What Is Munchausen Syndrome, Exactly?

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Tuesday night’s “Real Housewives of Beverly Hills” was an emotional episode for Lyme disease sufferer and show co-star Yolanda Foster.

In it, Foster confronted fellow castmember Lisa Rinna about gossip that suggested she might have Munchausen Syndrome, a psychiatric disorder in which people fake symptoms of an illness.

“I don’t even know what that means! It’s not even in my vocabulary,” Foster said.

She’s not alone. While most people have heard of “faking it,” Munchausen Syndrome is a more serious version of it.

According to the Mayo Clinic, Munchausen Syndrome is a “serious mental disorder in which someone deceives others by appearing sick, by purposely getting sick, or by self-injury.” Patients may make up symptoms or even tamper with medical tests to convince others that treatment (including high-risk surgery) is needed.

Munchausen Syndrome expert Marc Feldman, MD, author of “Playing Sick,” tells Yahoo Health that it’s hard to know for sure how common the disorder is. However, he cites American Psychiatric Association data that says about one percent of people who are admitted to the hospital have factitious disorder, which in its most severe form is Munchausen Syndrome.

Unlike hypochondriacs, people with Munchausen Syndrome are aware that they’re lying about their condition. “They know that they’re faking it, but they may not know why,” Feldman says. “Some people have described it as an addiction to making themselves sick.”

Hard-to-diagnose conditions like Lyme disease are most commonly used by people with this disorder, Feldman says, because they’re difficult to prove or disprove.

But why would anyone do this? Psychiatrist Gail Saltz, MD, author of “Becoming Real: The Stories We Tell Ourselves That Hold Us Back,” tells Yahoo Health that it’s difficult to know. “However, there is a high correlation with people who have suffered real medical illness as a child,” she says. “There may be some need to repeat something in terms of feel connected to people or loved.”

The biggest clues that someone has Munchausen, per Saltz: The patient doctor shops, has inconsistencies in symptoms, gets better and then gets worse again, and has multiple ongoing procedures but still has a mysterious illness. Munchausen patients can really run the gamut, though. “I once saw a woman who injected herself with water from a fish tank and kept having infections,” says Saltz.

Experts are mixed on whether people with Munchausen Syndrome can be cured. “The common view in the medical community is that it’s untreatable,” Feldman says.

However, he’s found that if patients will admit to what they’ve done, they may benefit from psychotherapy. “Some of the most severe patients I’ve seen have stopped the behavior as a result of psychiatric treatment,” Feldman says.

But getting to that point is a big hurdle. “Most patients won’t admit to what they’ve done, even when there is evidence to the contrary,” Feldman says. “In those cases, the prognosis is really bleak.”

Foster, who maintains that she has Lyme disease, called the accusation “the biggest f—ing blow I’ve ever had in my life.”

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