Why Are People Faking Illness Online?

When it comes to Facebook, no one wants to be the person who doesn't join in the group, "Pray for Baby Rosalie," or "Share this if you care for Ryan." But before you click, know this: The ill person you think you’re supporting could be perfectly healthy.

While we’ve all faked an illness to take a sick day at work, doctors say this virtual pseudo-sickness is an increasing trend called Munchausen by Internet (MBI), a web-based version of the old psychiatric disorder Munchausen syndrome.

Munchausen syndrome is a mental disorder in which a person fakes an illness or injury for attention. Another version, Munchausen by proxy, occurs when a person fakes a disorder or injury in another person (usually a child) and tries to live through that person. But in the past five years, doctors have seen a rise in MBI within online support groups and social networks.

"I'd say that the advent of the Internet and a broader net access makes this more enticing to people," says Marc Feldman, MD, a psychiatry professor at the University of Alabama. "Before the Internet, a person would have to go from hospital to hospital to get the attention they craved, and now they can sign onto an online forum."

These people who make up cancer (the most common illness to fake, according to Dr. Feldman) or other unspeakable traumas typically have a deep-seated personality disorder that prevents them from getting the attention they crave in a healthy way, Dr. Feldman says.

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"There are some cases that are really predatory," he says. "There was a recent case in Florida in which there was a real misappropriation of time and money, and a lot of people felt really betrayed and the perpetrator was just unrepentant."

But those cases are rare, he says, and most involve people who are lonely or desperate for a social connection.

Although Munchausen syndrome is recognized by the American Psychiatric Association, Munchausen by Internet is not, and that makes tracking the disorder very difficult.

"I don't have a system for tracking the disorder," Dr. Feldman says. "The way I hear about cases is when someone emails or decides to reach out to me. But I probably see about two cases a week, and I'm just one guy in Alabama."

In addition to being difficult to diagnose and track, there's also no known cure for the disorder, though therapy has been shown to treat it.

"Many patients with Munchausen think of treatment as a recovery, much like an addict would," Dr. Feldman says. "There's not really a cure; there's a process, and there's always temptation to default back into that pattern of behavior."

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