She first saw psychiatrist in 2005, being sensitive and very bad-tempered, with paranoid ideations and hallucinations. In 3-4 months with medication she got better, but soon got a relapse as she got a new job, because she couldn’t handle the stress from work. Since then she has never worked. During the end of 2005, despite the medication her condition got much worse, more paranoid, fearful,  having persecutory delusions. Her husband and sister accompanied her to visit various temples, praying, seeking for help through different mediums.  Two sets of 6 ECTs were done from Dec 2005 to Jan 2006, because she didn’t get better significantly after first set of ECT, still hallucinating (see here for a case study of a severely depressed woman recovered through ECT).

Through 2006 to 2011, her condition wasn’t that good. She wasn’t keen to take certain medicine as she thinks those medicine cause weight gain (which was quite right). So it was difficult to have her condition under control. She continued to be sensitive, paranoid, avoiding crowds, hallucinating, and also getting more and more obsessed with body weight. Later she got a lot more stable from mid 2011, till recently…

The husband said he wanted to go to start a business with a work partner in East Malaysia, he will have to be there for at least 6 months. This is when the patient got unwell again… Irritable, insomnia, restless, hearing voices, agitated despite maintaining all her medication. The husband gave up the idea and the business plan, continues running his coffee shop.

However, the patient doesn’t recover just when the husband made the decision to stay with her. He brought the patient with the sister to consult doctor almost every day, for injection and medication. The husband is now suffering financially paying for the bills and not being able to work. But she doesn’t turn better, at all. Despite all kind of medication she’s taking, she’s still restless at night, wanting husband to bring her out, saying someone is waiting for her outside. During the day she stays at home, saying someone is coming to visit her soon. Of course none of these “someone”s turns up. She continues to hear voices, paranoid, and not sleeping. Sometimes she doesn’t use the toilet at home but does the business outside of her house. Sometimes she stays in the rain not wanting to go indoor.

Sometimes when we talk to her, she seems to be completely fine and ok. But when we hear the description of what she does outside of the clinic, it seems completely abnormal and unwell. Then one staff has come out with this theory (which doctor also kind of agrees with it), that this is a revenge plan:

The patient is trying to revenge to the husband, for “attempting” to abandon her, at the same time, (I think) she is also wanting to stay unwell [subconsciously maybe], so that all her family especially her husband will stay with her, be there for her and care about her.

What do you think? How do people fake their mental illness to serve some purposes? What can we do about these people? How do we know if she’s really unwell or just faking? Are people really willing to ruin their own life and those of their family members’ just for the sake of care and love?