Before our virtual consultation, the nurse practitioner gave me a call and asked me a few quick questions. “Have you recently felt depressed?” No, I answered with assurance, despite the fact that I had been nervous about parenting two young children in the midst of a pandemic. “Great! We like to hear that, she retorted.
She’s so happy with me, I thought proudly at the time. But why did I make such a hasty decision to speak a blatant lie?
Lying about our health is a serious problem. Truth be told – no pun intended – there are many different types of medical and health lying, each with its own motivations and effects.
Unharmful Lie or Serious Issue?
According to University of Utah professor of population health sciences Angie Fagerlin, PhD, many of us conceal things during medical appointments.
She claims, “Based on our data, we know that patients are not being honest with their physicians.” Fagerlin and colleagues have written two publications regarding the phenomena, and a third one about our COVID lies will be published soon.
One study, co-authored by Fagerlin and published in JAMA Network Open in 2018, examined the honesty with which over 4,500 American adults responded to questions about their health practises, medical treatments, and interactions with their provider.
People most frequently admitted to lying to their healthcare provider when they either disagreed with their recommended course of treatment or even when they first didn’t understand what the doctor was saying.
Other causes? They weren’t exercising, eating poorly, following the directions on their prescription medications, or they were taking someone else’s medication.
So why weren’t people coming clean?
According to Fagerlin, “the most frequent reaction from 82% of patients is that they didn’t want to be lectured or criticised about their behaviour.” Additionally, 61% of respondents reported feeling embarrassed, while 76% indicated they didn’t want to know that what they were doing was detrimental. Even some patients admitted that they didn’t want to appear demanding or use more of the doctor’s time.
A 2019 study by Fagerlin and colleagues examined the disclosure of severe and occasionally fatal problems such depression, suicidal thoughts, abuse, and sexual assault. One-fourth didn’t inform their provider, mostly out of shame, fear of judgement, reluctance to seek assistance (such as seeing a therapist), desire to avoid having it recorded in their medical file, or belief that their physician couldn’t assist.
However, this is illogical – and counterproductive: We actively seek medical attention and then aggressively interfere with our doctors’ ability to provide us with appropriate, thorough care because we are worried about how others will view us.
Fagerlin acknowledges that it can be perplexing, but it happens frequently.
“People frequently respect and seek the best for their providers. They don’t want to do anything that might damage that relationship or reputation,” the speaker claims.
However, if your doctor is unaware that you are experiencing issues with your medications, they won’t know to modify them, they won’t know to check for drug interactions if you are taking someone else’s prescription, and they won’t be able to refer you to a mental health specialist. Says Fagerlin.
Not that we don’t want to be honest. The exact opposite. According to previous research published in Computers in Human Behavior, people are more forthcoming and truthful when they believe they are conversing with an online chatbot controlled by a machine, especially when it comes to discussing their mental health.
According to Gale Lucas, PhD, a research assistant professor at the University of Southern California, “People talked more about their symptoms with the computer when they thought there was no human engaged compared to when they felt they were interacting with a person over technology.”
Again, the lies were fueled by the fear of being stigmatised or having a doctor have a bad opinion of you, according to Lucas. We find that a computer won’t judge you, as opposed to talking to someone in person who would, more consoling.
There are different types of lying
Falsehoods can sometimes cross the line. These are the stories we frequently hear about people inventing cancer diagnoses, frequently visiting hospitals, or creating their own medical issues. According to Marc Feldman, MD, clinical professor of psychiatry at the University of Alabama and author of Dying to Be Ill, factitious disorder, formerly known as Munchausen syndrome, is a mental illness in which a person “feigns, exaggerates, or self-induces a medical problem in order to get attention, care, or concern that they feel unable to get any other way.”
According to Feldman, it is uncommon but not unheard of for 1% of patients hospitalised to general hospitals to fabricate their symptoms. However, the majority of these people have secure employment and relationships with their loved ones and only lie in this manner occasionally “when they can’t handle the stress in their lives and they need compassion,” according to him.
It feels good and gives you a sense of belonging to have a respected member of the medical community listen to everything you say. In general, he claims, doctors are not instructed to interrogate patients. Sometimes this sympathy can be obtained from family, friends, or other community members, and it can be enough to satisfy them so that they don’t need to see a doctor at all.
Fewer persons with factitious disorder consistently tell lies, but some do, and fabricating medical information becomes a way of life for them.
“There are many reasons why people do things, but in my experience, seeking nurturing is the most common. People who don’t feel in control of their own life can feel in charge by controlling professionals, according to Feldman.
However, for other people, chronic lying is caused by an underlying personality condition. While for some, it’s about the money. Some people exaggerate their health in order to make large sums of money, but they also suffer significant repercussions.
When a California woman’s false illness diagnosis resulted in more than $100,000 in illegal crowdfunding donations, she was recently sentenced to 5 years in prison for wire fraud.
And earlier this year, a writer for the television series Grey’s Anatomy lost her job and her reputation after it was revealed that every detail of her medical background, including an abortion while receiving chemotherapy and a rare form of bone cancer, was untrue. She made everything up in order to further her writing career on the show and in major magazines.
Help for factitious illness is nuanced and sophisticated for those who require true mental health care, and there aren’t enough clinicians with this kind of experience, according to Feldman.
Talking to a therapist can help patients accept the truth that their ailment is psychological rather than medical. Reduction tactics are one way mental health professionals address this problem (such as diversion when one feels the impulse to go to the hospital, for example).
How to Be Honest and Not LIE
Recognizing that lying about your health, on some level, gives you a psychological gain is one part of the solution, whether you’re understating your alcohol consumption for brownie points or feeling overwhelmed by sympathy after telling a coworker you have cancer.
But is the benefit worth the costs?
Owning up to medical truth can be difficult, especially in a clinical setting where the power dynamic seems to be slanted against you. However, avoiding difficult conversations and – even if they are tiny – seemingly innocent lies might hinder your capacity to receive effective treatment for a problem or prevent you from making changes to your daily routine that will improve your health in the long run.
The first step is realising that you’re likely to lie or not tell the whole truth.
“Our research indicates that the decision to withhold information is motivated by a fear of evaluation. Knowing that might offer you the ability to decide whether to share with providers, which is a difficult choice, adds Lucas.
Another option is to be open with your doctor about any challenges you may be facing, such maintaining a healthy lifestyle. For example, most doctors will say, “Hey, I know it’s tough to exercise regularly; it’s hard for me, too.” Patients will find it easier to be honest about their own routines and struggles as a result. Nearly all of us fail when a healthy lifestyle is made the norm.
Humans find it challenging to deviate from the norm and to admit it, according to Fagerlin. But be aware that “those who choose to work in medicine want to support you in leading the healthiest life possible. If they don’t know the entire story, they can’t do it.