Munchausen Syndrome is a psychological and behavioral condition where someone fakes, exaggerates or induces symptoms of illnesses in order to get attention and sympathy. Munchausen by internet is when it happens online.
When it comes to seeking medical advice, we all know to leave it up to the professionals. Any doctor will advise their patients to avoid diagnosing their own illnesses by looking up their symptoms online, or worse yet, going to social media or internet forums in search of answers to health-related questions.
But in the early days of COVID-19, when doctors' appointments were scarce and testing or gaining an official diagnosis was nearly impossible, many turned to social media to share their own experience with the hope of raising awareness or delivering helpful insight to their followers.
Unfortunately, as can sometimes be the case of social media, not every account sharing its story is truthful. In fact, a small number social media users sharing detailed accounts of symptoms or sick relatives may even be faking illness altogether.
Such behavior is known as Munchausen by Internet, a term coined by Munchausen psychiatrist Dr. Marc Feldman in 2000 after witnessing cases in virtual support groups.
While Munchausen Syndrome refers to the psychological and behavioral condition where someone fakes, exaggerates or induces symptoms of illnesses in order to get attention and sympathy, Munchausen by internet refers to the phenomena in instances it occurs either partially or entirely online.
“It can go to a whole new level online when you not only make up a name, but you can make up sock puppets, people to endorse your story, when it's all stemming from the same individual using different email accounts or other social media accounts,” Feldman tells Inside Edition Digital. “They avoid having to go to emergency rooms and hospitals. They avoid having to play sick, and they can nonetheless be totally convincing.”
The behavior is neither new nor uncommon, but during the pandemic, Feldman says he saw an uptick in cases of Munchausen by internet, since those feigning sickness can often claim to have COVID-19 or be anxious about contracting COVID-19, thereby avoiding face-to-face contact with medical professionals or supporters.
While a study published in the National Library of Medicine estimates that less than 1% of patients in a clinical setting have Munchausen Syndrome, many experts, including Feldman, say they believe the number is likely much higher when taking into consideration the number of patients who do not seek help or go undetected.
And Munchausen by internet is even more difficult to concretely catch.
“Who is going to imagine that another person has the audacity to claim they have terminal breast cancer? It’s the last thing that would enter your mind,” Feldman says. “It’s so counterintuitive that even when the evidence is there, it tends to get disregarded for a really long time or never picked up on.”
Falsely claiming to have an illness or be close to someone who has an illness may seem inconceivable to many, but Feldman says the motivations are often common ones.
“Usually the primary goal is attention, sympathy and controlling other people,” he explained. “They, just like any other troll, like destroying groups and diverting attention from the authentic health challenges people are wrestling with.”
Those with the condition who rely on the internet for the attention they desire have access to a bigger audience, and the virtual nature of their interactions means they may not necessarily have to undergo the same painful procedures or expensive doctor’s visits in order to garner the same level of attention and sympathy.
And online imposters have the advantage of anonymity. “Many of the posers are aware that if they don’t provide a convincing portrayal, they can just go elsewhere on the internet with a simple click and start with a new illness or crisis,” he explained.
Removing the veil of anonymity and exposing them is the key to stopping the behavior, Feldman said.
"It holds them accountable, even if nothing results from it," he said. "It makes it crystal clear that the consequences of lying about health information and health treatment can be exposure and they can be dire."
True treatment, however, is more rare. Many of those with Munchausen by internet who have sought help report feeling guilty and feeling like they can't stop their behavior – but usually, being exposed for faking their illness is what finally leads them to seek treatment, Feldman said.
"But I have to say, most of them never reach clinical attention," he explained. "So there's no opportunity to help them, and the behavior is so intrinsically gratifying, they don't really want to stop."
And even though the illness, or in some cases, the internet persona sharing it, may not be real, their intricate story can cause lasting trauma on those who believe it.
“Those tend to be the people who have gotten over-involved with a poser. But still, these are well-meaning individuals who may be laboring with terminal illnesses of their own,” Feldman says. “The fact is that other people are adopting their pain falsely, and that's cruel in the end, whether or not cruelty was their real intention.”
