawn directly from Britt's own years in journalism.

She described the exhaustion of working twice as hard just to be taken seriously, and how chronic illness layers onto that. Both the invisibility of migraine and the visibility of being the only person who looks like you in a room require a kind of sustained performance that takes a real toll.

Sophia named it clearly: when you add the pressure of intersectional identity to the labor of managing a chronic condition, the weight compounds. Brinton's story holds both at once.

On representation in romance and why it matters right now

The romance genre has historically centered a very narrow set of bodies, identities, and experiences. Britt talked about what it means to be putting this book out in a moment when those conversations are loud and ongoing.

The book that changed everything for her was Get a Life, Chloe Brown by Talia Hibbert, a romance centered on a protagonist with chronic illness, whose love interest cares for her without making her condition the tragedy of the story. Tia Williams, who has spoken publicly about living with migraine, has also been a sustained influence.

Britt is self-publishing American Love Song because she believes in it and didn't want to wait for a mainstream publishing infrastructure that doesn't always make space for stories like this one. She was direct about it: the books are out there, but they often don't get the marketing budgets or the front-of-store placement. Finding them sometimes requires being intentional.

She invited anyone who has written a book centering on chronic illness, intersectional identity, or experiences like these to find her; she wants to read it, support it, and shout it out.

Sophia's hope for the future is that books like this stop being categorized as niche and just become literature. Good stories, full stop.

"You're just so much better for it when you can read outside of your own life experience."

What Britt wants the Chronically Peachy community to take away

Don't be afraid to take care of yourself. That's where Britt landed.

Living with multiple chronic conditions, as she does, means some days the energy for all of it simply isn't there. That's real. But knowing you deserve to feel well, even imperfectly, even on the days that aren't a ten, is a foundation worth building on. You can't always control what your body does. You can commit to treating it with the dignity it deserves.

American Love Song by Britt Middleton is out May 19th on Amazon and at BrittMiddleton.com. Find her everywhere at @TheBrittMiddleton, and if you mention Chronically Peachy when you sign up to be an early reader, she'll make sure you get an early copy.

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