Yes, some of the PTSD (post traumatic stress disorder) symptoms can be faked. However, the physical symptoms of PTSD are difficult to fake, as the physical symptoms are outside your voluntary control. The physical symptoms are manifestations of the activation of the sympathetic nervous system and the release of adrenaline, noradrenaline, and cortisol, which is the fight or flight response.
Sadly, there are people who fake having PTSD for personal gain, to obtain disability benefits from the military, Social Security, or the employer. This takes away from those people who actually have PTSD and are genuinely disabled by it. But because psychiatry has no biological markers to confirm clinical diagnoses like PTSD, there are some people who can fake the symptoms and be labelled with PTSD, and possibly even get disability from this misdiagnosis. How does this happen with a psychiatric assessment? These misdiagnoses occur all the time, as many of the symptoms for the DSM checklists can be obtained from the patient’s own words and clinical history.
In PTSD, there are three main categories of symptoms: re-experiencing of the traumatic event, avoidance of reminders of the trauma, and hyperarousal symptoms. It is easy to fake the re-experiencing and avoidant symptoms, as these symptoms can come from the patient’s own account of them from their clinical history, fabricated or not:
- You can fake having nightmares and flashbacks of the feigned traumatic event
- You can fake avoiding situations which remind you of the feigned trauma
- You can fake having an emotional detachment
- You can fake being emotionally numb
- You can fake having depression, worry, or guilt
- You can fake having anhedonia and losing interest in things
What you can’t fake are hyperarousal symptoms, as these are manifestations of the fight or flight response, which is caused by the activation of the sympathetic nervous system and release of stress hormones:
- You can’t fake being easily startled
- You can’t fake being on edge
- You can’t fake being hypervigilant for danger
- You can’t fake sleep problems, especially when you are referred for sleep studies in a sleep lab to confirm your sleep disturbance
- You can’t fake the increased heart beat, and the increased blood pressure that comes with activation of the fight or flight response
- You can’t fake the dilated pupils when you are on guard
So to summarize, not all of the symptoms of PTSD can be faked, but many can. It takes a skilled psychiatrist to figure out who actually has PTSD, and who may be faking it. The best way to confirm symptoms is to get collateral information from family, friends, and co-workers to see if they observe any of the symptoms that the patient is reporting. A thorough psychiatrist will also get vitals, do a physical exam, and may refer the patient for sleep studies, just to observe for any objective evidence of PTSD.
When there is the potential for personal gain, like getting disability, psychiatrists should not make the diagnosis of PTSD by the patient’s own words alone. Such is the state of modern psychiatry, where patients can go into a psychiatric assessment, deliberately feign symptoms, and walk out with a diagnosis.
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I’m so glad now to have come across your website. I have been struggling with my “Emotional State” for some years now. I had quit drinking some years back with the help of the VA. They diagnosed me with Bi polar NOS and PTSd, and some depression. I have since gotten a lot better. They said that it was hard to treat me, and they were right. I do have mood swings, and the mania can be awful. that’s the bipolar side. The PTSD is what I seem to struggle with. Generally speaking, “society” really doesn’t understand this form of anxiety. People have often asked me “What is PTSD”? I can now explain it better thanks to you!
My PTSD is the result of Sexual Trauma and Domestic Violence ; “Political Terror” as I put it.
I’m like a mouse that has imprisoned herself. Always looking for a way to escape. I can’t seem to
get out of this bubble! But I’m working on it. It’s hard though, being treated through the VA. There’s a conflict of interest which impedes my trust. I often feel like a “Lab Rat”. going through a maze:)
Thank You Dr. Carlo,
Mindy
Dear Mindy,
I’m glad you find the website helpful. Good luck on your recovery.
Best Regards,
Dr. Carlo
I need help. I have a check mark near every symptom. I’ve been through a massacre, seen people die, been tortured. But I don’t know. Am I faking it? Am I fooling myself. Is it even possible. I’ve had the dreams, the flashbacks, the triggers, feeling that I can’t feel. I can’t feel love, pain, or anything. Am I fooling myself? Is it even possible? Please help. I don’t know what’s wrong with me. Do I really have PTSD, or did I convince myself so badly that my body actually thinks it has. Am I doing it just for show? Or am I really screwed up. I don’t like talking to people about it. But at the same time I feel the urge to tell someone, to let them know. I was 14-15 at the time.I am now 17 and these symptoms are popping out.
You need to see a psychiatrist to answer your question. Please go to your family doctor, and ask for a referral to a psychiatrist.
Hi I am an emotional abuse victim of a man who is a Covert narcissist, our relationship is over. I have been told I have Cptsd I have a mother with NPD and have had another abusive marriage. Ive recently had a suicide attempt and not coping with life, have withdrawn and find it really hard to leave the house, easily startled not sleeping, other symptoms. For reasons I haven’t sought help for it yet, partly because Im leaving the area where I live, and partly because I can’t emotionally do it.
Yesterday I found out that my abusive partner has been going to see a psych saying HE HAS PTSD! Its believed he’s faking so he can have a paper trail so he can claim his abused not the abuser! I was appalled naturally, but I felt powerless AGAIN just another way of abusing me, belittling my pain and terror. Im a prisoner and he is going about his life having a fat old time and having a great social life, he’s moved on, and is definitely not in any shape or form suffering from PTSD.
Thanks so much, this article made me feel a little better.
I’m glad that the article made you feel better. However, if you are not currently getting help, then you can start the recovery process by taking the anxiety test on this website. You still being affected by your partner is part of the emotional trauma you suffered. Once you are able to get help and recover, then you will not be affected as much by your ex-partner. Once you settle into your new place, then seeking out a therapist or visiting with your family doctor would be highly recommended.
Yes, thank you for this, it does help because I’ve “worked” on myself for over a decade – CBT, personal life coach, private yoga lessons on spirituality (did Vinyasa yoga for years, five classes a week plus worked out another hour or two for many years) and worked A LOT. Tried to commit suicide three times last Nov and just literally found out there is such a thing as trauma therapists and psychiatrists (no one EVER told me that before), now seeing them. But I have often wondered the same as Alyeldin above, am I possibly faking it? I have always been a behind the scenes gal, more so than wanting a lot of attention. Used to ALWAYS be the kindest, warming, loving, understanding friend and family member but have lost so many people (that I was friends with for five or ten years, or since growing up even. I mean, there are so many things I could share – head hurts all the time, fall out of nowhere, had multiple muscoskeletal surgeries due to so much pain (now chronic), crying spells, nightmares, relived entire thing for another year (like I did 14 years ago, right after gang rape happened), nightmares, etc. etc…I feel like I can’t even think anymore. I’m angry all the time, can’t sleep and was wondering if my head has just been playing games on me. I’m so extremely scared and my psychiatrist (worked as the top psychiatrist in our big city for 20 years at the VA) is obviously being conservative, trying to see the truth over time (I can never think on my feet like I used to, I was a top sales person for many years, that’s why “working” on things so very important to me, but I can’t work on what’s been going on lately because I can’t make any sense of whom I have become suddenly). It’s lonely and I don’t even want to walk the dog outside because I don’t want to run into anyone and have to talk. It’s scary because I feel like my brain is not my own at times, yet I’m still there watching it get so snappy/irritated all the time (don’t know how to even explain half of anything going on inside). This is completely and totally nuts, I just want answers after dealing with this for 14 years. I used to be the BEST at numbers (career in Sales then Accounting, have always been a numbers person, can’t even count anymore). I only want to be with my dog and watch (have to re watch 5-10 afterwards) movies/tv. This is miserable not having anyone else to talk with who knows what I’m truly talking about, wish I did have another person to talk with who has been through the same stuff. I’ve already lost so many years how many more must I lose? Keep going back and forth between thinking I can still be whom I was before, that very strong and independent woman, but then realize physiologically I have changed and am so scared that I do not know if I can go back to anywhere near whom I was before. I just wish I had an answer to am I crazy or not?! I have truly recognized what it is like living one day at a time, I cannot even think otherwise – used to work 60-80 hours a week and now not working, nor working out (still need more surgeries) and it’s hard. Anyway, thanks again for this article, are there any others you can suggest? DBT is interesting, but also limiting based on so many in the class.
I forgot to ask, is it starnge Prazosin does not help my nightmares? I was taking 4mg a night and it did nothing for me at all. Thanks!
Prazosin is an alpha blocker and used to relieve the nightmares associated with PTSD. However, higher doses of prazosin are often required to relieve PTSD nightmares, but doctors are reluctant due to concerns about side effects. Please discuss with your doctor about the possibility of increasing your dose.
Jadie:
I take a medication called Propranolol, which is similar to Prazosin but it helps me more – I found after trying each of those meds. Maybe ask your doctor that’s prescribing the prazosin if he thinks that swapping might be worth a try. – I know Propranolol is hard to pronounce! and even tough to spell! But for me it’s worth the trouble! Good luck to you.
Thank you for your share Allie! Another option for nightmares associated with PTSD is nabilone, a synthetic cannabinoid. Talk to your psychiatrist about this option: http://www.sciencedirect.com/science/article/pii/S0306453014004132.
Thank you for your share, and hope you can regain your functioning and relieve you symptoms. Here is another article that you might find interesting: https://anxietyboss.com/how-ptsd-evolves-the-negative-cycle-of-post-traumatic-stress-disorder/
Great article, thank you.
My ex-wife has been off work for over 5 years and claims to have PTSD. When we were together she reduced her hours (as a mental health nurse) to part time in order to focus on opening up a counselling business, then she went on sick leave and put all of her efforts into trying to make a successful business. She has stayed on sick leave ever since and I’m convinced she is faking PTSD; alleging an incident of sexual assault over 30 years ago that was never proven as being the cause.
She leads a great life, with no impediments, living of her disability payments coupled with my large support payments – so she has no incentive to work.
How can I go about proving she is faking this?
Proving it is fake is very difficult. But the insurance company paying out the disability- I’m sure they are already on it.