#munchausen's

[oppypositron]

I don't know how to explain to the person that I rely on that despite me not physically needing a cane, using one would make my soul happy. I have access to one and I need to go get it but it's gonna have to be a hide-it-and-use-it-elsewhere situation because she does not understand </3

[drferox]

Veterinary Munchausen’s

Anonymous said: Hi doctor! There is a half funny half sad tweet about the hills recall. It says “ · Feb 20, 2019 Dogs are fun cause you can go 9 years with only one oh shit vet emergency and then rack up enough in 4 months that you have to start rotating vets so they don’t think you have dog munchausens”. Can people have dog mumchausens? How do you tell?

Such a case would fall under ‘Munchausen’s By Proxy’ and most experts would then put it in its own ‘pet’ subcategory. It is not as well studied as cases where the patient in human, and it is probably rarer. I think it’s usually called Factitious disorder imposed on another” now, the ‘Factitious’ bit meaning it looks believable instead of completely made up.

Munchausen’s By Proxy is a terrible, and sometimes tragic, situation where a caregiver invents medical symptoms for someone/something in their care, basically in order to earn medical attention. Sometimes this will escalate to inducing illnesses via poisoning or other neglect/abuse. Munchausen’s directed at the self is a mental illness and not something I intend to discuss here, even though I’m using Munchausen’s as a shorthand.

Now, veterinary medicine differs from human medicine in a few key ways when it comes to a potential Munchausen’s case.

The owner is paying the bill for veterinary care, not the government. If you want to get your pet into ICU because you want medical attention, that’s going to be an expensive way to do it.

Owners typically can’t stay in ICU with their pet. We don’t let owners hang out in the hospital all day. So they’re not really getting that much attention/reward/satisfaction, and pets are then observed without their owners, being fed our hospital food, and so on.

If the animal becomes too sick, euthanasia is offered. And once euthanasia happens, that’s the end of that medical attention, which is not what a Munchausen’s case is seeking.

Animals often hide symptoms, especially in the vet clinic. So if an owner says they’re doing something at home, my default response is to absolutely believe them and take it seriously.

Animals also do silly things of their own volition, like eating literal garbage, so they will make themselves sick with no owner intervention.

So I would possibly not be able to tell if somebody had ‘Doggy Munchausen’s’ because of all the things dogs do to themselves anyway, or how vague their symptoms could be. And as long as that client isn’t getting angry at me for doing tests, which they wont, because they typically want the tests if they have Munchausen’s, I’m not going to mind doing further non-invasive diagnostics on their pet.

This combination of a limit to the extremes veterinary medicine can go to in order to save a pet, coupled with financial limits and pets in a veterinary hospital spending a long period of time without their owner’s present, and those visits typically have veterinary staff nearby in an ICU type situation, means Munchausen’s is less likely in a veterinary setting, and probably less satisfying for the person with it. And I say satisfying because someone with Munchausen’s does seem to behave like it is a compulsion to seek this medical attention, and frankly some sources will recommend that the best way to stop the behavior from escalating to more extreme scenarios is to just give that medical attention in the first place and take everything seriously. Which is fair, given that the potential to miss a diagnosis on the assumption that you’ve come across an extremely rare Munchausen’s by proxy case is unacceptable. 

In scenarios where I suspect something might be going on, I have no way of determining the difference between Munchausen’s and plain old carelessness. But I also can’t really report a dog that gets gastro all the time or frequent minor illnesses, not like I could report owners for allowing their two dogs to get into fights all the time.

That said, there are occasional people where I have wondered what was going on when they kept booking appointments for “Tail not wagging right” or vague symptoms like that, and then declining all treatments and referrals. This is probably not Munchausen’s though, and more likely just a worried owner after some reassurance and I would always, always rather see an owner for paranoia than regret.

[lettuce-and-trek]

People recovering from Munchausen's Syndrome are lovely ❣️

[oppypositron]

Words are hard have some vent memes

[oppypositron]

Munchausen's Appreciation/Awareness Day, February 10th

Take a moment to think about and appreciate your friends with Munchausens Syndrome, also known as Fictitious Disorder Imposed on Oneself. We are real, we are here, and our voices deserve to be heard!

Among mental health circles those of us with factitious disorder are still struggling to be recognized. We're often dismissed or treated as liars or abusers with our own symptoms being ignored or used against us. But factitious disorder is more than just faking illness and the world needs to understand that.

Happy February 10th my fellow Munchies!

[delcat177]

Like other forms of the [Munchausen’s], Feldman explains that Munchausen by internet usually manifests in the late teens or early 20s. It's often preempted or accompanied by other psychological issues, most commonly personality disorders...

...The lies escalate slowly, which makes them harder to detect. Someone might sound like a walking textbook when talking about their symptoms, or they may be quick to duplicate the symptoms of other people around them. The lies are intricate, detailed, engrossing. Terrible setbacks are followed by miraculous recoveries. And if someone else becomes the center of attention, their condition will dramatically worsen or they will become the victim of a sudden tragic event.

"A death in the family is common," Feldman adds. "They're usually gruesome deaths or multiple deaths—like a motor accident that kills the entire family. Either that or they're surprisingly vivid, like someone describing a decapitation in vivid detail."

Some people even invent tertiary characters—friends, siblings, a concerned mother—to jump into internet threads and corroborate their stories.

The lies slowly escalate, pile up, and create an improbable whole. Then one day, you realize you're friends with a 15-year-old chronic migraine sufferer online who also happens to be a fourth-year medical school student who plays drums in a band at night—despite those crippling migraines—to pay his med school tuition because his [D]eaf mother and alcoholic stepfather have no interest in his baby-genius education. Oh, and since he's not yet old enough to drive, he skateboards three miles a day to get to class.

And on that day, you feel like a total schmuck.

(...)

Think of it: You're anonymous—you can manifest any symptoms you want... And instead of being examined by the trained eyes of a doctor, you're welcomed unconditionally by flocks of people who stand on-call, ready to shower you with attention and emotional support 24 hours a day. For weeks or months or years, you can live out your deception without the fear of having your lies challenged in person. And if someone does eventually doubt your story, you can simply log out. Change your name or your illness. Find a fresh group of sympathizers.

This accessibility makes Munchausen by internet "way, way more common than Munchausen ever was or could have been," Dr. Feldman says. "Unfortunately, a lot of therapists have no clue what Munchausen is, let alone Munchausen by internet."

CW: Cancer, emetephobia, stalking, harassment, (fictitious) CSA/rape mention, (fictitious) abortion mention

Keep your compassion and your love, but be aware of those who’d abuse it.