The presence, or potential presence, of mental illness should not be taken lightly. It is likely that a mental illness, while common, may require professional help in order to improve. It is important to note that a mental illness is different than having mental health concerns. Everyone can have periods of their life where their mental health is not good. We may feel more anxious, have a lower mood, but typically, you can return to a baseline of functioning not too long after. A mental illness typically is a series of symptoms that present for an extended period of time that has significant impact in your daily functioning, including work and family. That being said, it is still possible to fake, or exaggerate, mental illness.
In general, it is very hard to tell if someone is faking mental illness. Even trained professionals may not be able to tell right away if someone is faking or exaggerating mental illness symptoms. If someone is faking symptoms of a mental illness, that in itself may be an indication there is some underlying mental illness or a request for help. If the severity of the portrayed mental illness is high and having significant impacts in their life, someone could qualify for a diagnosis of personality disorders or Factitious Disorder. Factitious Disorder is a mental illness that someone is knowingly deceiving others by creating illness or ailments, physically and/or psychologically, but may not know the underlying reason why. Personality disorders are ways of thinking, feeling, and behaving that deviates from the expectations of their culture, causes distress or problems functioning, and lasts over time. There are multiple different types of personality disorder diagnoses and significant psychological evaluation can help determine if a particular diagnosis is present.
There may not be any tell tale signs to indicate that someone is faking mental illness or not. Professionals may need an extended period of time working and evaluating someone to be able to recognize fake versus legitimate symptoms. However, some indications of faking mental illness can include exaggerating any existing symptoms, making up medical or psychological histories, causing self-harm, tampering with medical tests, or malingering. Malingering has a different motivation; malingering is a deliberate creation of illness or disability in order to achieve a particular outcome. There is intentionality behind it, whereas a diagnosis of Factitious Disorder likely has less of an external motivating factor.
Overall, however, it can be harmful to assume that someone is faking mental illness. Motivation as to why someone may choose to fake mental illness can vary. These motivations may include, but are not limited to, jealousy, low self-esteem, and loneliness. There is an unfortunate term in the mental health world, “attention seeking”, that has a negative connotation. When someone engages in behaviors or actions that require attention or help, it can be seen as desperate, annoying, or dramatic. However, it is critical to consider why someone may be engaging in these behaviors. There may very well be a legitimate reason for this behavior; people may be needing admiration, social connectedness, or love.
Often, our own self-talk can make us believe we are making up our struggles, or unnecessarily over-amplifying them. This is significantly different than deliberately creating mental illness symptoms. If you are noticing thoughts around that you “shouldn’t” be feeling or acting a certain way, this could be an indication there is some presence of anxiety, depression, or other mental illness. Also, cultural messages around emotions and expression of emotions and mental health can amplify these thoughts. Too often, we are told we should minimize expression of emotions, particularly uncomfortable ones such as sadness, anger, or fear. These messages lead us to believe that our emotions are not valid, and therefore we think that any amount of feeling this way is too much, dramatic, and not okay. This can absolutely lead someone to believe that what they are experiencing is not real and they are only “seeking attention”.
In any case, it can always be helpful to find an outlet for your mental health concerns. Whether it is medication, therapy, or your primary care provider, talking and sifting through what you are experiencing is beneficial. Feelings and thoughts are powerful, and talking through them can help you determine ways to cope and a course of action.
This blog post is meant to be educational in nature and does not replace the advice of a medical professional. See full disclaimer.
American Psychiatric Association. (n.d.-b). What Are Personality Disorders? Retrieved April 3, 2020, from https://www.psychiatry.org/patients-families/personality-disorders/what-are-personality-disorders
Frothingham, S. (2020, February 28). What You Should Know About Attention-Seeking Behavior in Adults. Retrieved April 3, 2020, from https://www.healthline.com/health/mental-health/attention-seeking-behavior
American Psychiatric Association. (n.d.-a). APA Dictionary of Psychology. Retrieved March 30, 2020, from https://dictionary.apa.org/malingering
Mayo Clinic. (2019b, December 14). Factitious disorder – Symptoms and causes. Retrieved March 30, 2020, from https://www.mayoclinic.org/diseases-conditions/factitious-disorder/symptoms-causes/syc-20356028
American Psychiatric Association. (n.d.-b). What Is Mental Illness? Retrieved April 3, 2020, from https://www.psychiatry.org/patients-families/what-is-mental-illness