Munchausen Syndrome : The Masquerade

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This article that you’re about to read, is a very intriguing topic. Because, the first time I heard about this, it grabbed my interest right away.

So I have a friend who’s pursuing a psychology degree. Once, I was going through some psychology books and there was this book, which was about psychological disorders. And I saw this different, fancy-looking name. “Munchausen syndrome”. It caught my attention just because of its name. Although, I had a hard time pronouncing it in the right way. I asked this friend of mine for the pronunciation and she said, it’s pronounced as “Muncchawsen”. And she also asked me to have a look at it, saying that it’s an interesting topic. When I perused, It said “Munchausen’s syndrome is a psychological disorder where someone pretends to be ill or deliberately produces symptoms of illness in themselves.” I was bewildered and really intrigued. And, I shot her with all sorts of questions like, “How is this even a disorder?”, “Doesn’t everyone do this?”, “Do I have this disorder, because I’ve done this to skip school?”. She asked me to calm down, and explained it to me, meticulously. It was really interesting. But, I completely forgot about it, after that day.

And today, I was frantically thinking about a topic for this article. I’ve given a thought to topics like Covid-19 and various legal concepts. But, all of it seemed too mainstream. And I thought, I could choose something different and something science-related and this struck my mind, right away.

Munchausen syndrome. Why I chose this? One, it was really interesting. Two, not everyone knows about this. Or at least, I didn’t know about it, before the other day. So, I settled down with the topic. And, here I am. This is going to be a concise article on Munchausen Syndrome, a psychological disorder.

Introduction

Munchausen syndrome. It’s also known as, Factitious disorder. The word Factitious clearly says it all. Coming up with something artificial. Same here, but coming up with fake illness and symptoms.

This is a disorder where someone pretends to be sick and claims that they need medical attention. They even fake symptoms like chest pains, vomiting, or even asphyxiation. In the starting, I found it funny, as most of them had done it once in their life, at least. But when I dug deep into it, I realised that it is a very serious disorder and it could also lead to fatal outcomes like being administered with heavy drugs like morphine and other psychotropic medication or even taken for a risky medical procedure like endoscopy or even surgeries. They even try to make themselves purposefully unwell. There’s also a type of this disorder called, Munchausen syndrome by proxy (MSBP). This disorder is even more chilling to hear. It’s a disorder where a mother or a father makes their child, purposefully sick or makes others believe that their child is sick. This is also known as a form of child abuse.

They have this very unusual exigency for this specific type of attention and sympathy. Some do it to get prescribed medicine from the doctors and sell it for a price, because there’re people who’re addicted to prescribed drugs like morphine, Xanax, or even valium. Some even do it, because they’re deprived of love and affection. It’s just surprising what an emotionally distraught person could do.

This disorder is actually very hard to diagnose. Because, no one even knows that a disorder like this, exists. And, it’s very hard to observe and deduce them, as a layman. Also, they’re very good at convincing you and the doctors. This might lead to risky complications and long-term effects. And, cure? There isn’t a specific treatment for this. It’s just the therapies and trying to get them to avoid unnecessary treatments and drugs. It focuses more on managing this syndrome, rather than curing it. Because the succession rate is really scarce.

Symptoms

The symptoms are very subtle and are very hard to recognise. And also, the fact that them being very good at convincing, doesn’t help at all. Or, it gets too late before you could realise what’s happening. As this disorder could be very fatal because the risky procedures and the drugs might take a toll on them. But on the other note, you can deduce it, if you look close enough. Let me elaborate on some of the symptoms they have :

1. A spectacular medical history :  If you take a look at their medical history, you’ll find an enormous and a very random set of medical tests, medical procedures, pressured drugs and surgeries. Like, it doesn’t make sense, if a 15 year old continuously comes up, saying that they’re having a heart condition, even if they’re tested properly and they turn out to be normal. Because, this disorder is more prominent in young adults, ranging from 13 to all the way till 30.
2. Odd symptoms, which are unrelated :  They don’t always know how the symptoms are. So, they just try to convince their peers by just coming up with some symptom, which isn’t even related to the other symptoms and the disease. People just show their skin allergy and claim to have cancer just because they got in touch with a cancer patient. If you think, why not? I may have some news for you…Cancers are Non-communicable diseases! It never spreads from person to person. And people say that, they’re having a heart attack. But in reality, they’re just anxious. So that’s the picture.
3. New symptoms even after the medical test prove negative : They say that, they’re still feeling sick, even after many tests which turned out to be negative. They’re just desperate, because the medical test proved them negative. So they come up with new symptoms, and try to convince their peer that they’re sick. This is the symptom which can be easily observed.
4. An unusual level of knowledge about many different illnesses :  They have an extensive knowledge about many diseases and their symptoms, which isn’t really common with a layman.
5. Requesting for irrelevant medical procedure :  They have this urge to get medically treated. So, they try to come up with with some symptoms and convince the doctors that they need to go under a medical procedure. Like, endoscopy, laparoscopy. This is the most riskiest symptom. Because, this may lead to catastrophic events.
6. Uncontrollable symptoms :  They show uncontrollable symptoms and it even gets worse, even after the treatment has begun.

Why is it hard to diagnose?

1. Symptoms don’t make sense at all, comparing it to the test results.
2. They don’t respond to treatments in a predictable way.
3. The people around them don’t substantiate their symptoms.

They don’t cooperate with the doctors. In fact, they purposefully try to do what the doctor warned them not to.

Common Behaviour

The common behaviour is where most of the diagnosis happens. People generally deduce it with a certain set of behaviours, they have.

1. Pretend to be in pain :  They dissemble to be in pain. It drives their peers, mentally. If someone’s in pain, no would be able to say that they’re pretending to be in pain. So, they take advantage over this psychology.
2. Exaggerate symptoms :  They tend to exaggerate their symptoms. There were some cases where, People who had a normal cold, claimed to be positive for Covid-19. It created a major fiasco in the hospitals. And it also lead to instances where these people had frequently visited the corona ward, and they got infected from the ward. A lot of people with munchausen syndrome were exposed during the pandemic.
3. Being eager to undergo medical procedures : They tend to get excited to get medical attention. The doctors can notice this, very well. Because, no one would be happy to undergo a medical procedure. And they also get excited to get into a medical routine like, daily dosage of drugs or to undergo nebulisation, every day.
4. Capable of harming themselves :  To get medical attention or to get attention and sympathy from the others, they harm themselves, by making noticeable cuts on their body. By looking at a scar, you can easily tell it, if it’s an accident or been made on purpose. So, you can see a lot of scars like these, on their body. They might also poison themselves with chemicals.
5. Tampering with the test samples :  This is something very shocking to hear. They even mess up with their test samples, by adding sugar or blood in their urine sample. Which might make the doctor believe that the they’re having glycosuria or haematuria.
6. Ignoring a genuine medical problem :  To make things even more worse, they ignore their genuine medical illness and wait until it gets serious and calls for medical attention. They either try to create an illness or they wait until their illness gets worse.

Common complications

1. Side effects from drugs :  Some drugs have a lot of side effects. So, they only administer it to the patients who really need it. But, they try to convince the doctors to administer those drug to them. Having access to dangerous drugs like, alprazolam, Xanax and morphine is very risky. The side effect would be catastrophic.
2. Complications from self-harm : This is a serious issue. Because, if they’re trying to harm themselves, they might even kill themselves, though they were just trying to make a minor effect on their body. Like, cutting themselves or getting intoxicated.
3. Complications from medical procedures :  This is the most fatal complication. Because, undergoing a medical procedure is really serious. One could even die, if they’re given with a wrong treatment. And, surgeries are a lot more complicated.

Long term effects

1. A history of mental problems : All of these would lead to a lot of mental health issues like, depression, hallucination or even suicidal thoughts. And, it’s very hard to cure them or sometimes, not curable, at all.
2. Blaming personal failures on their illness : They use this as an advantage, to blame their personal failures on. And this would lead to them being unmotivated and unambitious in life.
3. Ability to lie and manipulate : With time, they’ll get really used to lying and manipulating their peers and their doctor. And eventually, they’ll start lying to everyone, often.
4. Muddled relationship : They lie and fake a lot about their health. Which eventually leads to, breaking the trust of their loved ones. And they get really used to lying, like I mentioned earlier. So, this will lead to a lot of estranged relationships and breaking trusts.
5. Difficulty in distinguishing between reality and fantasy : They have a hard time differentiating between fantasy and reality. This would take a big hit on their mental health.

Root Cause

The causes of this disorder are very hard to deduce. After years of research and observations, the psychologists settled down with these root causes.

1. Childhood traumas : This is the major cause of Munchausen syndrome.  A lot of children go through terrible traumas, that they don’t deserve. Traumas like, sexual abuse, parental neglects or even witnessing a gruesome accident or incidents like that. It scars those little minds, forever. This leads to a lot of mental health issues. Which might eventually lead to be the cause of Munchausen syndrome.
2. Personality disorders : A lot of personality disorders leads the path to Munchausen syndrome. Like, Anxiety disorders, bipolar and even Post Traumatic Stress Disorder (PTSD). These lead to patterns of abnormal thinking and behaviour. And might cause them to have the Munchausen syndrome. Even loneliness could be a cause because, they need closure and the attention. So, they choose this way to get the attention, they need.

Treatment

1. Visiting a psychologist : Visiting the psychologist is the first step, that everyone should do. People generally take therapies and counselling sessions for granted. People don’t value the psychologists, at all. No one realises the importance of psychology and therapy sessions. So, the therapies and counselling might offer the best chance of cure.
2. Restricting them : Restricting them from taking unnecessary medications and medical procedure, would be the best method of prevention. We can expect aggressive behaviour from them, during those times. But, it’s the best chance of prevention.
3. Closure and affection : Finally, the most important of all, they need people. People who truly care for them. People who can actually get them to open up their mind. Loneliness is the main root cause of mental health issues. And sadly, that’s the most common and the most neglected issue. They need to have the closure form the people they love.

These treatments mainly aim for the management of this syndrome, rather than curing it. Because disorders like these have the least chance of cure. That’s the reality. So, managing it is the only feasible option. Because the succession rate of cure is scarce.

The Conclusion

The ultimate taboo that needs to be demolished, is mental health predicaments. Sadly, It’s the most neglected thing in our society. When someone has mental health issues, people call them weak and make them feel like it’s not even a problem in life. And hearing that, they fool themselves and go on with their lives, living with the stress and depression. Someone just can’t cry in the public. If they do, they’re labeled as “weak”. Teenagers are the most susceptible population to depression.

Disorders like these, are taken very easily by people. And they don’t think of going to the psychologist, as an option. Mental health issues should be taken up and should be heard by everyone in this magnificent blue orb, earth. It should be spoken by everyone until the affected take a step ahead. Until everyone thinks, it’s okay to have mental health issues. Until everyone thinks, it’s okay to need help, to free up their minds. Munchausen syndrome is a tiny speck in the pool of mental health issues. But the tiniest specks are the ones that are barely noticed by anyone. So is this syndrome. When I came to know about this syndrome, I was just flummoxed thinking, how does no one know about this. Because this is a perilous disorder. It’s too dangerous to be unnoticed. But it’s getting away, right under our noses. And, that’s the reality.

References

1. https://www.trainingjournal.com/articles/opinion/how-can-we-break-taboo-mental-health-workplace
2. https://www.nhs.uk/conditions/munchausens-syndrome/
3. https://my.clevelandclinic.org/health/diseases/9833-factitious-disorder-imposed-on-self-munchausen-syndrome
4. Munchausen syndrome : Identification and intervention – by Walk, Alexandra; Davies, Susan C.
5. Practical Aspects of Munchausen by Proxy and Munchausen Syndrome Investigation (Amazon – https://www.amazon.in/Practical-Munchausen-Syndrome-Investigation-Investigations/dp/0849381622/ref=sr_1_1?dchild=1&keywords=munchausen+syndrome&qid=1627823609&sr=8-1 )
6. Credits : Dhamni. G (Pursuing Psychology in PSG College, Coimbatore)