Factitious Disorder and Addiction Treatment

Most of us don’t like being sick, but can still appreciate the perks of mild, short-term ailments, like an excuse to lie in bed all day catching up on Netflix or having a loved one bring you delicious soup. People with factitious disorder imposed on self, however, aren’t really sick, nor are they looking for an excuse for a day off work. Rather, they deliberately invent or exaggerate physical or psychological illness because they so deeply desire the perceived benefits of illness, including love, attention, and affection. When factitious disorder is accompanied by drug addiction, dual diagnosis treatment is essential to healing.

Faking Illness to Meet Real Needs


Factitious disorder is often confused with illness anxiety disorder, or hypochondria, a condition in which people are preoccupied with the possibility of becoming ill and diagnose even the most minor of symptoms as catastrophic medical events. But factitious disorder and hypochondria are entirely different. Those suffering from factitious disorder imposed on self (also known as Munchausen) do not truly believe they have these illnesses. Instead, they deliberately feign or exaggerate symptoms, and may at times even produce them by harming themselves physically. They may undergo unnecessary medical testing and treatments—ostensibly to try to resolve the conditions from which they are suffering, but of course they are never cured. In the most extreme cases, people with factitious disorder may even submit themselves to multiple, unnecessary surgeries in their quest for attention.

Not all people with factitious disorder focus on themselves; those with factious disorder imposed on another (Munchausen-by-proxy) fabricate or produce symptoms in someone else, typically someone in their care such as a child, a disabled partner, an elderly relative, or a pet. Most often, people with factitious disorder imposed on another are mothers who invent illnesses for their children and may intentionally harm them to produce the illnesses or injuries they purport to have. For children, this can have a devastating psychological and sometimes physical impact, resulting in lifelong emotional suffering, real bodily harm, and even death.

While people with factitious disorders are manipulative by definition, their motivations do not appear to be malicious. Rather, they are desperately searching for attention, love, and affection that they do not feel can be fulfilled in ordinary life.  And although the causes of factitious disorder are poorly understood, experts believe that childhood abuse or neglect may be a factor in many cases. An extensive history of childhood illness or the illness of a loved one during one’s formative years may also contribute to the emergence of the disorder.

Symptoms of Factitious Disorder


The symptoms of Factitious Disorder are multiple and varied, and typically only become recognizable as a pattern of damaging behavior over time. These symptoms include:

  • Dramatic and inconsistent medical history
  • Vague, shifting symptoms that do not respond to treatment and get worse over time
  • New symptoms emerging even after negative medical tests
  • Symptoms occurring only when the person is alone
  • Seeing multiple doctors
  • Eagerness to undergo medical procedures
  • An encyclopedic knowledge of medical illnesses and terms
  • An unwillingness to let loved ones speak with their healthcare providers

In cases of factitious disorder imposed on another, the victim may be led to believe that they do in fact have the illness their parent is telling them they have, causing tremendous distress.

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Factitious Disorder and Addiction


People suffering from factitious disorder, like others who struggle with mental illness, may turn to drugs to find relief from overwhelming emotional distress, creating a cycle of suffering and addiction from which is very difficult to break free. However, factitious disorder also presents unique risk factors for addiction, including:

  • Using therapeutic or recreational drugs to feign illness or produce specific symptoms
  • Using therapeutic or recreational drugs to feign or deliberately produce drug addiction
  • Becoming addicted to prescription drugs administered from physicians attempting to address what they believe to be real illness, particularly benzodiazepines and opioid pain killers

When drug use becomes an integral part of the deception, it can be extraordinarily difficult for people with factitious disorder to recognize that they have a problem; in fact, some may revel in the idea that they now have a legitimate medical concern that requires treatment rather than having true concern about their own well-being and interest in recovery.

Dual Diagnosis Treatment


Factitious disorder is notoriously difficult to treat, as those who suffer from it are typically deeply invested in denying they have the illness at all; very few people with factitious disorder spontaneously seek diagnosis and care. The most common scenario, therefore, is diagnosis by the physicians who are treating them for their imaginary ailments. If your loved one or your patient is experiencing both factitious disorder and real drug addiction, dual diagnosis treatment is the optimal course for healing.

Dual diagnosis treatment seeks to create a holistic healing experience wherein all components of a person’s suffering are addressed using modern, evidence-based therapies by clinicians trained specifically in dual diagnosis care. Because each person’s situation is unique, this treatment must be tailored to each individual’s personal circumstances to ensure that treatment is effective, meaningful, and relevant to the client. The most effective therapeutic modalities for factitious disorder and addiction include:

  • Cognitive Behavioral Therapy
  • Psychodynamic Therapy
  • Experiential Therapy
  • Holistic Therapies
  • 12-step support groups

Although there is no medicine designed to treat factitious disorder, pharmacological therapies may be used to treat co-occurring disorders such as depression or anxiety.

Because people with factitious disorder are masterful at medical deception, it is imperative that the treatment team has the experience and expertise to create effective interventions. The goal of these interventions is to break through the drug addiction and change the client’s behavior while simultaneously uncovering the driving force behind the factitious disorder and guiding them towards new, healthy ways of meeting their emotional needs. If the client has a history of trauma, specialized trauma-focused therapies can be essential to the healing process. All therapies should be modulated to help the client get the most out of them while avoiding potential deception that works to further fuel their illness.

In some cases, the victims of someone with factitious disorder imposed on another may want to repair the relationship that has so often been broken due to the illness. Selecting a treatment facility with dedicated family programs provides a space where they can feel safe and supported and you explore the trajectory of the relationship and begin to mend the wounds caused by the person suffering from factitious disorder. Such programming can also be vital to healing other relationships with loved ones and creating the framework for healthy, functional, and balanced relationships.

If you would like more information about drug addiction and factitious disorder, or have any questions about dual diagnosis treatment, we encourage you to contact us at any time. We are always available to offer support and guidance to help you find the help you need to establish the emotional stability you need to create a brighter, more fulfilling future.