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Ever come across someone who frequently visits the clinic and is never satisfied with how the doctor is treating him or her? These individuals are always suffering from one clinical illness or another. No matter how many doctors they try visiting, their illness just never improves. If you think that someone in your circle exhibits the same features or if you find yourself involved in these activities then it is very likely that there is an underlying psychological condition known as Munchausen Syndrome behind these unusual activities. 

Munchausen Syndrome is a psychological condition in which an individual pretends as having physical illness and puts on a show of all the symptoms he or she is experiencing, of the feigned illness. Often the motive behind this pretence is to gain sympathy and to seek attention from others and getting any practical benefits is usually not the reason that individuals act this way.

Named after a German aristocrat, Baron Munchausen who used to be renowned for telling tales that were wild and unbelievable, this psychological condition is complex to understand and even trickier to spot, in the first place. 

People with Munchausen Syndrome may present differently. For instance, some individuals may fake the symptoms of physical illness and claim to have pain in the epigastrium or other physical symptoms whereas, some individuals fake mental illnesses and present with psychological complaints like hearing voices and hallucinating, etc. Additionally, some individuals try to infect themselves by contaminating their wounds and taking other measures deliberately, to make them ill. These individuals fake illness to get attention and are experts at manipulating which is why it is so hard to pick them out. 

When doctors discover that they have been lying and acting about their symptoms the whole time, these individuals simply never return to that hospital and switch to another doctor and hospital altogether thereby escaping from being caught. 

Munchausen Syndrome is such a controlling psychological condition that individuals affected with it undergo risky and painful surgeries despite knowing the dangers associated with the surgery. They are so blinded by their desire to pretend to be sick to get attention, that they put their lives in danger.

Munchausen Syndrome is commonly seen in females aged 20 to 40 years with a healthcare background and in males, it is mostly seen in white men of 30 to 50 years of age who are unmarried. 

As mentioned earlier, it is no easy task to spot an individual with Munchausen Syndrome but here is the list of red flags that can help you identify individuals with this disorder:

  • Visiting hospitals frequently and mostly different hospitals 
  • Complaining of fake symptoms that have no medical evidence 
  • Claiming to have symptoms that contradict with test results since test results are mostly normal
  • Having a pretty good grasp of medical knowledge
  • Complaining that symptoms are getting worse without any apparent cause
  • Not receiving visitors in the hospital since they usually live an isolated life and have minimal contact with friends and family 
  • Agreeing to undergo life-threatening surgical procedures or other risky tests 
  • Telling unrealistic tales about their life and exaggerating events
  • Explaining symptoms as depicted in the textbook and their history is often vague and not consistent 

Following are the signs and symptoms seen in individuals with Munchausen Syndrome:

  • They fake their symptoms and often state symptoms that can not be outrightly ruled out by the doctor such as having an intense headache or pretending to have convulsions or passing out. They simply deceive doctors into believing that they have a life-threatening medical condition. 
  • They can go to extreme lengths to exaggerate their symptoms and to prove that they are actually sick and not faking their illness. For instance, they heat the thermometer to show that they have a fever and they even add blood to their urine sample depicting a grave illness. 
  • They self-inflict illness upon them by adopting habits that can cause the disease to happen such as overdosing on drugs to poison themselves, or they might cut or burn themselves to seek attention, and may even eat food that is known for being contaminated and therefore dangerous to health. 
  • They can even open their previously stitched wounds and can run dirt and faeces over their wounds to cause an infection. 

Munchausen syndrome is one of the inadequately understood conditions due to the complex nature of this psychological disorder. Since individuals with these disorders straight away deny having any psychiatric condition and do not believe the doctors when they try to educate them so they never show up to visit a psychologist for their treatment, hence this condition remains untreated and unregistered most of the time. Due to these reasons, there has not been sufficient information regarding this syndrome. 

However, certain factors have been identified to have a role in causing Munchausen Syndrome such as emotional trauma during childhood, a personality disorder, or simply a grudge against healthcare professionals and authority figures.

  • Childhood trauma 

In cases of parental neglect or abandonment, or in any case of childhood trauma, the child is denied the basic emotional support from their parents or caregivers. 

Consequently, the child develops a psychological condition such as Munchausen Syndrome where he or she fakes their symptoms to get attention from their parents. They even impose illness on themselves when they think they don’t deserve to live a healthy life because they feel they are not worthy of it. 

These children have a strong desire to be the centre of attention hence they pretend to be ill most of the time. They feel an urge to make others take responsibility for their health. 

Additionally, children who have been through extensive medical treatment in their childhood may develop Munchausen syndrome as they become adults because they have been used to receiving attention due to their illness and they desire to be taken care of like that again. 

  • Personality Disorder

Multiple personality disorders are linked with Munchausen syndrome. Individuals with disruptive personalities are prone to have unusual patterns of thoughts and this results in different psychological conditions. 

Some of the personality disorders that can lead to Munchausen Syndrome include Borderline Personality Disorder since these individuals keep shifting their view of others, Narcissistic Personality Disorder in which the identity of these individuals swings between being the best to being nobody, and Antisocial Personality Disorder in which individuals seeks pleasure from deceiving and manipulating doctors as they feel in control while doing so. 

When these individuals pretend to become sick and get admitted to a hospital, they feel accepted and receive support giving them immense self-satisfaction.

It is extremely difficult to diagnose Munchausen Syndrome because these individuals are really good at pretending and faking illness. However, doctors can diagnose a case of Munchausen Syndrome when they suspect inconsistencies in the history of their patients. Visiting several doctors with different complaints is another reason to suspect Munchausen Syndrome in a patient. 

In order to diagnose Munchausen Syndrome, doctors have to exclude all causes of gain and benefits for seeking treatment and they need to rule out any history of substance use disorder for getting a prescription of strong analgesics. Upon identification of the following features, a  diagnosis of Munchausen Syndrome can be made:

  • When there is evidence that they are fabricating illness and feigning symptoms 
  • When the key purpose is to assume a ‘sick role’ 
  • When there is no other reason underlying their fabrications and pretentious behaviour 

It is very challenging to treat Munchausen Syndrome and deal with individuals who have this disorder because the individual never agrees or believes that he or she has a psychological condition. When a patient does not cooperate, it is very difficult for doctors to begin treatment in order to improve their condition.

Individuals with Munchausen Syndrome should be referred to a psychologist and confronted in a non-aggressive way because it is highly likely that they will not listen to a healthcare professional when they find out that the doctor knows that they were deceiving. 

Since it is a serious psychological condition, these individuals do not know why they are pretending about an illness that does not exist and they are in dire need of help hence they should be referred to a psychiatrist at the soonest. When doctors approach them compassionately and in a non-aggressive way they are more likely to listen to them and follow their advice even if it involves consulting a psychiatrist. 

The goal is to avoid the individual with Munchausen Syndrome to get unnecessary treatments such as taking medicines and going through risky surgical procedures and this is done by changing their mindset. For this purpose, some individuals are referred to their family doctor so that they establish a relationship with one doctor when they take the individual into confidence so that these people avoid visiting multiple doctors and surgeons for unneeded procedures. 

Some individuals also benefit from talk therapy which is a form of psychotherapy that targets the thought pattern by discussing the condition of the affected individual. Cognitive Behavioural Therapy (CBT) has shown success in treating individuals with this disorder as it helps individuals to change their thought processes and respond to them in a strategic manner such that these impulses have no control over them. 

Enrolling in a luxury inpatient rehabilitation centre is an excellent opportunity for recovery from Munchausen Syndrome. In a high-end rehabilitation centre located in a picturesque setting under the care of the highly esteemed team of healthcare workers these individuals have a chance to recover. In such a setting, holistic therapies and cutting-edge facilities are provided to these individuals so that they can recover in the safest and most comfortable environment packed with luxury while valuing privacy of these individuals. 

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