Munchausen syndrome can be described as a mental condition in which someone pretends to be sick or purposely creates symptoms of illness within themselves. The main goal is to play that "sick role" so that they are taken care of and become the center of attention. People with Munchausen syndrome might be making up to be suffering from psychological issues such as saying they hear voices or seeing things that aren't. They may also pretend to be suffering from physical symptoms, such as claiming that they have chest pains or stomach pain. They could be actively seeking to become sick, for example, by deliberately getting a wound infected by rubbing dirt on the wound.

Few people suffering from Munchausen syndrome could spend years visiting from hospital to institution, pretending to be suffering from various diseases. If it is discovered that they are lying, they could suddenly leave the hospital and go to a different place. Patients with Munchausen syndrome can be extremely manipulative, and in the most serious instances, they may undergo painful and life-threatening surgery even though they realize it's not needed.

Causes of Munchausen Syndrome

Munchausen syndrome is a complex condition that is not well understood. People with the syndrome are often resistant to therapy or psycho-social profiling and it's difficult to determine why people who suffer from the disorder behave as they do. There are a variety of factors that were identified as potential reasons for Munchausen syndrome. This includes:

• Trauma or illness that affects the Childhood

Munchausen syndrome could result from parents' abandonment and neglect or any other trauma from childhood. Because of this experience, someone might have issues that are not resolved with their parents, which leads them to pretend to be sick. This could be because they feel compelled to make themselves sick as they are not worthy. They may also require to feel valued and be the center of attention. They should be able to transfer the responsibility for their health and their care to others

• Personality disorder

The various personality disorders that are believed to be associated with Munchausen syndrome are antisocial personality disorder where an individual may enjoy manipulating doctors and deceiving them which gives them the feeling of power and control; borderline personality disorder where the sufferer struggles to manage their emotions and is often prone to swing between positive and negative opinions of other people; narcissistic personality disorder, in which a person is often prone to seeing themselves as unique and denying that they are not worth it.

It is possible that the person is unsure of their identity and is also having difficulty making meaningful connections with other people.

Symptoms from Munchausen Syndrome

If you are suffering from Munchausen syndrome, you intentionally create or exaggerate symptoms in a variety of ways. You could be lying about or fabricating symptoms or hurting yourself in order to trigger symptoms or alter the diagnostic test results (such as contaminating urine tests with blood). The warning signs that could indicate Munchausen syndrome include:

• Their medical history is erratic and inconsistent. Inconvenient symptoms are not easily controlled and are more severe or worsen when treatment is initiated.
• Self-esteem issues and identity problems.
• The possibility of relapses becomes a predictable outcome following the improvement in health.
• An extensive knowledge of hospitals and/or medical terminology, in addition to the descriptions in textbooks of diseases. Medical knowledge could be vast from numerous hospitalizations, or from prior work.
• Multiple scars from surgery.
• The appearance of new or more symptoms after negative results from tests.
• The presence of symptoms is only evident when the patient is in a private setting or not being watched (e.g. seizures or passing out).
• Intention or desire to undergo medical examinations, operations, or any other procedure. It is more comfortable to be at the hospital than one imagines.
• History of seeking treatment at various hospitals, clinics, and doctors' offices perhaps in various cities.
• Resistance to letting healthcare professionals speak to or meet with friends or family members or previous healthcare professionals.

Certain people may pour urine in the form of blood or inject themselves by urinating, rubbing dirt inside their veins, or tying rubber bands around their legs or arm. They could appear to swallow their pills however they store them in their cheeks to take them out in the future. Deliberate dehydration also has been observed.

Treatment

While a person suffering from Munchausen syndrome seeks out treatments for the conditions they create but they are often not willing to acknowledge seeking treatment or admit to having any kind of disorder. This makes treating patients, suffering from Munchausen syndrome, extremely difficult, and the chances of the recovery process, bleak. 

If you suffer from this condition, you should actively seek treatment. Ask your caregivers to shield you from self-harm, and let them inform you of the negative dangers that could occur and the consequences that can result. Try to decrease your symptoms by reaching out to your doctor or an Online Counsellor at TalktoAngel Asia’s No. 1 Mental Health & Wellbeing Platform, seek an Online Counselling platform and be consistent with them.

If treatment for Munchausen Syndrome is sought initially, the treatment will aim to change the way you behave and limit the amount of time you use medical aids. When this goal is achieved then treatment is designed to sort out any psychological issues that could be behind your behavior, or to help you identify solutions for your other needs in your social life.

The main treatment option to treat Munchausen's condition is psychotherapy or Online Counselling. Treatment will focus on changing your thinking and behavior to seek the best cognitive-behavioral therapy. Family Therapy can help in educating your family members concerning Munchausen Syndrome. Group Therapy can help alleviate feelings of loneliness or the feeling that nobody cares about you.

Contributed by: Dr (Prof) R K Suri and Utkarsh Yadav