Depression or attention seeking (understanding malingering)

From the following article, we will gather vast information about the topic ” Depression or attention seeking?”. We will understand the term malingering and its causes. We will also know what to do if we think someone is faking symptoms of depression.

Depression or attention seeking?

Depression is a mental illness. Falsification of symptoms of depression for the purpose of seeking attention should be understood thoroughly, because at times the mimicry of the symptoms are so deceiving that professionals fail to differentiate.

Depression is a mental disorder which characterizes various symptoms which are severe at times, but in some cases people fake or exaggerate the symptoms for personal gains like rewards or to avoid undesirable circumstances.

This phenomenon of faking symptoms of depression(or any other mental disorder) is also known as malingering.

Malingering

The DSM-5 describes malingering as the intentional production of false or grossly exaggerated physical or psychological problems.

The act of malingering is a falsification of either physical or mental  to gain external benefits such as avoiding work or responsibility, seeking drugs, avoiding trial (law), seeking attention, avoiding military services, leave from school, paid leave from a job, among others.

For example, a student may fake symptoms of depression to seek special attention and sympathy from the professor. 

Some examples of malingering behaviour is 

• putting makeup on your face to create a black eye
• adding contaminants to a urine sample to change its chemistry
• placing a thermometer near a lamp or in hot water to increase its temperature

Malingering is difficult to direct because many symptoms of depression are easy to act out, particularly if the person has knowledge about the condition. 

Factitious disorder 

Factitious disorder on the other hand, is considered a serious mental illness characterizing symptoms of deceiving others by mimicking or exaggerating symptoms of an illness. These people are willing to undergo painful or risky tests to get sympathy and special attention.

Symptoms of factitious disorder include :

• Lie about or mimic symptoms

• Hurt themselves to bring on symptoms

• Alter diagnostic tests (such as 

contaminating a urine sample or tampering with a wound to prevent healing)

• Be willing to undergo painful or risky tests and operations in order to obtain the sympathy and special attention given to people who are truly medically ill

People suffering from this, are usually not aware about the existence of this disorder. They do not even know why they are fabricating an illness. Usually patients with  factitious disorder may also suffer from other forms of mental disorders like personality or identity disorders.

Difference between Malingering and Factitious Disorder

Malingering is an intentional falsification of symptoms of mental illness.

On the other hand in factitious disorder, the person does not have the awareness of them deceiving another by mimicking symptoms of mental illness. When asked they are even unable to state reasons for their behaviours.

Similarity between Malingering and Factitious Disorder

One of the similarities found between these two mental conditions is that both are difficult to detect. Clinicals often fail to recognise a person malingering or suffering from factitious disorder because of how natural and real the symptoms appear to them. 

Another similarity is, both are done for seeking some kind of attention or avoiding some critical circumstances. 

Explaining attention seeking behaviours

Attention seeking is generally considered a bad thing. Humas, since their childhood, seeks for attention to fulfill both practical and emotional needs. As Oliver Burkeman points out, “we need attention almost as desperately as food and warmth.” Most of our daily behaviours are influenced by unconscious desire for attention.

The craving we have for getting validated, acknowledged and attended to is so deep seated that the absence of it may make us behave in uncontrollable ways.

Research suggests that if an adult is ignored and not cared about, they may become emotionally destroyed in all ways possible. 

A study published in the recent times states that being ignored at work was even more psychologically damaging than being actively harassed. Another research found that being socially marginalized and excluded may induce within an individual anger, depression, jealousy, sadness and every other negative emotion. 

Attention seeking is a mechanism with which we defend our insecurities which may pop up due to lack of attention from people around us.

Attention seeking as an expression of pain and suffering 

Our natural inclination in seeking attention can lead us from a healthy safe place to symptoms of serious psychological distress like malingering. In these cases, attention seeking can take the form of behaving in loud and dramatic ways.

It is believed these behaviours arise from deep seated painful experiences like traumas and psychological disturbances and a way to cope with the emotional breakdown.

Attention seeking is also “a brain wiring response to early developmental trauma caused by neglect”. This conveys the message that people who have experienced extreme pain, neglect and trauma in their childhood, may seek for that love, care and attention in people later on in life to fill those voids and get over deep rooted hurt.

Causes of attention seeking behaviours

• jealousy
• low self-esteem
• loneliness

• histrionic personality disorder
• borderline personality disorder
• narcissistic personality disorder

Jealousy

Jealousy is a negative emotion which may be experienced when one feels attacked by another person receiving all the attention. 

People who have malingering tendencies may fake symptoms of depression or any other mental illness to get all the attention.

Self-esteem

The concept of self is a complex cognition. Our self has various forms and states about how we view ourselves.

Seeking validation about our own self through attention can be a way of reassuring people that they are worthy.

Malingering can be practised by a person to deceive other people to give themselves validations about their capabilities.

When a person is faking depression, maybe they want to care and attention from others to feel good about themselves.

Loneliness

Being lonely and devoid of social support can result in an urge to seek attention. 

Histrionic personality disorder

According to the National Library of Medicine, Historic personality disorder is characterized by feeling worthless when not appreciated and attended by other people.

Following are the criterias to be met so as to get diagnosed with histrionic personality disorder.

• uncomfortable when not the center of attention
• provocative or seductive behavior
• shallow and shifting emotions
• using appearance to draw attention
• vague or impressionistic speech
• exaggerated or dramatic emotions
• is suggestible
• treating relationships as more intimate than they are

Borderline personality disorder

According to DSM-5, BPD is diagnosed on the basis of (1) a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and (2) marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by at least five of the following:

• Frantic efforts to avoid real or imagined abandonment; this does not include suicidal or self-mutilating behavior covered in criterion 

• A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation

• Markedly and persistently unstable self-image or sense of self

• Impulsivity in at least two areas that are potentially self-damaging (eg, spending, sex, substance abuse, reckless driving, binge eating)  ; this does not include suicidal or self-mutilating behavior covered in criterion 

• Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior

• Affective instability due to a marked reactivity of mood (eg, intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)

• Chronic feelings of emptiness

• Inappropriate, intense anger or difficulty controlling anger (eg, frequent displays of temper, constant anger, or recurrent physical fights)

• Transient, stress-related paranoid ideation or severe dissociative symptoms

Narcissistic personality disorder

According to the American Psychiatric Association, for someone to receive a diagnosis of narcissistic personality disorder, they need to display at least 5 of the following criteria:

• a grandiose sense of self-importance
• a preoccupation with fantasies of power, unlimited success, brilliance, ideal love, beauty
• a belief in their own uniqueness, especially that they should only associate with, and will only be understood by, high-status institutions and high-status people
• demand for excessive admiration
• a sense of entitlement and unreasonable expectation of favorable treatment or automatic compliance with their expectations
• taking advantage of others to achieve their own ends
• unwillingness to identify with or recognize the needs and feelings of others
• envy of others and belief that others are envious of them
• haughty, arrogant attitudes or behaviors.

Understanding depression

Before distinguishing someone is malingering or actually having depression, it is important to understand the true symptoms of depression.

In order to recognise if someone is having depression, you can talk to them and ask about how they are feeling. 

 The following symptoms should be considered when diagnosing depression :

• Inability to make decisions, judgement
• Difficulty in remembering things 
• Feeling tired and lethargic at work
• Feeling guilty and worthless
•  Seems irritable or restless
• Sleep issues
•  they used to enjoy like hobbies
• Seem to be losing or gaining weight without trying
• Complain of pain, headaches, or digestive problems that don’t seem to get better even with treatment
• Seem sad or anxious
• Talk about suicide or not wanting to be around anymore

What should you do when you see someone faking symptoms of depression? 

It is very important to understand a few basics before you come to the conclusion of this piece.

If you see someone who has depression, smiling and laughing around, you may become suspicious about them faking the illness. How a person behaves in front of the society cannot be taken as a cue to understand the severity or veracity of their mental illness. 

Depression is not a behavioural, overt symptomatic illness. It has its effects mainly in the person’s mind and emotional state. Symptoms that you cannot see are lack of sleep, feelings of worthlessness and lack of regularity. Most people having depression lead a very normal social life; they go to parties, laugh around, cracks jokes and even motivate other people. It is not always possible for a layman to even understand if a person has depression because it is an invisible illness.

 While faking symptoms of illness are absolutely possible, such as malingering, but even those are caused by reasons which have some dark and deep root to it. Seeking attention is not bad. It is to some extent good for the self. In cases when seeking attention goes beyond the limit then it has to be considered a condition that requires treatment by professionals.  

Rather than treating people with suspicion, try being supportive. Don’t judge people because everyone has a reason to behave a certain way. Try to understand their view point by talking to them rather than perceiving them as bad or harmful. Leave the diagnosis for a professional and become a supportive individual. Don’t forget to spread love!

Conclusion 

From the above article, we gathered vast information about the topic ” Depression or attention seeking?”. We also gathered information about the term malingering and its causes. We now know what to do if we think someone is faking symptoms of depression.

FAQs : Depression or Attention Seeking?

References 

https://www.verywellmind.com/faking-depression-1066887

Look At Me: Attention-Seeking Behavior as a Symptom of Psychological Distress