- Factitious disorder and hypochondria are both conditions involving illnesses that aren’t real, but that’s where the similarities end.
- Hypochondria, also called illness anxiety disorder, is when you’re completely preoccupied and worried that you’re sick.
- Munchausen syndrome, now known as factitious disorder, is when you always want to be sick.
- If you pass this need to be looked after onto someone else, like the infamous case of Dee Dee Blanchard and her daughter Gypsy Rose as told in Hulu’s true crime series “The Act,” it’s called factitious disorder imposed on another.
- “With illness anxiety you really think something is wrong, but factitious disorder, you don’t think something is wrong with you,” said therapist Kati Morton. “You just want to get attention. You’re falsifying signs and symptoms to get attention from doctors and to get a diagnosis.”
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Hulu’s “The Act” tells the true story of Dee Dee Blanchard, who is seen giving her daughter Gypsy Rose dozens of medications, administering liquidized food through a feeding tube, and transporting her around in a wheelchair.
But Gypsy Rose wasn’t a hypochondriac thinking she had all these health problems – instead, it’s what her mother led her to believe.
Hypochondria, also called illness anxiety disorder, is when you’re completely preoccupied and worried that you’re sick. Munchausen syndrome, now known as factitious disorder, is when you always want to be sick. If you pass this need to be looked after onto someone else, like Dee Dee did to Gypsy Rose, it’s called factitious disorder imposed on another.
Licensed therapist Kati Morton, who has a YouTube channel devoted to teaching viewers about mental illness, told INSIDER that those with illness anxiety disorder have an excessive preoccupation with being ill – they can barely think about anything else.
“I might think, oh I caught a cold, but I’ll be fine, and people tend to normally downplay it more,” she said. “Whereas people with illness anxiety disorder, it turns into this huge thing. And because they’re so worried they’re sick, they will avoid a lot of different places, and group outings, because they don’t want to get anybody sick or they’re afraid they’re going to get sick.”
They also make hundreds of doctor’s appointments, and are unlikely to believe medical professionals when they get a clean bill of health. In the US, and other countries with no universal healthcare, they pay out of pocket and can rack up thousands, if not hundreds of thousands, in medical bills.
“It’s almost like a delusion,” said Morton. “It’s somewhere in that firmly-held belief that you’re going to get sick, or you are sick … You’re just ruminating thoughts, like oh my goodness this could be happening.”
Sometimes hypochondria may develop from “illness trauma,” Morton said, which is where someone gets ill as a child with pneumonia, or something even more serious, and it’s really hard on them.
“If it was really hard on you when you were little, you might always foresee that as coming back,” she said. “But for most people, they always think every little ache or a cough or a sneeze means the worst.”
Dee Dee Blanchard constantly obsessed over her daughter’s care, but in reality, she was perfectly healthy. Dee Dee lied about Gypsy Rose’s age, never let her out alone, and forced her to use a wheelchair she never needed. One day, it all got too much for Gypsy Rose, so she planned to murder her mother with her boyfriend.
It is now widely believed that Dee Dee had factitious disorder imposed on another. She was purposefully giving her daughter pills and medicines to create symptoms of diseases she didn’t have, and shaved her head to give the illusion of cancer.
“With illness anxiety you really think something is wrong, but factitious disorder, you don’t think something is wrong with you,” said Morton. “You just want to get attention. You’re falsifying signs and symptoms to get attention from doctors and to get a diagnosis.”
Factitious disorder imposed on another is a form of child abuse, because the adult is purposefully putting their child through harmful tests and medical procedures. Gypsy Rose, for instance, even had a feeding tube inserted into her abdomen when she could eat perfectly normally, and was forced to take certain medications that made all of her teeth fall out.
For the adult, all the attention and praise for being a “good parent” far outweighs any of the negative impact on the child. This may be because they never developed a health attachment style when they grew up, Morton said. This is why they’re often seen laughing and smiling around the hospital, and being overly sociable with other patients and staff.
“Research shows that people who have factitious disorder of either kind usually have been abused growing up,” she said. “Not all the time, but they usually have suffered trauma by the hands of their parents.”
If their parents were emotionally abusive, or they were neglected, it may only be when they were sick that they received any attention at all. This link is then made in their minds and they associate being taken care of in illness with love and connection. In Dee Dee’s case, we will never know.
“If you don’t feel cared for or loved then you’ll go finding it in other ways,” Morton said. “And mental illnesses are creative, because a lot of them are like coping skills, and factitious disorder is co-morbid with substance issues, eating disorders, even pedophilia and other impulse control disorders.”
While people with hypochondria suffer immensely at the hands of their worrying and anxiety, for those with factitious disorder of any kind, they can never get enough of the illnesses, pills, and medical tests.
“They go to the doctor all the time, but they don’t want to get better, because they don’t see a problem,” said Morton. “The likelihood of them coming into therapy to find out what’s wrong with them is very low. I’d put it up there with narcissistic personality disorder, because those people don’t want to get help either.”
About 2 to 5% of the population have developed illness anxiety disorder, but there aren’t any clear statistics for factitious disorder, although one article by a physician puts the number at about 1%. What is known, however, is it’s more likely to affect men, while factitious disorder imposed on an other is much more commonly diagnosed in women.
“It’s by and large mothers. That’s just something for people to look out for,” said Morton. “I think doctors need to be better trained in psychological disorders … They could be a little more informed to the ones that could show themselves in their office most.”
Just one doctor, Dr Bernardo Flasterstein, noticed that Gypsy Rose had no abnormalities in MRI scans and blood tests. But he never followed up or reported Dee Dee to social services.
“Poor Gypsy,” he told Buzzfeed in 2016, wishing that he’d done more. “She suffered all those years, and for no reason.”