Munchausen vs. Munchausen by proxy: What you need to know

Munchausen syndrome and Munchausen by proxy are both factitious disorders involving the fabrication or induction of symptoms of diseases and even altering lab tests. Both conditions are recognized mental health issues. Those with either conditions pretend they or those under their care are sick and seek treatment at a variety of hospitals or emergency rooms. These mental health conditions cost the healthcare industry enormous amounts of money.

What are Munchausen syndrome and Munchausen syndrome by proxy?

Munchausen syndrome is a mental health condition in which an individual intentionally causes signs or symptoms of an illness or disease and then seeks medical or hospital care.

Munchausen syndrome by proxy is a mental health condition that affects a caregiver. This is most often the parent of a child, but can also be a caregiver to an adult. The caregiver gets attention from a medical professional by making up or exaggerating symptoms of a child or adult in their care. 

How common are Munchausen syndrome and Munchausen syndrome by proxy?

Munchausen syndrome and Munchausen syndrome by proxy are not common mental health conditions. Munchausen syndrome affects an estimated less than 1% of hospital patients. It is hard to determine an exact number of those affected by Munchausen syndrome. It can be difficult to diagnose. When confronted, those with Munchausen syndrome can try to deny their diagnosis or can become hostile. 

Munchausen syndrome by proxy also affects less than 1% of hospital patients as it falls under the same umbrella of Munchausen syndrome. In 85% of Munchausen syndrome by proxy cases, the mother is the responsible party. Munchausen syndrome by proxy is also considered a form of child abuse. Munchausen syndrome by proxy is diagnosed in the adult, not the child under the adult’s care. 

What can cause Munchausen syndrome and Munchausen syndrome by proxy?

There are no clear causes behind Munchausen syndrome or Munchausen syndrome by proxy. They are classified as factitious disorders. It is possible those who have Munchausen syndrome or Munchausen syndrome by proxy have a history of emotional, physical or sexual abuse during their own childhood. The early loss of a parent may also be a contributing factor. Major stressors can also possibly trigger the development of the conditions. 

What are the symptoms of Munchausen syndrome and Munchausen syndrome by proxy?

Both conditions involve the faking of illness symptoms to meet emotional needs of attention and validation from others. 

Symptoms of Munchausen syndrome can include:

  • Frequently visiting hospitals in different areas
  • Claiming a complicated medical history with no supporting evidence or documentation
  • Symptoms that don’t correlate to test results
  • Extensive medical knowledge
  • Symptoms that worsen with no reason
  • Few or no visitors during hospital stays due to a solitary lifestyle with little family or friend contact
  • Being willing to undergo painful or dangerous medical tests and procedures
  • Becoming aggressive and often leaving hospitals against advice when confronted about their behavior

Signs of Munchausen syndrome by proxy can include:

  • Caregiver adding blood to child’s/adult’s urine or stool samples
  • Caregiver withholding food from the child/adult to give the appearance of an inability to gain weight
  • Caregiver faking a child’s/adult’s fever
  • Caregiver giving the child/adult medications to induce vomiting or diarrhea
  • Caregiver with extensive medical knowledge
  • Caregiver being extremely devoted to the child/adult 
  • Child/adult seeing a lot of providers or being hospitalized frequently
  • Child’s/adult’s symptoms not fitting any diseases or lab results
  • Child’s/adult’s blood type not matching the samples taken
  • Drugs or chemicals found in the child’s/adult’s samples

How are Munchausen syndrome and Munchausen syndrome by proxy diagnosed?

Both conditions can be difficult to diagnose. Someone has to see the clues. They can often go undiagnosed due to omission of facts or outright lying. A thorough review of the Munchausen syndrome individual’s or the child’s/adult’s entire health history can signal a larger issue at hand.

How are Munchausen syndrome and Munchausen syndrome by proxy treated?

Treating both conditions can be incredibly difficult due to the difficulty of diagnosis. Those who have either condition typically refuse to admit they have a problem. Those who admit they have a problem and cooperate with treatment may be able to control their condition. 

The main priority in treating Munchausen syndrome by proxy is to help and protect the person under the care of the caregiver. This may involve the child/adult being taken completely out of the care of the caregiver to help them both the best. The child/adult may need medical attention and likely could also benefit from psychological treatment to learn to cope with any complications from the abuse. 

Psychotherapy can help with both conditions. Cognitive behavioral therapy (CBT) can be used to help treat both conditions by helping to identify unhelpful or unrealistic beliefs or behavioral patterns triggered by both conditions. A therapist can then help the individual with Munchausen syndrome or Munchausen syndrome by proxy to learn healthy coping mechanisms. 

Cognitive behavioral therapy is one of the therapies integrated into process-based therapy (PBT). The PBT approach, which is the clinical model we use at Lightfully, allows therapists to create individualized treatment plans that are as unique as the individual. The PBT approach starts with the identification of the four core processes of mental health disorders (emotions, thoughts, behaviors and/or relationships) and then determining which key process you are struggling with. Once identified, your therapist can then draw from multiple science-backed treatments, like CBT, to address issues you are struggling with in the core processes. If you are struggling with relationships due to the effects of having a loved one with Munchausen syndrome or Munchausen syndrome by proxy, your therapist may include PBT techniques to help address it. 

Lightfully can help you cope with Munchausen syndrome or Munchausen syndrome by proxy

We’re here to help you work through your struggles with the effects Munchausen syndrome or Munchausen syndrome by proxy have on your life. Having a loved one with Munchausen syndrome or Munchausen syndrome by proxy can be a heavy burden. At Lightfully, our licensed clinical therapists see more than your struggles; they see the whole complex human that you are. We want to help you lessen the effects having a loved one struggle with Munchausen syndrome or Munchausen syndrome by proxy has had on your life. 

Change is possible. When you’re ready to take the first step, reach out to our Admissions Concierge Team. We’ll take the next steps together, toward the fullest, brightest version of you.

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