Tag Archives: Münchausen Syndrome

Myths about Health Anxiety

In a chronic illness Facebook group I’m part of, a member talked about having “possible hypchondriac” written in her medical records. This led to a discussion of chornic illnes, hypochondriasis and illness anxiety, as hypochondriasis is now called in DSM-5, medical knowledge, imagining or faking symptoms. There are a lot of prevailing myths about health anxiety, which I feel compelled to write about.

First, this person had a known chornic illness. The DSM-5 criteria for illness anxiety disorder clearly state that, if a general medical condition is present or there is a high risk of developing such a condition (eg. strong family history), illness anxiety disorder should only be diagnosed if the person’s anxiety is clearly out of proportion to the medical condition. Also, the criteria say that people with illness anxieyt usually suffer no or only mild somatic symptoms. I am not sure how to interpret this, as everyone suffers somatic symptoms at times, and the DSM-IV specified that hypochondriacs misinterpreted real bodily signals. That’s not the same as somatic symptoms, I believe. Anyway, for these reasons, it is pretty unlikely that a person who has a known chornic illness, can be diagnosed with illness anxiety disorder.

Another prevailing myth is that knowing a lot about medical terminology indicates you’re ahypochondriac. Well, in such a case all doctors ought to be hypochondriacs. Also, talking, writing or reaidng a lot about illness is not a symptom of illness anxiety disorder, unless it’s accompanied by anxiety about having the acctual illness. I am not a hypochondriac for reading blogs about medical disorders that I don’t have. Yay!

Making up symptoms or creating them is also not hypochondriasis. People who fake illness to take on the sick role have a factitious disorder (aka Münchausen Syndrome). People who fake illness for secondary gains (eg. disability benefits), are malingering. These two need to be differentiated: factitious disorder, even in its harmful forms (ie. Münchausen by proxy), is a real mental illness and should be treated as such. Malingering is not. Doctors still have a hard time diagnosing certain cases of malingering due to having sympathy for the faker.

Lastly, please remember that having or being perceived as having a bad attitude about your health or illness, is not hypochondriasis. People deal with chronic or serious illness differently, and most of this falls within the normal range. Where it becomes distressing to the patient, it may be illness anxiety disorder (or depression or another mental illness). Being a pain in the butt for other people, may be too bad, but it’s not a psychiatric disorder.

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“Münchausen by Modem”?

i’ve been thinking of a few issues lately, and I want a way to write them out. Particularly, I’ve been thinking about various topics surrndoung my various diagnoses. I’ve only got a few diagnoses – not nearly as many as my Facebook group memberships would suggest -, but I’ve had many off-the-record labels.

Firstly, I have a diagnosis of Asperger’s or autism spectrum disorder. My parents say the diagnostician just gave me thsi label in order to get me services. My former therapist in the old city institution doubted my diagnosis too, thinking my theory of mind is too good for ASD. Now that whole theory-of-mind thing is controversial, but well. This therapist wondered whether a more correct diagnosis would be acquired brain injury, because I had a brain bleed as a newborn which resulted in hydrocephalus. I used this off-the-record label to gain access to some groups for brain injury and am finding them very supportive. (Yes, I did explain my situation in each of the groups and made sure I wasn’t seen as an intruder.) I’ve asked people in the autism groups for their opinion on the brain injury/autsim link, and 90% replied that autism is purely genetic. Kind fo shortsighted in my opinion.

I’ve also been thinking about my mild but slightly worsening motor deficits. I always self-identified as dyspraxic but have recently gotten to wonder what my diagnosis was as a child. I saw a physiatrist (physical disabilities doctor) until around age eight and have many of the syptooms and complications of mild cerebral palsy, including a significant left/right disparity, the need for a cast on my left foot at age five and scoliosis. These issues do not seem to happen to dyspraxics.

In a way, diagnosis shouldn’t matter. I know this. I worry sometimes that I’m only seeking for diagnoses so that I can collect an impressive list of labels. I remember about ten years ago reading something about “Münchausen by Modem”, ie. the tendency of some people to join Internet groups for diseases they don’t have. Am I a classic case of this? I’m not sure, but some people think so. At least, the people in the Dutch DID organization thought so. I guess it’s about time I work on developing a disorder-free sense of self.