What is Malingering? | How do those who fake psychosis get caught?
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- Опубліковано 29 тра 2024
- This video attempts to answer several questions: What is malingering? Can somebody fake a mental illness? Which ones are often faked? What about psychosis and malingering?
The first thing I want to do is draw the distinction between malingering, factitious disorder, and somatic symptom disorder. These disorders are relatively rare. Malingering is not a mental disorder, rather it is a V code, so it's really a condition and it can be the focus of clinical attention, but it's not something that somebody can be diagnosed like a mental disorder.
Malingering is when somebody fakes mental health symptoms (or physical health symptoms) for external gain and activity is deliberate. Factitious disorder is actually somewhat similar, except it is a mental disorder, but the faking of mental health symptoms is done for sympathy, not for money or any other material gain.
Somatic symptom disorder is really quite different from those other two. Somatic symptom disorder is when somebody has real symptoms that are not explained. There's no other explanation for the symptoms but they seem to have something to do with the mental health side as opposed to having a physical cause.
Resnick, P. J., & Knoll, J. L., IV. (2018). Malingered psychosis. In R. Rogers & S. D. Bender (Eds.), Clinical assessment of malingering and deception., 4th ed. (pp. 98-121). New York, NY: Guilford Press.
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As a psych nurse and someone who’s had major depressive disorder, you can absolutely be depressed and still be able to laugh hysterically. I wouldn’t consider a depressed person laughing to be a sign of malingering
Honestly a depressed person laughing hysterically in the waiting room reminds me of psychomotor agitation- a symptom of a major depressive episode. I know my affect would be all over the place when my thoughts were racing.
I agree.
As someone, who's pissed to still be alive when waking up and hoping to die in my sleep every day, I'm still able to laugh hysterically every once in a while, like e.g. after reading a hilarious comment or meme; (not meaning any comments here).
This isn't malingering imo.
Thank you I came to comment section to see if anyone said this. I can't believe he actually believes depressed people don't laugh. I find that absurd. I know this is an extreme example but look how many comedians commit suicide.
@@bcharlieee I think he gave that as a very brief and simple example, but I agree, he probably should have clarified it so that people wouldn't make assumptions based on how a person presents.
@@clodaghtobin6139 but as a brief and simple example -it's still absurd. There is no way to clarify that.
Not laughing while depressed is ridiculous. I have suffered major depressive disorder for years. I laugh at things I find funny. I’ve described depression as darkness with brief flashes of happiness that never last. When someone does something kind for me. I am genuinely happy and grateful. It just doesn’t last long before the darkness crushes back down on me.
Laughter, and jokes is a coping mechanism. Those who are tortured inside, have the best sense of humor of all. Even if you are a child in an abusie home, you tend to look at things in a humorous way, in order to deal.
I agree with you You’re Right. 💯
I think what Dr. G tried to convey is if the person is outside your door cracking up and then they walk in and act like they're deeply depressed...it's more like the sudden change of mood. I have MDD and been dealing with it for years and even in deep depression I could laugh obviously but if I'm in a crisis I'm really not able to enjoy much. Thankfully I'm well medicated and haven't had a major crisis in years but I'm still chronically depressed...I just learned to manage my symptoms through coping skills, therapy medication, etc. I think he's talking about a sharp charge in your affect not the idea that depressed people can't laugh because we surely can. I laugh with my therapist and my psychiatrist all the time and this doesn't mean they think I'm malingering. They're smarter than that!
@@PaxCool8 Thank you, you explained that really well. Cheers.
I am borderline as f*uck! And when I am so depressed, I look at meme and laugh like a psycho for 3h or so. It was like all of the happiness that I have never had will be sum into this 3h, you can imagine my mother ran into call with mental institution many times.
I’ve seen people with diagnosed depression claim to be happy to not bother anyone.
Appearing ”happy” doesn’t mean anything
Matias Hännikäinen suomalaiset ja meijän korkeet itsemurha tasot ✊😔
Exactly what I replied as well. I totally agree
Fax cuz if anything, people with depression don’t want the attention and don’t want to be worried about so them looking happy just means they don’t want the attention and other stuff and being called an attention seeker, heck, I was called an attention seeker by my sister for crying for no reason and I don’t even know why and since I’m overly sensitive which is one of the things that can come with ADHD I can’t really control it expectally if I don’t even know why I am most of the time so no I’m not attention seeking if I’m crying your just being insensitive to other peoples problems which they can’t control, if you don’t deal with the same problem then you can’t say how or what we should be feeling or say we’re seeking attention or should be ashamed for feeling a certain way, if it’s a professional that’s a different story since they have experience for most likely over 10 years I believe to be a doctor since it’s one of the most important and good paying jobs
So true.
I can go from happy to hating my existence so quickly.
My dad had Schizophrenia, he would have never said he was hallucinating or hearing voices because he had no idea they were not real, they were real to him and we couldn’t change that no matter how hard we tried
If it is normal is it a problem? Maybe not. The sudden transition from not having Schizophrenia to having it is a problem.
@@thirtythree160 the problem most likely comes with the delusions, or with scary hallucinations. Also, it can be quite scary to know that your father is sometimes so off from reality that you, for example, can't leave him alone.
I'm in the minority who hallucinate daily but are not psychotic. We call ourselves a person who hears voices/sees things.
Sometimes a doctor will think I'm trying to fake psychosis, until I tell them that I know the hallucinations aren't real.
@@blackswan1983 - same
yo, when i was young i remember putting my ear to the wall and listen to bats inside the walls. dont tell me there were no bats because there was. i remember the bats coming into the house. i remember killing the bats almost every night during august.
Being accused of malingering by a physician or counselor is one of my greatest fears. I thing I would fall into total hopelessness if a person who was supposed to help me, would say that I´m lying about things.
very good comment
It happened to me when I was a kid. Truly frightening.
@@jasa_m7990 I can't imagine the pain it caused you. I'm sorry you went through that
Don't make them cross because they have a lot of power.
@Peter Hicks What do you mean?It's weird that people who need help for illnesses, get help from professionals?
When I was a psychiatric nurse I was hospitalized with depression. I was on the phone to a friend when my money ran out. My friend was very concerned about me and phoned the ward. The charge nurse decided that because I knew the symptoms of depression and suicidal ideation I was manipulating my friend and wasn’t actually ill. As you can imagine that was very unhelpful
Wow
Wow... So no one can be educated about anything they have because they "might be faking it" jfc 🙄 that nurse is s c u m .
It is unfortunate the 'baggage' people bring to their jobs in MH field. Scary to know that there are people practicing with a particular belief system/agenda that is toxic and destructive. Honestly, in grad school, there were students I could not imagine sending an enemy too for treatment. When I was a paramedic, there were medics I wouldn't let treat my dog much less a person. I think the worst abuses I see, in terms of 'bringing baggage' is in CPI/DCF cases.
A psychiatrist once wrote a report about me, saying she doubted the sincerity of my symptoms. I was SO angry. She completely misinterpreted me. I have a psychology degree and I am a self aware person. She perceived that as me appearing to "read from a text book". Ah...no. I don't need a text book, thanks. I wish she'd TOLD me at the time that I was coming across that way, as I would have been aware, changed how I expressed myself, or asked how she would prefer me to explain my feelings and thoughts. Ugh. SO disappointing.
@@ladybaabaa3294 I'm sorry, truly, for your experience. I endeavor to share my observations and diagnostic findings, having a genuine conversation about the presenting issues. For the therapeutic relationship to work trust is essential, we have to start of together otherwise, not much is accomplished. I'm never really certain why some providers, including colleagues mete out information like we are rationing water in a desert. It leads to situations like you experienced with the patient/client not finding out until much later adverse findings. Thanks for sharing your story.
Malingering is a real phenomenon but I think it’s important to point out that many people with mental illness are accused of malingering when they’re not. Its the stigma of just using your illness as an excuse or to seek attention. This stigma is strong enough that I avoid honestly communicating my symptoms for fear of being perceived as malingering.
Oh god, same. It took me forever to tell my psychiatrist about my hallucinations simply because of this.
i see my doctor once a year. if she doesn't ask about something i won't mention it. no one believed me when i had actual problems so i stopped telling anyone.
Candle Jenner Many “malingerers” end up homeless. So, these individuals “malinger” themselves all the way to using a park bench for a bed.
Very interesting and helpful comment.
Ruby Spacek I regularly tell people who think they might have ADHD and want a diagnosis that they should describe their symptoms in terms of how their lives are affected rather than with the actual list of symptoms, and I caution them not to mention ADHD. Just say you want to be assessed to find out what’s going on, because X and X and X, and it’s really making things hard. I did that when I told my GP I was depressed, because yeah I know what to watch for given it’s a recurring problem, but I am not someone who wants to take medication if I don’t need it either. And I know doctors are more likely to take me seriously if I don’t tell them outright what’s wrong, even though I usually do know.
Everything you said makes sense but I question the laughing part. Chester bennington looked happy laughing hysterically playing cards with family hours before taking his own life. Individuals with chronic depression/anxiety are usually high functioning and very good at masking it, often act happy or outgoing.
I know I can and do have big laughter spells i hide a lot of my axiousness
I don’t think that’s what he means. Dr. Grande is speaking in a clinical context, where patients are seeking treatment. You’re speaking about behavior in a public setting where there are several people around, which does usually make the patient attempt to cover it up. (I shouldn’t say usually, but I have a severe depressive disorder and I always try to cover it up. With a counselor I may try to hide it, but they see through the facade pretty quickly)
I will say it again. LAUGHTER IS A COPING MECHANISM. SOme of the most humerous people have suffered their own terrible demons.
Chester did smile a lot but he also talked about how dangerous the space between his ears was. He is a legend. I love Linkin Park.
He died becsuse he and his close friend chris cornell were getting too close to the rabbit.they were both involved in exposing aspects of the elites pizzagate related info.i dont think either of them commited suicide.although he did battle mental illness rip to them both
Me, an anxious-depressive who constantly answers with 'I don't know': ..............
Please Don’t say I don’t know to everything to your kids.
Lol, I was thinking the same thing. Half the time I’m asked a question in therapy it’s followed by me taking ten seconds to think about it before realizing I have no clue what to say.
For real that's my default response even if I do know my brain says I don't know it's mainly to buy myself time
Same
How annoying to everybody. My aged mother keeps saying I don't know, when she does know.
I have "mild" OCD (and autistic-based black and white and ruminative thinking styles) and I have obsessions about how I'm malingering, faking my anxiety disorder. 🙄🙄
SAME. When i saw this video pop up I totally thought i was being called out directly even though that makes absolutely no sense haha
same
@Suspicious Ned Flanders hey, glad you're watching Grande's videos, got the notification for your reply while watching another of his. In trying to assume where you're coming from, replying to a comment that's a year old; do you think I'm sharing my experience in the comments with the underlying intent to seek pity from others? I am autistic after all, so anything you can do to elaborate your suggestion is super helpful
super late answer but same. I was diagnosed with anxiety and ocd a little while ago and I still am super scared I have been faking it all. Also autistic so. I feel ya
This is a very anxious statement, so good news is I don’t think ur faking bad news is I don’t think ur faking... it will get better love.
When you said someone can't be depressed if they're caught laughing, you lost me because often people with depression, hide it! You can have a deep inner sadness but 'put on a show'. So it's possible to fake not being depressed. That's all I'm saying.
I agree. I am seriously depressed but laugh alot out of nervousness
@@joesnelson4041 This is why I think it's dangerous to assume we can ever really know 100% what we are seeing. Even a trained eye can be fooled or taken by psychopaths so the same can be said for misunderstanding depression among other things. I have personally experienced people denying the reality of what I was saying, feeling, etc. Because it didn't fit with their 'expert' training when I'm the expert when it comes to myself thanks. It can be frustrating. Oh you're laughing so the depression isn't real. No, it's because we know how people respond to negativity or don't want to deal with hearing stupid things from ignorant but well meaning people. Or ignorant and rude people or we don't need everyone to know our weakness because there are people who take advantage or create more problems surrounding it. In some cases, it might be accurate in others, compartmentalized or inaccurate all together. People on the other side of it can only make educated guesses which are not far off from assumptions. The smarter ones look at the bigger picture (context) rather than focus on the details alone. Therapists, Drs and Psychiatrists are just people too and not always people I want to be open with either cause some of them have serious issues. So when people protect what they want others to know about them, I get that. Habit or protection, it's being smart.
Yeah. It’s quite insensitive. But the video is very informative though.
@@joynermaidana2375 Partially, I mean it's his opinion. Since if that's his information on depressed people, he's missing some insight.
@@LuxMeow It's one thing to hear someone laugh and say they're not depressed, it's another when a professional sees the sparks in the eyes, the wrinkles around the eyes, the relaxed tone of laughter and not the pressed nervous one. If one is good one should spot the difference between nervous laughter/fake laughter and actual joyous laughter. I think he meant the actual laughter in the video.
One other thing though is that when having atypical depression (quite common) you can be temporary lifted in your mood and laugh actual joyous laughter, but it only lasts for that little time, then you go back to your core mood that is depression. I have atypical depression and people rarely see I'm depressed at all because when I'm too low to be lifted up by meeting people, I just don't meet people. So they just see me temporarily quite happy and don't know about me crying later that night because I'm too tired and depressed to brush my teeth.
"HellothisisDoctorGrande"
This phrase is repeating 247 in my mind... God make it stop
He's taking after freud lol
"HellothisisDoctorGrande" to you 🖖
if you have any questions or comments, please place them in the comments section below. they always initiate an interesting dialogue.
@@pepe6666 like this one right here.
i feel like I’m having early signs of psychosis.. but after watching this video I feel like what if I’m making it up in my head?? It’s stressing me out a lot
hows it going man
i hope you are okay!!
this is how it started out for me, i eventually ended up in a psych ward multiple times in a year.
What symtoms are you experiencing
Same here
Feeling this, I have never been diagnosed with psychosis but I have been with mental health teams that help people with early signs. I've been diagnosed with depression. After watching this I'm getting paranoid that I'm actually a liar and make things up and I'm sure this dr said people who ask their dr " do you think I'm faking " is a sigh of faking..omg I just don't know anymore I'm now wondering if they all think I'm lying about everything and now I don't trust them as they will probably take me to fourth for wasting their time.
If it is so rare, how is it that so many doctors imply or diagnose it at the drop of a hat, for so many people with chronic health problems? I've been inappropriately accused of it because the doctors wouldn't run stupid lab tests to rule other things out. It took me five years to finally find doctors willing to run the damn lab tests I asked for, even with money in hand to cover what insurance refused to cover, and the lab tests were found to be positive. Repeat lat bests done by other doctors confirmed those tests. But by then, the damage had been done. If doctors had just run the stupid lab tests years earlier when I had asked, I would have been saved serious permanent damage from the infections and autoimmune problems that I was suffering from, and I wouldn't suffer disability, today. And I know countless other people who have had the same issue. Malingering has become a wastebasket diagnosis because doctor's don't want to have to deal with complex patients. It's an excuse to send them out the door without any real help because they can't fit those complicated patients into short 15-minute time slots to keep the money rolling in. It should be RARELY diagnosed as you said. Unfortunately, it's become an over-used diagnosis by lazy and greedy doctors. And it's causing unimaginable harm to people, and driving up health care costs for everyone.
lindajonesartist what autoimmune disorder were you diagnosed with?
Are you female? Statistics have shown that females often times are not taken seriously in clinical settings. Regardless if you're female or male, next time a doctor or a professional of any kind decides to brush your concerns off and not take you seriously tell them that you want it in writing on your chart that they refused to do the tests you wanted because nine times out of ten they will turn back around and give you the tests. I'm sorry you've went through this. I hope things get cleared up.
@@LuvBugBlaqkHart the information in your comment is helpful, my doctor was not interested in finding out why I have a constantly fluctuating high or low level of white blood cells every time I’ve been blood tested over the last year. I’ll tell them next time that I want it on the chart that I have a high white blood cell count and they won’t test for any potential causes
Same with me! It’s absolutely frustrating when you know that the doctors begin to think that you are faking,..or it’s all in your head! When a doctor finally takes you seriously,..and finds the diagnosis,…you just want to fall on your knees with gratitude.💔
I can relate. I was finally diagnosed in my 30’s with the genetic disability that I was born with. I had been being accused of faking or my symptoms being in my head and was treated accordingly, since I was first taken to a doctor with agonising pain and a persistent limp, at the age of 3. I even actively had things that I found helpful for my symptoms taken away from me because they said I was only using them as an ‘emotional crutch’ so they didn’t want to let me rely on them.
I’m now almost entirely bed bound and a wheelchair user, with many other issues too, and I’m convinced my health would not be this bad (not to mention how it has effected my mental health to be treated that way all those years) if my condition had not been wrongly treated for so long.
To make matters worse, my younger sister and also my mother were diagnosed with the same condition only after mentioning my diagnosis to doctors. They have both probably would have suffered much less if they had had the diagnosis earlier too.
I know this is a year-old video, but this somehow strikes a chord with me because I keep thinking that I'm malingering even after being diagnosed and being assured that my symptoms align with the diagnosis and that the assessment I did in the process is pretty good at screening for a "fake" patient. I just can't get over the possibility that I might be faking or deliberately acting out my symptoms for sympathy or avoidance (hopelessness, dread, lack of interest in things I used to enjoy, oversleeping, social withdrawal, irritability etc.), even when ppl around me notice the changes and when these are actually causing real problems and my work/reputation is suffering. I also always need to look for words to say anything to anyone, and it takes effort to stop myself from thinking that my treatment team secretly believes that I'm malingering too! lol
What kind of process did they do?
Oh I knew someone who has been caught lying about medical stuff about herself and her family too.... dramatizes even a minor fender bender to make it seem like her daughter and grandson may be dead! and even straight up lies about having different kinds of cancer too! She is a "frequent flyer" at the ER as she is there 40+ times per year for different problems and usually asking for pain meds. I do think she has mental health and addiction issues, that part is true. But all the other stuff is lies.
Yea me too.
I suffer from major depression which I am getting recovered very effectively. I understand what you are feeling and I had this myself. I was devaluating my symptoms cause I was too flat to "experience them". I was dissociating and distancing from them and would just go on hibernation mode. Therefore, they would not feel mine. I believe it is a defense mechanism but the guilt trip tfat it creates doesn't help.
Of course there is a feedback cycle. That's one of the complications with psychological problems. That you get into a role. Like me procrastinating at the moment. I'm wasting time, but I'm also wasting more time since I put myself into the role of a time-waster. There is a real information hazard to diagnosis. But there is also a blessing to it, because diagnosis also helps you work against the undesriable psychological circumstance.
How do you tell if a person is pretending to be ok when they are sick. I imagine this is more common.
If they look like there trying to hide how they feel and/or if they blow up over nothing or cry for a reason even unknown by them could also be a sign that there not really okay but also being mad and/or crying easily can also be a symptom of having a mental disorder and I know from experience because I’ve always been like that and found out I had adhd when I was 9 and I’m pretty sure I had it since birth 100 percent because I was always talkative and other things that since I got diagnosed at 9 that means that it was around for a really long time
I believe they don't realize it their selves
Saposky has some interesting YT video explaining schizophrenia; it's insightful in that it sort of demonstrates why it takes so long for health care providers to get to a diagnosis. LISTENING to the patient, and they will tell you.
@@Kaby629 it is good...I've watched it many times
nah too many people fake diseases for clout
It's not true that "voices" are necessarily distinct. They happen on a continuum from quiet and murmuring to loud. Lots of people start off hearing mumbling voices that gradually get clearer (and louder) over time.
Gled Wood he said usually clear not always lol
they can be like a radio too sort of fzzzy then clear. i've only heard it a few times. a lot when i was say, under 7yrs old.
imo, a lot of the time (for people experiencing audial hallucinations, not just myself personally.) it's telepathy, but i already know what a shrink would say about that. even though the fields of parapsychology have been widely studied in psychiatry since goodness knows when. 80's, 90's, ongoing.
@Matthew Wehri
probably, yeah, people think of telepathy as some sort of superpower , but it's just a muscle that's gotten out of use, and atrophied but like any muscle , it can be strengthened again if we want it to be. well, imo. or you could have spoken without realising it , if you were stressed, or, if they'd given you some meds that made you disassociated?
In addition I must say that I’m also obsessed with examining malingering patterns and DSM criteria of my disease because I’m actually convinced I was malingering in the first place. I have schizoaffective disorder and my anosignosia (which doesn’t always rear its head) makes me believe I made up my symptoms. I lost my career and my livelihood and still am convinced I made it up and am rather afraid my doctors feel the same way.
As a doctor you should not question what a person is telling you. As soon as you go down that road you start to assume people are faking things when something doesn't fit your model of a disorder.
I bet this happens a lot. And itis one reason why many people give up on doctors - and on family, on friends, and on life.
It's funny because I have major depression and I have such a good social mask that I can appear perfectly normal, laugh etc and be fighting wanting to kill myself.
I think because I have good social skills I can appear much better than I am. It's also hard when in treatment for me to remember how things are going etc so I downplay or don't mention things.
I know it's because it is a coping mechanism from growing up. We had to survive so we forgive and force forgetfulness.
So it's interesting that my coping skills hit so many nails on this topic lol. I appreciate your talking about being sensitive about addressing it because if I had a dr doubt me... It would be devastating and would hurt so much that I would avoid getting the help I need. Lol it's hard enough to be vulnerable. Thank you for discussing this!
A good theapist and psychiatrist will see genuine coping mechanisms from faking. They will sense your depression. They will see the defenses. They will also see a manipulator a mile away!
this is exactly my experience too
This is exactly what im experiencing. I down play everything as i dont want to tell them and think thatif i do tell them they wont believe me as im soing everything i should be. Ive gotten so good at faking i think i deserve an oscar lol
I use to not allow myself to laugh or briefly find joy in things while in an episode from my MDD cause my circle of people didn't understand my diagnosis and seeing that to them meant all was well and no more sadness. I don't do that anymore. The closest ones in my life understand how it doesn't work that way.
Wanted to let you know, because I have auditory hallucinations/voices and actually the most common and usual voices for me I cannot make out any words specifics, they are muffled. I've learned this is not only pretty standard for other ppl with voices, but we have the same experience where straining to understand words in these hallucinations only makes voices quieter and seem to move farther away.
Same. Most of the time the voices are mumbling and I'll hear bits and pieces of the conversation but can never figure out the fill context of what's being talked about. Before I realized they were in my head I'd spent hours with my ear pressed to the door/wall trying to figure out what friends/family were saying about me. It always seemed like there was something big that they were either hiding from me or something big that someone was going to talk to me about, but I could never figure out what IT was no matter how much I even dropped which was extremely frustrating for me. Little did I know none of it was real lmao knee something was wrong when my deceased dad joined the conversation 🙃 Sometimes they're extremely clear tho, just like any other voice, which is equally frustrating
I have remained quite or been vague when asked questions about delusions or hallucinations as I do not want to discuss them as to do so would make them real and I was trying to hold on to what insight I had. I have suffered with a misdiagnosis of bpd and find it very difficult to trust mental health professionals as they always seem hostile when I'm ill. Between episodes I can objectively see that they are not, but I find it hard to maintain any semblance of objectively when unwell. I find my diagnosis so frustrating as it just doesn't fit: stable marriage for 15 years; episodic nature of illness with high functioning in between. No splitting or frantic efforts to avoid abandonment.
Get another opinion. Possibly a double board certified neurologist/psychiatrist with experience in that field. It can be hard to detect
I'm the same Laura too. I don't talk about voices j hear either
That sounds rough.
Now I know what not to do the next time I fake psychosis.
🤣
I have depression and ADHD, both medicated. I often reply “I don’t know” to questions, because it buys me some time to process the question. (Processing is hard with ADHD.) My depression largely manifests through increased anxiety, irritability, negative thought spirals, and lower motivation. My ADHD is inconsistent (because it’s ADHD), but generally my executive functioning sucks and I have very little control over where I spend my attention. I know my IQ, and my profile (i.e., where my deficits lie) is indicative of ADHD: lower working memory, low processing speed, and poor auditory discrimination (as in, I have trouble paying attention to important audio input over unimportant input).
I feel for you on the adhd part for me it’s hard to process things since my memory sucks and certain questions can be difficult to answer since I might not know how to say it or get it out if it’s something I’ve never talked about before so when he says the idk part I was like that’s probably with people who don’t have problems with memory and who don’t have problems with saying stuff and since I’m talkative since I have the combined type adhd and if it’s hard for me to say something then that means something since normally it’s not hard for me to get words out but sometimes it is
ok
I just blurt out the first thing. It's embarrassing. I have tics though so that could be why lol...the adhd meds do help me listen a tiny bit better. I usually just cut them off or say "get to the point." Cuz i can't follow along
"poor auditory discrimination" holy shit that's also a symptom?? I'm trying to get tested for ADHD but I thought I had auditory processing disorder because I really struggle if there's background noise or they don't speak very clearly.
@@trouty7947 Yup, it's a common thing. Basically your brain can't figure out what it's supposed to be listening to or it picks out an unimportant sound as the important one. With APD, the auditory input is actually scrambled.
You might touch upon the "diagnosis" of malingering when that is not happening, May happen when the individual is of a stigmatized group. Something similar can happen with an individual with a bona fide injury is accused of drug seeking behavior. Research in the 1990s, it was found that many young African American men with sickle cell trait who present in the ER in crisis were undertreated or even not treated at all. So it does go both ways.
He did touch on it. He pointed out it was a V code.
They need to rewrite somataform, factitious and malingering. It is all too often a callous doctor can slap one of those disorders on a person who really is sick and they are labeled for life. The words are even harsh to listen to.
It’s a HUGE problem now. Everyone is looked at as drug seeking.
@@chandlerrose4545 I have extreme chronic pain for 9 years have been prescribed Tylenol. Nurses have urged me to get my doctors to assist with my pain. Anytime I brought it up it was told I am not prescribing you anything. This is why you have some ppl getting drugs on the street and becoming addicted. Pain management is a thing and needs to be utilized properly.
That is horrifying and just plain evil. Those poor men!
Could you cover Munchausens please 🙂
Yes, I will add it to the production list - thanks for the idea!
@@DrGrande thank you 😊
Yes. Especially ...by proxy.
Jani' and Bodhi's case's especially. Poor kids.
I believe Dr. Grande covered this in the Gypsy Rose case-not entirely sure.
You also just described how I display as an autistic person, sometimes don’t engage, sensitive to even small questions, delaying when answering.
So, you can be a genuine person but have those behaviours.
I have GAD and episodes of psychosis, yet I can come across at times like I’m not at all anxious despite the fact my anxiety is at a 10. Being autistic I learnt to mask from being very young and it gets applied to almost every area of my life.
My delusions are always there but sometimes I have more insight than other times. Sometimes I can rationalise and reality check better than other times.
I have hallucinations, they are very on and off, sometimes it can be all day long and other times I can go a full week or two weeks without anything.
Thank you for this video! This topic needed to be addressed.
I have a moderate-to-severe anxiety disorder and I know that I'm not faking it. I would love it if I woke up one day and it turned out it was all fake. I wouldn't be disappointed if it turned out didn't have to live with an anxiety disorder- I'd be relieved!
I'm not concerned with other people validating me. I just want a solution so that I can live my life in peace. I don't want my mental struggles to be my identity. I want to get better and move past them.
I'm not a psychiatrist, but my guess is that people who are malingering often have unaddressed mental problems associating with attention-seeking behaviors.
Again, thank you for presenting a real issue that many are afraid to touch. You have my respect, Dr. Grande.
I can confirm all you said. I worked 10 years in psychiatric supermax for the criminally insane. We had 2-3 patients a year tranferred from a prison due to suspicion of psychotic behaviour. Close to 100% was malingering. We observed for anywhere between 1-3 months before eventually sending them back. The preferred "symptoms" was primarily: hearing voices, hallucinations like demons coming out of the walls etc. In most cases they give up, as it's virtually impossible to keep up the charade, under near constant observation.
@Brown Incel Why? - they are faking. They do it to get a vacation from prison - and in the long run it's not healthy for them. A psychiatric supermax is a very strict environment with a lot more staff with many more rules and restrictions than a prison, due to the types of patients.
I was told I was malingering whilst having seizures, diagnosed with mania and commited... Turns out I had a brain tumour!!!
Dont feel bad for 2 years the doctors said I was making up being sick to get out of work, turns out I had Ulcerative colitis that went fulminant because no one believed me. I damn near died to blood loss and had to be transfused then had to have infusions for 6 months. Now I live on a litany of pills and other assorted therapies to keep the beast at bay. But im mad as hell that this could have been treated early and never got so bad.
@@dbrown2430 Like you I have that anger within, especially when so many people struggle to access mental health care, and I was just launched in there as a danger to society! Appealed the section, was released, no diagnosis, no meds, left to deal with the traumatic experience as well the new diagnosis. So sorry to hear you have to suffer similar with medical doctors who think they can play God. The fact you almost lost your life is even worse. They then make you question yourself as to whether you make this stuff up don't they. But they're never held accountable, never apologise, just move on to the next patient.
Just searched "malingering" and my favorite channel Dr. Grande is first result! ❤
I once had a client who was mentally ill, and she would just blurt out words that were not connected at all and do it in a somewhat conversational manner. I petitioned the court to refer her for evaluation, and when the judge seemed reluctant, I just asked her to speak with the judge. When this scramble of unconnected words spilled out, he couldn’t refer her quickly enough. Sadly, I lost touch with her after that.
I had no way to refer to that phenomenon until now: word salad. Perfect description.
Great information, Dr. G.
I had an inpatient psychiatrist speculate (not as much accusatory than it was a note in my file) that I was malingering. It was awful.
I'm diagnosed with Schizophrenia, ASPD, and Unspecified Depressive Disorder (Double depression, but that's not an actual diagnosis). I recognize I have a small amount of those 'indicators' but all for rather simple reasons (that she didn't ask or discuss with me about). One was the habit of being vague; except I'm vague about almost everything to everyone in any situation. As far as I know that's one of the disorganized symptoms, but I can't say because I don't really know how it works. But in the case with this psychiatrist, I very much disliked her and began restricting details because I didn't want to talk to her, she was being very flippant. Sort of related to that, but talking about auditory hallucinations, I have trouble remembering what is said unless I write it down right away.
The other was the dull reactions to things that are stressful, which I later discussed with my current psychiatrist are partially from the personality disorder. I've been in car wrecks and other crisis situations with an expression of complete disinterest. And to also take into account I have been experiencing the same symptoms since I was young, I'm accustomed to a lot of them. I have trouble expressing when I'm feeling anything because emotions just don't bubble up like they do for other people. People think I'm fine because I don't react, and that's why I have so much trouble having people take me seriously.
Anyway, I found out she wrote that she "thought my symptoms were fictitious" and that my dissociative reaction to her telling me I probably don't experience psychosis was "very telling". When I was first going through the diagnostic procedure (a psychosis program) they nearly turned me away, because I was being dishonest about what I was experiencing. It was my first time actually talking about that sort of thing, and I knew saying it out loud is really unnerving. I panicked thinking I wouldn't get any help. So it kind of kicked me in the butt to be more upfront about symptoms, and when she said that it took me right back to that place of panic.
Thought I'd share a story related, because it's easy to misinterpret some behaviours. In my situation it was unfortunate, but fortunately she isn't my actual psychiatrist, just someone I saw for 5 minutes a day for a week when inpatient.
It's hard when someone is disputing your reality when you know it is what you are really experiencing. Infact, That's a good way to shut someone down altogether. All types of psych doctors and those in the medical field in general need to be more careful about assuming things vs knowing things.
cheatednomore really yeah. I have lots of doubt about her anyway, considering how many discrepancies were in my chart. I really need doctors to ask questions because a lot of the time i dont know if things i do arent considered normal
I understand about them not listening or understanding. The last hospital I went to, I got to see what was in my chart because of my disability case. My therapist had me committed. I had said that my house was foreclosed, so it said I was homeless in my chart (I'm not homeless) and I was upset because I couldn't sleep the first night I was there because I never got to see the doctor so I got no medication, so they said I was there drug seeking, which was a complete lie because I had all my medications at home actually they were there I had the cops bring them they just wouldn't allow them. The hospital's in WA state were much better but the low budget no insurance hell hole in Florida was the worse. I would rather jump off a bridge then go there again. They treat people like crap and I got bed bugs, too.
I've noticed a lot of inpatient psychiatrists and psychologists are really quick to write people off and really quick to diagnose even though they don't see these individuals for long periods of time every single day so how can these people actually know their clients? It's upsetting. I was also treated similarly... was told I had an "attitude problem" when I was reacting to how I was being mistreated in a new, uncomfortable (mentally and physically), and scary environment. I have ASD so I'm not good with my routine being messed up. These people had no empathy or understanding. Treated us all like inmates, children, and cattle. Not adult human beings who are in need of extra help. No wonder why people turn away from getting professional help when struggling with mental illness. There's too much room for human error when it comes to diagnosing and psychology in general. I know myself better than some stranger that only started to get to know me for less than an hour. I may not know everything and I may not see some things they might but sometimes these professionals need extra training on how to listen to their clients. Otherwise they're just projecting who they think these people are like onto them while not actually seeing the real them. One of the main reasons I'm having a tough time getting the courage, desire, and motivation to get a therapist again. I just don't trust anyone anymore after all the shit I've been through. I've helped myself more than any professional I've seen and that's not me saying I'm smarter than these clinicians but that they don't take the time to truly understand. One of them talked more about themselves than they allowed me to talk during the time I was in their office with them lmao. Another claimed that the terrifying negative reaction I had when withdrawaling from a pharmaceutical they said it was just me and that it was all in my head... turns out she was unbelievably wrong. She also lied to me and said there were no lower dosages than 25mg for that drug but when I went to my GP she was able to prescribe me a 5mg dose lmao. Another therapist knew less about PMDD than I did and she also had PMDD!
you were showing the signs of malingering and she just wrote that it could be a possibility. She's a doctor who was writing everything down that could be relevant to keep a detailed file. What if she wasn't this detailed to people who showed signs and ended up misdiagnosis someone? That's a lot more serious and damaging than a detail written in your file that ultimately did not cause affect your going on to be correctly diagnosed. If you're not totally honest with health care providers how can you expect their notes to accurately reflect the reality of your mind and life? as you say eventually you realised this and opened up. I believe doctors must have a basic level of skepticism and (and as a science psychology students are taught this from the beginning to follow the method to disprove or prove their ideas) imagine if there was no skepticism and someone was misdiagnosed and recieved a lot of damage from taking the wrong medication?
I don’t think someone acting happy/laughing is a sign that they’re faking depression,seems more likely they’re faking happiness. Or like in my case I can be suicidally depressed and bed ridden but still act somewhat normal and genuinely laugh with others at times. Most comedians struggle with depression and use humor as s coping mechanism.
Many people fake happiness. Not just those that suffer from depression. It's a form of masking. People put on masks to prevent getting unwanted attention.
People that lack emotional affect put on masks too in order to blend in. Even healthy minded people put on masks from time to time for various reasons.
Some people are better at it than others of course. Lots of people do it to some degree. Not everyone, but many.
I agree with your last statement about having to be very careful about considering this. In the context of your work, if the therapist or a psychiatrist was wrong about malingering it could end in disaster. In a medical context dismissing patients physical symptoms also is an issue. I know someone who had previous Mental Health concerns who saw her medical doctor because of pain in her abdomen. After running some very basic tests and finding a bit of inconsistency in the symptoms the doctor said it was related to her anxiety and mental health history. She went back a while later because of the same issue and this time no tests were done and the doctor suggested more intense mental health therapy as she was now losing weight because of it. It was only a few weeks later that she went to the hospital when vomiting profusely and it turns out she had Advanced ovarian cancer. She died in the hospital two days later. A couple weeks earlier she was considered a healthy person with a severe anxiety issue. Things can get overlooked if we're too quick to make a judgment about how real somebody's symptoms are.
Does the reverse situation ever happen when a person who has been involuntarily admitted to hospital has been succesful in trying to hide the symptoms of their mental illness while hoping doing that will convince their caregivers to discharge them sooner?
This is an interesting question, and my gut says that yes, at least some intelligent/well-informed patients might do this for certain conditions. I have my own list of specific symptoms that I will never, ever reveal to a clinician because I know they are obligated to report certain things and I wont risk having my freedom taken away. For instance, the only time I have ever been genuinely suicidal, I intentionally hid this from my providers because I knew they would attempt to intervene (thankfully the plan was nixed by other events). I googled auditory hallucinations to judge how common and how alarming they might be to a provider before I revealed that I had experienced them. I can imagine that at least some patients get fed up with the lack of freedom and (often) condescension that comes with being inpatient and would rather be a risk to themselves than literally locked up. I feel like you'd only be able to accomplish it for certain symptoms though-- most of the things that go along with being seriously mentally ill aren't an option or controllable, which is why you end up inpatient in the first place.
Edward Kemper did that. He became familiar with the tests administered by the psychiatrists because he was a model prisoner and was able to assist them administer the tests and was released relatively soon after shooting his grandparents.
Yes. My schizophrenic family member did this to avoid hospitalization, simulated normalcy, oh he knows he can't really be a prophet etc etc. managed to fool the shrink on duty that night, but got admitted the next day.
I have done this before 😂
@@metalheadmermaid What woman hasn't in our 'modern' world? My grandmother once remarked that after awhile she figured out that the best way to get any real help from a country doctor was to tell him what was wrong with her first. My aunt said the same because on one occasion at a doctor's office she noticed that the 'dear' doctor instead of looking for a diagnosis appeared to be trying to draw her into something else.
My husband was in a coma due to Meningitis. During that time he had a stroke and a closed head TBI. Once he woke up he was hearing voices. He didn't before, but after he. To him it seems like people are whispering in the corner of the room.. And no.. he can't always make it out. (A symptom you mentioned might indicate faking/malingering)
My husband thought the whispering meant he was actually still in the coma, and that these were actually doctors and nurses he was hearing. He tried to "wake up for real" by attempting to kill himself. He was, and is,*not faking*. If he were your patient, I am fairly certain you would have come to that same conclusion.
Now that he's on medication he is doing better most of the time. Also, by now he knows it's a physical effect of the damage he's suffered. It took a while though, and it was miserable trying to get people to just *listen* already.
Please remember that atypical symptoms may *not* be a sign of faking a mental disorder, but actually an indication of a *physical problem*.
People are told "it's just depression" all the time, when the problem may instead be physical.
They may be seeing the wrong specialist.
Send them to for example a neurologist, rather than concluding they're probably faking.
The right treatment can make a world of difference.
I *briefly* lived with a roommate who claimed to have *D.I.D.*
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While I was cleaning one day I found some Library Books on the subject that she had marked with Post-it-Notes.
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Within a day or two she was mimicking the symptoms from the books to the letter.
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When I told her that I had found her books while I was cleaning, she simply said, "Oh." She never tried to convince me she had *D.I.D.* again.
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She still tried with our mutual friends and her Counselor though.
It’s also possible that she got the books because she was concerned she might have it. I obsessed over autism when I realized I have it. Then maybe she thought you thought she was faking it, so she felt uncomfortable talking about it with you after that.
I enjoyed this video, but I always worry they work as training films for the wrong people.
As a Physician Assistant who works in Correctional Medicine/Healthcare I can attest to everything said in this video about prisoners’ dishonesty when presenting to the Urgent Care. I also see inmates with true mental health disorders. I can say that with more time and amount of patients seen discerning what is real versus fake becomes easier.
Thank you Dr. Grande, I have watched some of your other vids, but after this one, I had to Subscribe! Thanks again!
In my opinion, clinicians seeking malingering in every case is more of an issue than malingering itself... That could be potentially extremely dangerous for someone who needs help. Some of the things mentioned in this video are simply not always the reality of these disorders; people with depression can laugh, people with paranoia may fear that professionals think they're faking and question that as a result, auditory hallucinations are not always clear (for me, they were often unclear/jumbled, with occasional clarity). While I understand that you yourself are not saying these things are impossible, I fear that putting symptoms into *too* rigid a box can be harmful overall.
I don't know why anyone would fake psychosis, because the pdoc gives you antipsychotic medication when you do that. Most antipsychotics make people feel really, really bad. I tend to minimize my symptoms when I'm talking to a pdoc. If I went running to my pdoc every time a stray thought about suicide entered my head I never would leave the hospital.
I started watching to try to find out more about my social anxiety as it's gotten really bad lately but I find I can't stop watching as the way the human mind works is very interesting
Have not heard the word 'Malingering' used in a conversation for several decades. At one time it was now and then. Good word too!
I cannot guess why in the world this guy isn’t a psychiatrist. He is absolutely amazing at what he does.
What do you mean by that.
Never seen someone malingering an anxiety disorder?! You must not have xanax on the formulary where you work!
That's what I was thinking too
Why does everyone think xanax is such a bad drug some people really need it, this way of thinking doesn't help people with real disorders.
Yeah my friend has been malingering a mental disorder for 2 years and im uncomfortable around people enough imagen around somebody who is not beeing himself (-`~-´)
@@tonifelise6297 this! Xanax has literally saved me so many times
@@speedyboi349 ruining it for those who actually need help
Two years ago, I went into a behavioral health appointment, at my lowest point in my life. That clinic decided that I wasn’t depressed enough, despite the fact that I’m there in tears because my entire life is falling apart, and all I’m trying to do is get help, and they tell me I’m not depressed enough to get help. So I leave the place and go to the emergency room because I had literally no where else to turn because I was at the end of my rope, and they send me off to a crisis center, where I finally got the help I needed. It’s important to note that sometimes, you do know yourself better than your doctor does, do not let them just bulldoze you because of people that Malinger: it’s super super important for a doctor to at least humor the idea that the patient might know a bit themselves about the situation. Cause I’ve never been uninformed ABOUT my illness, I do not feeel like I need to be punished for that
Greetings from Canada. Retired psychiatric RN here. I worked 8 years in forensic psychiatry and came across a case of malingering only once. His motive was wanting to get a disability pension. Most of our clients are not sophisticated people. They really can't keep up the ruse when they are observed 24-7 in hospital, and we review their mental health history (if any) very carefully, interviewing family and friends.
Omg I was diagnosed schizotypal and I didnt even know what that was before my diagnosis but the way you're describing malingering with answering "I don't know" and having inconsistencies in answers/ sometimes observable symptoms, and hesitation as if I'm thinking hard about answering something definitely applies to me. & now I'm afraid that I'll malinger if I go to a therapist again, although I also know that those tendencies can apply to schizotypy easily. Sometimes I cant tell if I'm putting on an act or not, I have definitely exaggerated some things I do while also not focusing on the real issues/downplaying issues because half of my brain feels shut off when entering a therapists office
my boyfriend says I act more incapable than I am
I thought this described a sick way to get all the attention all the time and wasting your time and energy along with the cost of it all to the household. It has happened. Long term is much worse than cancer.
She's adamant that I'm the crazy one. She said she would tell everyone that I was crazy, she did and plays the victim so well too Perfect for her role.
I find this a really difficult subject. I have met multiple people where their psychiatrist didn't take them seriously when they told thwir symptoms (both women) when they didn't appear emotional (crying etc.) when they told the symptoms. Months later they bith really needed medication, for OCD and Bipolar, but it took them months to convince the paychiatrist. Only when highly emotional the psychiatrists "believed" them, when they told the truth the whole time. I think you should always trust the patient, only if there is VERY strong evidence to not to. The harm done when NOT believing a patient that DOES have real symptoms is way worse than the other way around.
these are all so interesting, thank you very much for teaching all of this!
This channel is so useful and educational. So much I didn’t know ...
When you consider that everyone is at least “a little bit crazy”, then it isn’t hard to imagine how someone could “pass for” being being mentally deranged. I believe that ignorance and/or denial of a legitimate disorder are far more prevalent in our society, than people “faking” a condition of some kind.
That’s true and expectally if they used to think they didn’t have a problem for such a long time that once they realize that they actually could have something that they never had any idea of having it in there life that they feel like they could be faking it and thinking what there feeling Isn’t real and that people will say there making it up cuz that’s how I’ve been feeling
Back in the 1980s I was accused of malingering and also diagnosed as borderline. The stigma of both diagnoses followed me for years, even into primary care and orthopedics. The problem was neither although I did benefit immensely from DBT, originally create by Linehan for people with BPD.
I also benefitted from DBT even though I am not Borderline. I think DBT could benefit almost anybody.
does this something have to do with bojack horseman? BACK IN THE 90S
I had a hallucination before when I was on a medication for insomnia. Saw my wife and baby girl's eyes go black and their teeth extended into fangs and the whole room went this scarlet color. I sat there and was like this is totally a hallucination. I had a conversation about it with my wife while she was there looking like a vampire going to rip my throat out. I thought the doctor wasn't going to believe me because I didn't believe the hallucination but luckily he switched my medication and I didn't have anymore but it was the weirdest experience of my life.
Holy shit. Glad it was switched.
That is horrific
How fascinating! I'm very late to this video, but on the off chance Dr. Grande happens to still read the comments (or anyone else who may have some ideas) - I'm curious about the lilliputian hallucinations you mentioned. My family and I used to live in a cave house in the countryside (very typical in Granada province in Spain), and one of our closest neighbours could sometimes be found on our 'roof' in the early hours of the morning, occasionally with a female friend. According to him, they were taking photos of the 'fairies'... This man, although artistic and fairly eccentric, came across as an otherwise rational, intelligent person of around 60 or so. I can't say much about the lady as I think she was from Barcelona, so I only met her in the passing when she came down to visit him. All I know is that both of them were adamant that there was a fairy colony on our roof, and that their photographs were proof of this (they weren't - there was nothing on the photos aside from some light reflections and the occasional scorpion lol). Would this be considered a lilliputian hallucination? Can you have a shared hallucination as well as a shared delusion? Were they on drugs or dodgy home made wine?! I've always wondered what was going on there!
I was raised atheist but became a Christian 26 years ago. I always want to do the right thing, but do fall short and always feel guilty when I'm not forthright.
I believe lieing and exaggerating akin to stealing, because it's taking the truth (reality) away from the person lied to.
This episode brought me to connecting the fact that I often exaggerate how poorly I feel when I'm sick to my loved ones to this day, because I remembered that one of my childhood abusers would never bother me when I was asleep or had a fever.
For some reason a sleepy or sick child was treated with more compassion by this speific one than a well and/or well-rested child would be.
This dynamic never dawned on me before, maybe now I'll feel safe to state my symptoms accurately without playing the pity card.
This is a very big breakthrough for me, since I've too often victimized myself and my loved ones over and over again even though my abusers are long gone.
However, they still live in my memories from when I was 5 & 10 as though it was yesterday and still with the power to destroy me.
The shame they made me wear I've never fully healed from and I'm almost 60, much of my life has been a veil of tears. I look forward to Jesus bringing me home.
I have psychosis and have been accused for malingering for saying "I don't know" a lot when asked questions because I honestly wasn't sure or I was too anxious to answer the question lol
I have never been accused but I do the same when I'm anxious and it makes me accuse myself of Malingering x
that's so crazy, the second you started describing what malingering was I thought "wait, that's like the same thing as munchausen syndrome but that's in the DSM, what's the difference?" and then like 30 seconds later you answer my question hahahaha. you're ahead of the curve, Grande.
I’ve always wondered this, actually! Thanks for the video!
Thank you Dr. Grande. Another informative video. I was unaware people faked mental illnesses. I don't understand why unless they might have some other sort mental illness or self-imposed Munchausen syndrome or something. I'm a Biploar 1 and I'd give almost anything to get rid of it.
Rhiannon, I am sorry for your struggles. People who fake are not suffering like people who are really ill. I see many people come in to use the system. They know just what they have to say and learn more each time how to fake the system. Heartbreakingly they bed block the people who really need the help.
Well done DR. G
I know more about psychosis than I ever imagined I would. Just over a year ago; I had a psychotic break due to a prescribed medication. It took a few days to get the medication out of my system. Although hospitalized; I had absolutely no (other) medication to provide any relief from the psychosis during this period. I remember everything that "happened" while I was psychotic. This experience has permanently altered my life.
You're the best Dr Grande! Love you!
Binging on Dr Grande. Anyone else?
Me...
How infuriating that people do this to gain and manipulate while people are out here struggling to actually get on the right treatment course.
Someone who is depressed, may have high cognitive understanding of their condition and over-compensate by looking for joy… I bet a lot of comedians will reluctantly agree
Robin Williams.
Thank you for helping me understand
"What are some signs of Malingering?"
(begins to list every interview trait possible)
As a clinician in a large non-profit it is a real problem. I hear, 'I need an evaluation so I can get SSI (or SSDI); my (mother, sister, auntie, friend, priest, iguana, etc.) said I have (bipolar, depression, anxiety, etc.). Sometimes they meet some of the criteria but as stated in the video the client exaggerates or makes up symptoms. When the story is a mile wide and an inch deep it raises flags. The sad truth is how much clinical time is taken from those that really need help and how many resources are used by those that successfully play the system.
Jack_K2 curious about the nonprofit you work for. In my experience as a social worker, getting SSI and SSDI is extremely difficult and so even if someone came in to you for an evaluation, there’s no way if they were malingering that they’d end up with SSI or SSDI. So I’m not sure how they’re playing the system. They might try, but they’d fail right out the gate.
@@truecrimecurator9874 I do agree the majority of folks that come in without INTENT to defraud are sorted out appropriately. I've worked Midwest and East Coast agencies and there are more than a few instances of individuals that make it through. People that are very capable to either work for a living wage or at least part time. I am not suggesting by any stretch that agencies or the SSA are at fault. If you've worked with a large population of recipients you had to have come across individuals that on reevaluation would not requalify or that knowingly continue to receive assistance when they do not need it. Further, in both regions. I've had clients tell me straight up they have zero intention to do anything that would jeopardize their 'check.' This sentiment, in some cases, impedes therapeutic progress.
Jack_K2 I guess the people I’ve worked with were so disabled that I didn’t have a similar experience - they weren’t people who got well enough to get off of it. In my experience, the process of getting SSI or SSDI is so rigorous and lengthy that I didn’t see anyone who was trying to game the system willing to go through that. I also saw many people denied (repeatedly) that were not capable of working. And the amount is barely subsistence level. So it’s beyond me that people can game the system and get by. But I understand you’ve had a different clientele and have a legit different take on it.
@@truecrimecurator9874 I also have experienced clients that need SSI/DI badly and have to exhaust through appeals before they get assistance, mind boggling and heart breaking. Good luck to you, I appreciate the rewarding and difficult job you do.
Jack_K2 And how sad it is that it’s not unusual that truly sick people don’t get assistance because they’re too ill to handle the follow up and endless paperwork and The malingerers are right on top of it all !
Love your channel Doctor Grande! Helps me make sense of humanity.
You will NEVER "make sense" of humanity. If you did, you will never hear "history always repeats itself".
I didn't know this word before I watched this video. Definitely brings the Aiden/Tristyn story to mind right now!
I enjoy your series and you have straightened out many loose areas of understanding for me.
To fain a psychosis for some kind of personal gain. Surely people would know that such a medical record stays with them throughout their life.
Thoughts of that novel come to mind ‘Catch 22’ where in order to be seen as mentally ill, so as to go home, is to swear not that you are ill but more that you are okay. And perhaps there is some truth in this.
Today’s world appears to have gone quite mad so to swear that one-self is mentally ill places that person perhaps with the majority thus the status quo. Therefore for such a patient by recognizing certain symptoms they are indeed more self aware than the majority of us.
Hi, could you possibly do a video on comorbid BPD and ASPD? I was recently diagnosed with both and would be interested to hear your experiences dealing with these types of individuals and what sort of traits they’d most likely possess. Thanks.
We had a chronic schizophrenic who used to get admitted often. He had grown up in state hospital and graduated from high school in a state hospital. He was articulate and very animated in describing his fixed delusions. He was quite institutionalized and had difficulty coping in independent life. He would often be victimized due to his friendly kind nature and fears of being alone. One of our psychiatrists used to label him a malingerer which couldn't be further from the truth. It really made me angry. He made this judgement after a ten minute assessment. As this young man's nurse I had to advocate for him all the time because he got this label on admission. Most malingerers victimize real patients but he was always the victim. He had a fixed delusion of having been kidnapped by aliens and buried and brought back to life. He told this story every admission and would scream at the voices of the aliens when unstable. Malingering as Dr. Grande says is rare so don't throw the label around.
Thank you for this informative video. We are dealing w/malingering and psychosis w/my 68yr old mil currently. We have not accused her. We know she is doing it to avoid signing paperwork for her UK visa.
im leaning alot from you Todd gracias
My ex. Who is diagnosed with NPD. Used to fake suicide so he could go to the psyche hospital. He enjoyed manipulating the staff and stocking up on meds he could abuse. He was accused of malingering and discharged. Which is true. I do wish they would have institutionalized him forever though as he's very dangerous.
My friends that are in treatment for depression, anxiety, and one who has had severe delusions--all seem to be in denial and to deny that they have a problem--many people who have a mental illness diagnosis would just as soon pretend there is nothing wrong with them and even lie about it rather than act crazy. They say that if you think you are crazy you probably aren't lol.... like if you go around worrying to yourself "Am I crazy?" usually the answer is no. Thank you Dr. Grande! Great video!
Very good explanation of Malingering!
This is fascinating to me. Why would someone try to fake how I feel everyday. People are...weird.
Videos like these are helpful yet a little difficult as they force you to have to look at dysfunctional friends and family and understand that they aren’t all just victims of circumstance - often it’s mental illness and just as often their personal failures are being exacerbated by their own unwillingness to seek proper diagnosis and treatment.
mental illness is NOT a personality defect. That is like saying you can positively think your way out of an Asthma attack. Yes, there may be out side circumstances that trigger it or make it worse eg. lots of dust or chemicals in animal urine or animal dander etc but those things don't cause you to be an asthmatic. You have the underlying condition, circumstances CAN make it better or worse.
@@lccsd2392 I think you responded to the wrong comment. There was never a mention of "positively think your way out" of anything nor did I make a claim that mental illness is a personality defect. That doesn't even make sense as a statement.
I have a sister who has this I think. She doesn't fake psychosis but other things wrong and uses it in my opinion to avoid work, collect sympathy and excuses for actions. 16:30 YES ABSOLUTELY - gosh you nail things so well - had you chosen to be a sniper over a therapist you'd be the most deadly with accuracy. I have cornered her in inconsistencies in what she is saying to what actually happens and she becomes like a cornered animal. We are middle-aged now and this is something that won't change. Interesting video - you find so much useful content that no one else seems to discuss. Great work
When I’m having severe symptoms I have a hard time communicating (I get very confused and anxious) and I take a long time to answer direct questions and I do say “I don’t know “ a lot because I can’t make sense of my thoughts or express them in any way. Btw I have schizoaffective disorder. I also have auditory hallucinations which don’t always involve distinct voices (that I can decipher) but more like whispers and murmurs…I thought my neighbors were having conversations in my walls…for example. Rather inconsistent. Sometimes the voices were distinct and clear…but not always. Just my experience
I knew a university-level psych student who - every time she learned of a new malady - suddenly developed symptoms of it herself. This made her intolerable to be around, as she would pretend to "switch" personalities and swear at people, act out sexually, etc, and then would pretend to be paranoid, claim she had been forced to participate in satanic baby sacrifices as a child, and on down through the chapters of her textbooks. It made me really worried about her future as a clinician/doctor. I discovered a couple of decades later that she was a mental health practitioner and I found that worrisome as well. Perhaps she ended up being a good mental health care provider, but her willingness to lie and fake illness as a student is a troubling indicator of her sense of ethics. I do hope she grew up and out of those tendencies.
I'm curious, have you ever heard of Histrionic Personality Disorder? Also, many people can be highly-functioning and still have a personality disorder... they're just functional enough, in fact, they often are the last to seek therapy, and it might be possible (I know a couple of people like this) it helps to be the therapist instead of the therapised. Just thoughts :)
Dr.,I am a disabled Air Force veteran. I live with severe depression and I use humor as a coping skill. Besides if you can make fun of something it will hurt you alot less. I'm sure there is a way of disregarding this. Please feel free.
I'm right there with you! Retired Army vet here 🙌
Malingering commonly occurs in the Forensic Mental Health setting. The person malingering feigns symptoms or exaggerates symptoms so they can escape pending criminal charges or gain more favorable sentencing outcomes.
Thank you Dr. Grande. I appreciate you very much. 💜💜💜
I really appreciate your videos. And I imagine that this must be so difficult, to identify this in a patient and the need to be so sure. I was just thinking about how there are so many people who are categorically not believed by healthcare workers. Or are believed to be exaggerating. I know that when I go to in for anything, serious or not, from foot doctors to neurologists and everything in between, the doctors start from a place of active mistrust. Its really hard to stay believable, even when you're telling the truth, when you are put on the defense. Especially if there are clashing things going on inside you- for example women are much more likely to mask mental health symptoms automatically, like a subconscious deal that their upbringing as a woman made with society in order to be granted safety and respect. So her symptoms might be less visible but the fact that they're invisible when she is needing someone to believe her and help, especially when she realizes that the person doesn't believe her, could cause her to get defensive, or to exaggerate in a frantic bid to illustrate the urgency. This happens to me, my personal dignity combats the scrutiny of the Other by becoming more and more "respectable" but I'm trans, and unless the dr is particularly "woke", I was going to lose this the moment he or she laid eyes on me.
Do you think if I told my therapist that I'd been lying this whole time, he'd believe me? (I want my diagnosis gone)
I understand!!!
Probably depends what you were diagnosed with
I've tried that... I just got prescribe diff medication. So, I don't take anything and end up back at the Dr. a few mo later. You may be able to get around it but if your ill ... your symptoms wont go away & u can't hide them for long from your loved ones that have witnessed you on medication.
@@Crissy_tina Yeah, I'm doing fine now. I still get therapy and some medication that helps somewhat. I've come to terms with it. Thank you for your reply.
Maybe. Give it a try.
Awesome information Dr. Grande 👍👍👍👍
Good coverage! Kind of related. I got Tinnitus a few years back and was unreal, 24 /7. Went to 4 different hearing professionals and 2 clearly acted and reacted as if I was lying to get meds. It was heartbreaking to not be able to prove it and be suffering. I've since developed coping and have no intention of going through that unbelieving again.
A famous malingerer was Maxwell Q Klinger of the 4077th MASH unit.
5 seconds in: lol my ex faked multiple personalities and catching the evidence around it was because development of each personality provided no additional traits and was functionally only used to escape trouble. (10 years of knowing them, proved evidence of this being false, not a 6 month sort of detection)
Really great video 👍. For some reason UA-cam wouldn't play this last night but I'm glad I remembered it was suggested.
Very informative video. Thank you.
thanks amigo todd
How does one know what is a delusion ?
I think a delusion is something that you don’t notice cuz you believe it to be real or like for example you might have a grandiose delusion were you believe you the the greatest person in the world or something like that
No matter how hard people try to prove and convince you that these things are not true, even if they have proof it’s still real, the thought doesn’t go away and they can’t convince you. To you it’s a delusion to me it’s the reality. Simple as that.
I have auditory hallucinations. They are basically distant voices most of the time, or hearing my name being called from the woods or another room. It's definitely possible. But I'm glad you said that one symptom of malingering doesn't mean that's what's going on.
I always had it in the back of my mind that my symptoms were exaggerated. Well, my internal experience is at a disconnect to how people see me. I do have symptoms that impair my function. However, my complaints largely go unheard. I feel as though I'm making a big deal out of nothing. Perhaps I've been a malingerering attention seeker this whole time.
Food for thought. Scintillating stuff Dr. Grande.