Unlike physical illness, mental illness is largely invisible and dependent on subjective observations, instead of blood tests or an x-ray. While many mental conditions, such as trauma and depression, can show up on an MRI, it is not an accurate diagnostic tool and it is typically not used when diagnosing a patient. This opens up the possibility of misdiagnosis, which is rather common in mental health and about 50% of patients report being misdiagnosed at least once. It is possible to be misdiagnosed but you may be wondering if you are subconsciously, and unknowingly, faking the symptoms of your mental illness, which is contributing to your mental illness diagnosis. Before we go further though, we must understand what mental illness is.
MRI evidence of differences in the brain
What Is Mental Illness?
The human body can have a physical illness, which may impact muscles, the heart, blood, and oxygen levels, among other things. But there is also mental illness which may impact the way a person feels, thinks, and behaves. Physical illness is typically easier to diagnose than a mental illness because there are many tests which can be used to confirm a diagnosis or rule out possibilities. With a mental illness, there are no true tests which can 100% confirm a diagnosis, so the diagnosis is based on subjective observations of oneself, a licensed professional, and input from relatives. When diagnosing a patient, a psychiatrist (or other), looks for the following symptoms or behaviors:
- Mood swings
- Rage episodes
- Flashbacks
- Unexplainable extra energy, not sleeping
- Unexplainable exhaustion, excessive sleeping
- Social and physical self isolation
- Suicidal thoughts
- Unstable relationships
- Frequent career changes
- Substance abuse
- Impulsive and sudden risky decisions
- Persistent level of hopelessness, sadness, guilt, and shame.
- Not leaving bed
- Poor hygiene
The human mind is designed to handle complex emotions and it is a part of life to experience the emotions of grief, despair, elation, and anger. But when these emotions are extreme, they can impact functioning level, which will cause a major disruption in everyday life. Mental illness symptoms usually impact a person’s quality of life and can impair to the point that they maybe unable to live alone, or may require repeated hospitalizations.
Mental Illnesses can develop overtime due to trauma, such as Post Traumatic Stress Disorder, but some mental illnesses are part of a persons genetic makeup which are inherited conditions, such as Bipolar Disorder and Schizophrenia. Some mentally illnesses can start in childhood while other conditions can develop later in life, especially when in response to a traumatic event.
Am I Faking My Mental Illness?
Sadly, this is a common concern of people who have a legitimate mental health diagnosis. Much of the stigma of mental health is the belief that people with mental illness are exaggerating their symptoms or otherwise not being truthful. This stigma can become internalized as a person may doubt their own experience and diagnosis, due to the rejective response of society towards mental illness, among other factors.
If you are concerned that you are faking your mental illness symptoms, there are a few things you should consider:
- Think of when your symptoms began as some people experience symptoms starting in childhood and it is illogical to think that you could maintain a false narrative for 20 years, beginning at the age of 5.
- Ask your close friends and relatives if they observe your symptoms. While you may have an opinion on your own symptoms through self-observation, the testimony of others will reassure you that your symptoms are real and observable.
- Recognize that some thoughts are inherently abnormal on their own. For example, a mentally healthy person should almost never have thoughts of suicide (except, in rare cases, as a response to a traumatic life event). Having thoughts of hurting yourself, the desire to not exist, and fantasizing about your death are very abnormal thoughts which battles the natural instinct of survival. If you are having suicidal thought patterns, it is automatically abnormal as it is almost never a normal thought pattern.
- Consider your abnormal behavior. For example, many people with clinical depression spend most or all of the day laying in bed. A mentally healthy person would easily grow bored and restless, but a mentally ill person will lay in the same position for 13 hours and stare at a wall while having intrusive negative thoughts.
- Start a symptom journal and track your moods to use as future evidence.
- Seek another opinion if you find yourself seriously doubting your symptoms or diagnosis. Misdiagnosis is common in mental health, although typically it is just a different diagnosis and not because the person is simply not mentally ill.
Some people may confuse their experience with clinical depression as laziness or selfishness. When a person is lazy, they are simply choosing to not do something, but are otherwise in a healthy state of mind and feel little guilt. If a person is depressed, they often have intense emotions of guilt, shame, sadness, frustration, and sometimes being aware of obligations but just not being able to meet them. If you find yourself stressed out and crying over the mess in your home but simply being emotionally unable to tackle the task, it is likely more than laziness. Laziness is also a pretty mild state with little strong emotions, but depression is typically extremely emotionally taxing and exhausting.
Why Do I Think I Am Faking My Mental Illness?
Mental Illness impacts the way a person acts, behaves, and thinks. Your thoughts can become irrational and delusional, which can pair up with a nagging feeling that you are “just being dramatic” or “being lazy”, which is usually the cause of the stigma of mental illness as well as left over emotional invalidation in childhood. It is very common for people with a clinical mental illness to have doubts about their diagnosis.
Some people doubt their diagnosis because they do not view their behavior as abnormal and deny the diagnosis altogether. This is very common in Narcissist Personality Disorder as well as Borderline Personality Disorder because the person may reject their diagnosis due to the symptoms of the disorder being very taboo and difficult to accept.
Some people with mental illness experience an unofficial phenomenon nicknamed “emotional amnesia”, which is forgetting what emotions or symptoms feel like, especially from the recent past. A person may experience two months of severe depression, but then be unable to describe it or recall the emotions weeks later after the episode has subsided. This is a challenge in the clinical setting because people can seek treatment for depression, but then be unable to recall their symptoms once at the psychiatrist appointment.
It is common for people with Bipolar Disorder to question their diagnosis because the medication can sometimes influence their brain to believe they are “all better” or never truly ill in the first place. People with Bipolar can also have this thought pattern when manic and many discontinue medications while in a manic episode. This often starts a domino effect with Bipolar because many will abruptly discontinue medications and treatment which often leads to a severe manic or depressive episode and sometimes requires hospitalization.
Self hatred and low self esteem can also cause a person to doubt their diagnosis as they may blame themselves for the symptoms and chalk it up to them being a bad person. Many people have a difficult time accepting their depression and will blame themselves, calling themselves names such as lazy, stupid, dramatic, a baby, or weak. This thought process can lead to a person doubting their medical condition and instead, taking the blame for the symptoms. This is very common in depression.
What Else Can Cause Mental Illness Symptoms?
The many possible symptoms of mental illness are typically related to a mental health diagnosis, however, there are other circumstances and conditions which may cause mental illness-like symptoms. Some of these are:
- Side effects to medications
- Thyroid disorder
- Menopause or puberty
- Brain tumor
- Head injury
- Substance use
This is why it is important to receive a full physical check-up, and blood tests, when considering a mental health diagnosis. Many people go to the doctor with complaints of mood swings and low energy, and go on to find that it is a physical condition, such as a hormonal imbalance. When considering mental health, physical health should also be investigated to at least rule out other possible causes.
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