Munchausen Syndrome (Factitious Disorder)

1) What it is

Munchausen syndrome (factitious disorder imposed on self) is when someone deliberately produces or exaggerates symptoms to take on the “sick role,” often driven by deep emotional needs rather than external rewards.

2) What it feels like

“I need people to care or I feel empty.”

“Being ill feels like safety.”

“I don’t know how else to be supported.”

3) Signs

• frequent hospital visits
• inconsistent or unusual symptoms
• extensive medical history
• symptoms worsen when observed less
• distress when questioned
• high anxiety about being believed

4) Causes

• trauma and neglect
• attachment needs
• unmet emotional support
• identity formed around illness

5) Triggers

• rejection or loneliness
• stress and abandonment feelings
• conflict or lack of attention

6) Helps now

• compassionate, non-shaming approach
• reduce confrontation
• encourage mental health support

7) Longer-term

• long-term psychotherapy
• trauma therapy
• stable support structures

8) Treatment

• mental health team involvement
• coordinated care plan
• reducing unnecessary procedures safely

9) Medication

Not specific; may treat anxiety/depression if present.

10) Tips

Families: protect boundaries while being compassionate and encouraging treatment.

11) Urgent

Urgent if:

• self-harm through medical behaviours
• life-threatening actions
• suicidal thoughts

12) UK help

• NHS urgent help
• Samaritans / Shout
• Mind

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