Ever dealt with Munchausen Sydrome? (Longish)

In My Humble Opinion
1

Thank you in advance for any advice on dealing with the emotional aspects of this situation. I’m not sure that Munchausen’s fits the bill here, but it’s my (un)educated guess:

My sister is driving me crazy. To be more precise, she’s driven me crazy for the last 28 years, but it’s really intensified in the last six months.

She (henceforth “Sister”) has an unspecified seizure disorder that, despite hundreds of thousands of dollars in medical tests, has never really been “diagnosed.” My theory (and my other siblings’) is that the seizures started as a disocciative behavior 22 years ago during my parents’ really awful divorce and ensuing horrible homelife and functioned as a means for Sister gaining attention in a chaotic household. Then, they became permanent. Amateur psychology, I know, but the seizures are quite mild and they never, ever happen when she’s driving, having fun, spending money, the center of attention, etc . . .

Since her marriage and motherhood turned out not to be joyous moment after joyous moment, Sister’s problems have vastly multiplied and she has been in and out of the hospital with everything from a broken toenail (literally), a cold, and for brain tests. One doctor thought they might do brain surgery and Sister became very, very excited (they’ve since rescinded that possibility, since they couldn’t find any evidence, and she spent a week in bed weeping.) Sister loves to go to the doctor, the ER, and to stay in the hospital. I would estimate that she goes to the ER 10-12 times per month – she staggers her visits to different hospitals and manages to accumulate amazing amounts of heavy-duty drugs through this method.

I try to be kind and understanding, but I’ve come to the point of avoiding answering my phone in the evening in case it is Sister. I “do my duty” and put in an hour on the weekends listening to her maladies.

Sister has tried therapy, but quits as soon as anything meaningful begins to happen. She and her husband are on the verge on losing everything they have due to an unspeakable amount of medical bills and her $1200+ bill per month for independent insurance and prescriptions. I think her blue-collar, hard-working husband would leave her if he could find a way to keep the house and their toddler.

So, I can’t fix any of this, but I am beginning to think that Sister has a wicked case of Munchausen Sydrome. Has anyone experienced this personally or through a close friend or family member? How does one interact with a person suffering with a disorder like this in a kind/understanding way but not sign on to the drama?

2

Wouldn’t Munchausen’s be more a case of her intentionally hurting herself, or making herself ill in some way for the attention? Sounds to me more like a case of hypochondria than Munchausen’s but I’m as far from a doctor as you can get, so I could easily be wrong.

3

I was just going to say that. Hypochondriacs can drain the freekin’ life out of those around him or her. Any chance you can get her to a psychiatrist? There may be a drug that will help her to stop obsessing on herself. It’s sad to think that a person feels the only time anyone cares about them is when they’re sick (which is what it sounds like your sister is feeling). Good luck.

4

She already takes just about every anti-depressant/anti-anxiety drug known to humankind and will only go to a shrink so long as they don’t start talking about her culpability in her bad marriage, bad life, etc (at least, that’s my impression of the reason she stops going.) I think that some of the behavior is exacerbated by heavy RX drug use.

I’m not sure that hypochodria fits the bill, as she never seems frightened about being ill or worried that something might be serious – more so, deeply excited/gratified by medical attention.

5

If sis is regularly taking mood-altering drugs like opiates, benzodiazepines, barbituates, stimulants, alcohol, and so forth, her primary problem could be substance abuse.

And it’s nearly impossible to meaningfully diagnose psychiatric disorders on someone who’s abusing drugs until they’ve been completely drug-free for about 6 months anyway.

Good luck! Detach with love! You didn’t cause her problems, you can’t cure them, and you can’t control them or her. So don’t bother trying.

6

I think you’re right. Hypochondria revolves around the fear of having an illness. Munchausen’s would exactly describe someone who faked illness to get attention. There’s also somatization disorder, which is having multiple unexplained physical symptoms and complaints - but which wouldn’t involve conscious faking.

7

There are a lot of books on codependency that might help you with that detachment - I like Melody Beattie’s Codependent No More.

8

Honestly? I think she needs an intervention. But that’s where things get hairy: her husband may or may not want to bother with her anymore if he finds out she’s basically been faking it. And you’ll need her husband’s help to do one properly.

I’d talk to a psychologist who specializes in hese matters, or drug counselor, if I were you. Then you may need to break the matter gently to the hubby. Hopefully, he’ll agree to help and save his marriage - and his wife. If not, well, he’s probably going to leave and take the kid. OTOH, that would have happened anyway; he’s not going to stay fooled forever, if he hasn’t figured it out already. They’re both going to have to swim together, sink together, or split up. The choice is up to them.

Good luck.

9

I’m thinking that regardless of whether she’s “just” a drug addict or she has some kind of psychological syndrome that involves imagined or self-inflicted diseases/symptoms, she’s going to seriously resist going to a psychologist or therapist of any kind. I have an inlaw who has been in a similar situation, and even went - with another inlaw to watch what was going on - to the Mayo Clinic for a series of visits with different specialists regarding her mystery symptoms. I think all of the doctors included a psych eval in their recommendations, and she refused every time.

10

Sounds more like Somatization Disorder / Malingering than Munchausen, which is incredibly rare and has a particular behavior profile I’m not seeing here. Malingering fits well- highly exacerbated illnesses that get her out of duties, get her attention, etc. However, she may be genuinely somaticizing and not being manipulative at all, which would be more suggestive of Somatization disorder.

However, the seizure thing may not be entirely BS. Temporal lobe epilepsy and Complex Partial Seizures can cause a LOT of wacky behaviors and be difficult to diagnose.

Other rule outs that come to mind are drug dependence (the “injuries” may be drug-seeking behavior), borderline personality, dissociative identity, depersonalization disorder, and PTSD. I’d wager this has more than one of these as components, which could well include seizure disorder.

Diagnosis over the internet by second hand report is a bad game to play, especially when it involves complex diagnoses.

My strong suggestion would be to have your sister clinically evaluated by a neurologist specializing in complex partial seizures, and MOST CRITICALLY, a psychologist or psychiatrist that specializes in assessment. You are looking for a complete battery here- cognitive, projective, and personality testing. Insurance may pay for it, and if they won’t it’ll be WELL worth it for an accurate diagnosis so you can get specialized treatment. I would frame it to your sister as brain tests to get a more accurate picture of the brain dysfunction. Totally true, and neurological disorders would show up fairly clearly as such in a full battery. But this way she gets to feel it’s helping her “physical” problems which are likely easier to admit to than say being “batshit crazy.”

Good luck.

11

I wouldn’t think you would want to have an intervention until a professional has made a diagnosis.

You and your siblings can agree to do a little behavior modification though. When she is talking about her illnesses, you can ignore her or change the subject. When she begins talking about something else, give her plenty of attention immediately. Ask questions, look at her while she talks, etc.

I have lived with this (whatever it is) with a member of my family for over half a century. Sometimes she really does have physical problems and then I feel awful for not believing her. She has also become somewhat of a “medical authority” for the family and that causes problems. She exaggerates beyond belief – although I think she genuinely believes what she is saying. All of my life I feel like I have had to play along with her.

The saddest part is the she is one of the sweetest people I’ve ever known. I would give anything if we could just be real to each other.

12

Factitious disorder plus a substance abuse problem (which people with that disorder are more at risk from anyway) would probably fit the bill.

http://www.psychnet-uk.com/dsm_iv/factitious_disorder.htm

There is BTW, nothing to prevent you discussing your fears with any of her doctors. The can’t discuss her condition with you, but you can make them aware of your concerns.
People can’t be helped until they’re willing to help themselves, and she doesn’t seem to be. Support her husband and children, but don’t let her control you, it’s not your responsibility to fix her.

13

Words to live by.

14

Anyway, I’m not looking to conduct an intervention or get involved beyond doing my dutiful calls – I live 3,000 miles away and she has so alienated our other, geographically closer siblings that they just won’t deal with her besides basic holiday family gatherings. I work to stay loving but detached . . . a hard one!

Getting involved in any way with her doctors, her drugs, her diagnoses, spurs months of being sucked in, so I quit trying to fix the situation years ago. I like one of the poster’s suggestions about changing the subject every time she strikes up the old sickness band. Thank you also for the suggestions about looking up malingering and fictitious(?) syndromes.

15

Exactly how I feel! She is my only sister and we (at least I,) can’t be “real” with her because everything comes back to her illnesses. It really saddens me.

16

That’s factitious disorder, not fictitious, oddly enough.

Best of luck to you. (BTW – if she really does have Munchausen’s, and her hubby can prove it, his odds of keeping the toddler in a breakup are probably excellent.)

17

Wow, after reading this thread I realize I totally know someone with somatization disorder. Half her LJ entries are about her sicknesses; among the things that make her sick are being in an “unhealthy” working environment (really, any working situation–she doesn’t work) where–get this–the furniture was making her sick because it was covered with scratches and she thought there might be mold in the scratches. She says she can’t do any physical labor or even stand up for more than a half hour because she has weak joints like some kind of fragile Victorian, which she takes pills for, but I looked it up and the pills she takes aren’t for joint pain at all. There is other stuff too, but I don’t want to derail the thread. It all magically disappears, of course, when she’s doing something she wants to do, but I don’t think she’s consciously faking. I thought it was OCD mixed with hypochondria, but no, this seems more like it. Poor girl. Poor, annoying girl.

Good luck with your sister.

18

davenportavenger-Somatisation disorder (not Factitious disorder) doesn’t mean that the patient doesn’t feel the pain/stiffness/nausea/diarrhoea/whatever it is they’re complaining from. Just that there is no functional cause, and psychologically, being “sick” is of more benefit to them than being well, or that their way of dealing with psychological stress is to manifest it physically.

Some hard-core doctors will class everything from CFS, Fibromyalgia, IBS, migraine without aura, unexplained childhood abdominal pain, period pain, PMS and chronic back pain as such a disorder.

Those kind of doctors will probably offer tricyclic anti-depressants such as imipramine or amitryptaline as first-line treatments for the symptoms. Such drugs do seem to work, either by actually making the patient feel better, or by making them not show up to the same doctor again.

Somatisation disorder is much, much more common than you would believe, for some people it is there normal way of coping with stress, and it tends to run in families.