Another Underdiagnosed Illness

Guest · Post by **Guest** » Tue Nov 22, 2005 10:33 pm

DISEASE OR DECEPTION? THE MYSTERY OF FACTITIOUS DISORDERS
Marc D. Feldman, M.D.

Jenny (a pseudonym) was one of those "invisible" people we all know and overlook each day. A secretary for a manufacturing company, Jenny was as a diligent employee, but one who hadn't developed many friends at work. Nevertheless, she seemed to find all the companionship she needed in her relationship with her live-in boyfriend. Week in and week out, her world seemed never to change, and yet she seemed satisfied. Then one day everything, suddenly and quietly, fell apart.

Jenny's boyfriend announced he was leaving her: he had fallen in love with another woman and was moving out. Horrified and adrift, with no one to call on for comfort, Jenny chose a remarkable way out of her loneliness. She mobilized an instant support network by showing up at work one day and announcing, "I've just been diagnosed with breast cancer. And it's too late. It's terminal."

It was also a lie. Jenny had found a remarkable and desperate way to mobilize an instant support network of sympathetic co-workers. Eventually she enrolled in a breast cancer support group, shaved her head to mimic the effects of chemotherapy, and dieted to lose 50 pounds all to keep the illusion alive.

Jenny was suffering not only from a broken heart, but from an emotional ailment called "factitious disorder." People with factitious disorder feign or actually induce illness in themselves, typically to garner the nurturance of others. In bizarre cases called "Munchausen syndrome by proxy," they even falsify illness in another person (such as their own children) in order to garner attention and sympathy for themselves as the heroic caregiver.

Desperate? Of course. Yet more common than you might think. Experts estimate that one percent of hospitalized patients are faking their ailments. The medical bills in one case alone amounted to $6 million. Clearly factitious disorders are sapping an already-burdened health care system.

They also defy the imagination. Patients have bled themselves into anemia and then showed up at a doctor's office stating they haven't a clue about how they became so ill. Others have secretly taken laxatives to induce diarrhea, or mimicked seizures so convincingly that neurologists hospitalized them on the spot.

The good news: this phenomenon is finally coming out of the closet. In recent months, newspapers, magazines, and TV news programs have all described cases of factitious disorder, helping both health professionals and the general public to become aware. At the same time, factitious disorder patients are recognizing that, twisted as their behavior may seem even to themselves, help is available.

In Jenny's case, the ruse of cancer came crashing down when the leaders of the breast cancer support group discovered that she had lied about her medical care. Referred for psychiatric care, Jenny revealed feelings of overwhelming depression, and this deep depression had fueled her factitious behavior. Treated with antidepressant medication and psychotherapy, Jenny ended her illness portrayals and moved on--decisively--with her life. She has never resorted to factitious illness again.

The first step for factitious disorder patients is to realize they cannot go it alone. Though this is a hurdle they inevitably find intimidating, they simply must reach out to a therapist. The therapist can help them realize why the feigned illnesses began in the first place: why had the need for sympathy become so intense? The therapist can also discover underlying emotional problems--as in Jenny's case--that must be treated at once, and also provide the very caring these patients had previously had to go to extremes to elicit. Finally, the therapist can help teach the patient ways to get needs met without resorting to self-defeating, and even literally self-destructive, actions.

Families who suspect that a loved one has factitious disorder are invariably hungry for education about it. Consulting with a knowledgeable professional or reading about the disorder are important steps to take before they actually confront the patient. Heavy-handed, punitive confrontation doesn't work. Instead, we now know that factitious disorder is among the trickiest of psychological ailments to address, and intervention must be informed, carefully planned, and, above all, humane.

http://www.munchausen.com/

Ric · Post by **Ric** » Tue Nov 22, 2005 11:18 pm

Main Entry: fac·ti·tious
Pronunciation: fak-'ti-sh&s
Function: adjective
Etymology: Latin facticius, from factus, past participle of facere to make, do -- more at DO
1 : produced by humans rather than by natural forces
2 a : formed by or adapted to an artificial or conventional standard b : produced by special effort : SHAM <created a factitious demand by spreading rumors of shortage>

and...

Main Entry: Mun·chau·sen syndrome
Pronunciation: 'm&n-"chau-z&n-, "m&n-'chau-
Function: noun
Etymology: Baron K. F. H. von Münchhausen died 1797 German soldier and proverbial teller of exaggerated tales
: a condition characterized by the feigning of the symptoms of a disease or injury in order to undergo diagnostic tests, hospitalization, or medical or surgical treatment -- called also Munchausen's syndrome

Is "guest" suggesting we're all faking it ????
annonymous coward.

It actually crossed my mind going in to the sleep study, "I wonder if someone could fake OSA? and how?" The hardest part would be to fake the various stages of sleep, according to the EEG. Now that would be ASTONISHING! For many, if not most, the OSA events occur during definitive stages of sleep. Not EVEN "fakable". (don't look that one up)

rested gal · Post by **rested gal** » Wed Nov 23, 2005 12:59 pm

Is "guest" suggesting we're all faking it ????

I can't imagine anyone wanting to wear a mask all night if they didn't need to. Or...well....maybe. Not me!

Given its subject line, I read that post as a tongue-in-cheek suggestion of things to come for Munchhausen-ites. The increasing publicity about OSA and the availability of "no questions asked/no prescriptions needed" cpap machines and masks on internet auction sites could attract, I suppose, some who are desperate for the attention of having some kind of disorder - any disorder. No need to have a PSG that would verify having the disorder or not.

While the post was interesting to read, I think it's unlikely that a Munchhausen sufferer (and that would be an illness - mental illness - in and of itself) would choose cpap treatment. OSA is still too misunderstood to be a pity-inducing thing for a person to say they had. The reaction would more likely be, "Huh? Well, you probably just need to sleep more and lose weight."

Sleepless on LI · Post by **Sleepless on LI** » Wed Nov 23, 2005 1:22 pm

Is this spooking anyone or giving anyone else cause for concern? And I don't mean the content of the post.

ufo13 · Post by **ufo13** » Wed Nov 23, 2005 1:41 pm

I agree with Ric, RG, and Lori above. I also think "GUEST" needs to get a LIFE! What's your real point? Why don't YOU identify yourself?

steve,
ufo13

Sleepless on LI · Post by **Sleepless on LI** » Wed Nov 23, 2005 1:55 pm

ufo13 wrote:I agree with Ric, RG, and Lori above. I also think "GUEST" needs to get a LIFE! What's your real point? Why don't YOU identify yourself?

steve,
ufo13

Oh, Steve, you have no idea. I always get flack for saying I think people should have to register to post, but be allowed to read all they want otherwise. Some brave soul left me a doozy the other day accusing me of milking this site for sympathy and that I should, as they put it, "get over it, woman," and do what I do best, just listen and give out advice, instead of post about my own situation. As they implied, enough was enough with my saga and I should just help and be quiet.

And everyone says that it's probably someone who is suffering from the illness and is having a bad day. Well, you know what? I suffered for a couple of years feeling as low as anyone on this site could feel and I still used the manners that I was taught and NEVER did or would speak to anyone like that. There is no excuse for some of the garbage we are asked to swallow at the hands of these guests, having OSA or not. It's just called plain rude or sick (and I don't mean with a physical medical condition).

I think when guests start to turn a nice site like this into a cesspool of bad thoughts and comments, it's time to make the cowards either put a name to their posts or be stifled. They are very brave as long as no one knows who they are. But life does not allow you to go unidentified. You can't drive a car, get into an accident and refuse to identy yourself so you don't have to take responsibility for your actions. You turn over your license. I feel you must have an identity to prevent you from negative behavior and the fallout it causes. Sure, these guests are very brave since they can act like big shots and say nasty comments without the fear of being recognized, but that is unacceptable in my opinion. Everyone seems to think it's different here and it's okay so say whatever you want and you don't have to let anyone know who you are, sort of like a phony phone call. I say, either own up or shut up. I have never written anything that I was afraid to put my name on, whether positive or negative. It's just so amazing how ALL the acid posts on this site are labeled "Guest."

I'd give my left arm for the brave person who spoke to me that way to NOW IDENTIFY YOURSELF. That would never happen though. I have a strong hunch, as I wrote, as to who it is. But that person would not have the guts it takes to say it to my face. Would they???

Sleepless on LI · Post by **Sleepless on LI** » Wed Nov 23, 2005 2:23 pm

ufo13 wrote:I agree with Ric, RG, and Lori above. I also think "GUEST" needs to get a LIFE! What's your real point? Why don't YOU identify yourself?

steve,
ufo13

Oh, Steve, you have no idea. I always get flack for saying I think people should have to register to post, but be allowed to read all they want otherwise. Some brave soul left me a doozy the other day accusing me of milking this site for sympathy and that I should, as they put it, "get over it, woman," and do what I do best, just listen and give out advice, instead of post about my own situation. As they implied, enough was enough with my saga and I should just help or be quiet.

And everyone says that it's probably someone who is suffering from the illness and is having a bad day. Well, you know what? I suffered for a couple of years feeling as low as anyone on this site could feel and I still used the manners that I was taught and NEVER did or would speak to anyone like that. There is no excuse for some of the garbage we are asked to swallow at the hands of these guests, having OSA or not. It's just called plain rude or sick (and I don't mean with a physical medical condition).

I think when guests start to turn a nice site like this into a cesspool of bad thoughts and comments, it's time to make the cowards either put a name to their posts or be stifled. They are very brave as long as no one knows who they are. But life does not allow you to go unidentified. You can't drive a car, get into an accident and refuse to identy yourself so you don't have to take responsibility for your actions. You turn over your license. I feel you must have an identity to prevent you from negative behavior and the fallout it causes. Sure, these guests are very brave since they can act like big shots and say nasty comments without the fear of being recognized, but that is unacceptable in my opinion. Everyone seems to think it's different here and it's okay so say whatever you want and you don't have to let anyone know who you are, sort of like a phony phone call. I say, either own up or shut up. I have never written anything that I was afraid to put my name on, whether positive or negative. It's just so amazing how ALL the acid posts on this site are labeled "Guest."

I'd give my left arm for the brave person who spoke to me that way to NOW IDENTIFY YOURSELF. That would never happen though. I have a strong hunch, as I wrote, as to who it is. But that person would not have the guts it takes to say it to my face. Would they???

ufo13 · Post by **ufo13** » Wed Nov 23, 2005 2:24 pm

Lori:

I have been on the road and just got back to the site today after a few weeks, so i haven't caught up yet on a lot of the posts but after reading your post above all i can say is SHAME on that person (really want to use another word but...)! I agree with what you say and if you can't say something nice, positive, or constructive or if you have a different opinion -put your name to it! Maybe Johnny G can check to see if some of the guest's match any registered people or trace it etc. This is too good a site with too many good people to have it spoiled by a few jerks!
Just my opinion!

Best to you,

steve,
ufo13

ProfessorSleep · Post by **ProfessorSleep** » Wed Nov 23, 2005 2:41 pm

Hear, Hear, Steve and Lori! I wonder, though, if the best way to deal with such "factitious" people isn't to just ignore them? Registration might turn some off, but most would register under a sham identity. That might even make it worse. Let's just ignore the beasts.

It is also possible that the post was just something of interest that someone wanted to share. Guest could have added something implicating OSA sufferers more directly, or could have been far more into finger-pointing. Overall, the disorder presented in the post was minorly interesting, but not relevant to the group, IMHO.

Sleepless on LI · Post by **Sleepless on LI** » Wed Nov 23, 2005 2:51 pm

ProfessorSleep wrote:It is also possible that the post was just something of interest that someone wanted to share. Guest could have added something implicating OSA sufferers more directly, or could have been far more into finger-pointing. Overall, the disorder presented in the post was minorly interesting, but not relevant to the group, IMHO.

Beth,

Hi!!! How are you doing? Long time no speak.

Yes, anything's possible, but "probable" is another story. This one just really creeped me out.

I just think having to change identities each time someone wanted to be rude may turn out to be more trouble than it's worth to these "guests." I don't see the harm in allowing guests to read away. But if you want to be an active participant, why should you not be made to have an identity? Many sites, not necessarily OSA sites, insist, before you can even access the information their site provides, you must sign up. I would say anything that would cut out the insensitive "beasts" as you put it (LOL) would be welcomed.

ProfessorSleep · Post by **ProfessorSleep** » Wed Nov 23, 2005 3:44 pm

Hi there back at ya, Lori! I'm settling in here - even got myself a 420E and some software. Woo Hoo! I'm a real hosehead now!

And I agree totally regarding registration. I'm sure it won't alleviate all the beasts (not to be insensitive to actual beasts, that is), but it would be a start!

How's life without cpap, or do I even need to ask?

So now that you're showing up with an adorable little feline for an avatar, can I put my puppy picture up again?

Beth

Sleepless on LI · Post by **Sleepless on LI** » Wed Nov 23, 2005 4:41 pm

Beth,

Even I was sick of my face. Can imagine how the rest of the site felt (PLEASE, NO COMMENTS)?

I'm doing fine, thanks. A bit tired, but...uh-oh, better not talk about it or "Guest" will tell me to be quiet. I'm only allowed to give advice and listen, not allowed to talk about myself. BETH, PLAY BY THE RULES!!! You bad influence, you. Thanks for asking.

How YOU doin' (said in the voice of Joey Tribbiani-Friends)? Hope you are well. Have a very Happy Thanksgiving, and to all...

ProfessorSleep · Post by **ProfessorSleep** » Wed Nov 23, 2005 9:10 pm

Sent you a PM in response, Lori, lest we get bounced out of here for being too much off topic!

Sleepless on LI · Post by **Sleepless on LI** » Wed Nov 23, 2005 10:12 pm

Thanks, Beth. Sent you a reply.

Another Underdiagnosed Illness

Another Underdiagnosed Illness

if this helps...