Factitious and malingering · Uncategorized

Factitious disorder: faking sickness

Dear Doc Column

3-16-18  “Dear Doc, I’m a nursing student with a problem.  This might sound strange, but I find myself faking sickness to get medical treatment, for no reason at all except I like being a patient.  What’s wrong with me?”

It sounds like you’ve got yourself into a tough situation, but congratulations on making an enormous step in the right direction: you recognize you have a problem.

You might be struggling with factitious disorder.  Sometimes called Munchausen’s, it’s an illness characterized by the feigning of physical or psychological symptoms for no clear reason, except liking the “sick role.”

People with this disorder will go to great lengths to convince doctors they’re sick, often hurting themselves and blaming it on a false disease process, and they frequently undergo invasive procedures and treatment they don’t need.  The cause of this illness isn’t clear. People with factitious disorder don’t fake illness to miss time at work, avoid jail, win a lawsuit, or gain any other benefit, and they don’t suffer from hypochondriasis.  Unfortunately, sufferers of this disorder almost never admit their symptoms are feigned.  Most often, when Munchausen’s is discovered, the patient disappears and moves onto a new set of doctors.

Sometimes a person with factitious disorder will get their needs met by feigning symptoms in someone else, a subtype called Munchausen’s by proxy.

Factitious disorder is hard to treat if the person with the disorder isn’t motivated to get better.  The first step is to be honest with your doctors.  Next, work with a therapist to gain insight into your problem, process past trauma, improve self-esteem, and find other ways to meet your needs.  While there aren’t any medications that treat the disorder directly, psychiatrists will focus on getting other mental health symptoms under control, like depression and anxiety.  When it comes to your physical health, it’s important that you stick with one family doctor, meet regularly, and maintain open two-way conversation about your medical care. 

If you think you have factitious disorder, please reach out for help!

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