Am I faking my mental illness? Advice from a therapist

It’s not uncommon for folks with a mental illness to ask themselves this question. Because mental illnesses are not as visible as physical ones, they are routinely downplayed. Most of us with a mental illness have probably felt, at one point or another, that others think we are exaggerating or simply choosing not to “snap out of it.” 

It’s one thing to point out that these ideas are completely unsupported by science. Mental illness is very real, even if it’s not visible. But that alone may not be enough to satisfy your doubts. “After all,” you might think, “What if I’m one of the few who’s actually faking it?”

Keep reading for answers about why you might be worried you’re faking your mental illness and how you can get help in trusting your own experience and symptoms.

Are you faking your mental illness?

Frankly, it’s very rare that mental illness is faked. Mental illness is not fun or desirable, so why would you fake it? If the mean voice in the back of your head is saying something like, “You just want attention,” try to come back to the reality of your experience. The hard days where it feels like you’re in an endless fight with your brain. The moments of exhaustion. The worst, most debilitating symptoms of your mental illness. You can’t fake those—at least not to yourself. 

That said, if you’ve tried to ground yourself by remembering and trusting your own experience (perhaps over and over again), yet doubts about the legitimacy of your experience keep coming back, let’s look at why you might be in so much doubt about your condition.

Why are you worried that you’re faking it?

While the stigma surrounding mental illness has been on the decline in recent years, it’s certainly still alive. It’s likely that you were socialized with the internalized belief that mental illness was either indicative of a “weak,” “dramatic,” or “sensitive” person, or that mental illness was a term that only described “crazy” people—people you may believe have it much worse than you do.

April Kilduff, LCPC, LPCC, LMHC, a specialist in OCD and anxiety disorders, goes on to say, “If you come from a family of origin or culture that doesn’t support mental health, that might get you to second guess what’s going on with you—even if you have a skilled and experienced mental health professional telling you what you’re dealing with.”

Even when we grow in our understanding of mental health, it isn’t easy to shake the messages we got, and often continue to get, from the world around us. It can take time and effort to unlearn harmful beliefs.

Moreover, you may be used to dismissing or diminishing your own experience. Perhaps you were taught that it wasn’t okay or “normal” to have such negative feelings, or that it’s your responsibility to shrug them off or move on from them. Sometimes, in a process some call “self-gaslighting,” we start to recreate these dismissive attitudes ourselves because it’s what we’re used to. 

Introducing the “doubting disease”: OCD

There is also a mental illness that frequently features intense doubts about one’s own experience of their mental health: obsessive-compulsive disorder (OCD). OCD seeks 100% certainty. It will find any possible seed of doubt, any room for “what if?” 

It’s highly common for those with OCD to want to make sure that what they’re experiencing is really OCD—or any other mental health condition, for that matter. Remember at the beginning of this article, when I mentioned that it’s extremely rare for people to be faking their mental illness? As you read that, did you by chance think, “But what if I’m one of the ones who is faking it?” Of course, it’s not possible to be 100% certain—literally free of any doubt—of anything, especially a mental health diagnosis. But thoughts like that “what if?” are classic hallmarks of OCD, the doubting disease.

Kilduff offers a summary: “OCD demands certainty, but it won’t ever accept your answers and compulsions—it will always doubt everything. You can never satisfy OCD—That’s why resisting compulsions is your best response!”

If you’re unfamiliar with OCD, it consists of distressing intrusive thoughts, images, urges, sensations, or feelings (obsessions) and mental or physical responses (compulsions) done in an attempt to feel better or keep something bad from happening. Everyone has intrusive thoughts, but people with OCD take them as serious threats to who they are and what they believe to be true. They are overcome with an urgent need to “solve” or “figure out” these thoughts. 

In many cases, OCD threatens our self-image, since the disorder latches onto the things we value most. Says Kilduff, “You might really value being a true, authentic, and responsible person, so faking your mental illness would be a prime topic for OCD to pick on.” 

Here are some other examples of common OCD themes that focus on a person’s strongest values:

• Relationships. This is when one is plagued by intrusive doubts about their relationship, their feelings for their partner, their partner’s feelings for them, etc.
• Harm. This theme typically focuses on the fear of “snapping” and physically harming others, though it can extend to the fear of being a victim of harm.
• Sexual orientation. This theme involves fears of never knowing your “one, true” sexuality. Sufferers worry they’re lying to themselves and/or their partner.
• Pedophilia. This one sparks worries about being a pedophile. The sufferer becomes terrified that they are secretly harboring an attraction toward children.

To use the last example, someone with obsessive fears that they’re attracted to children might ask, “but what if it’s not OCD, and I actually am a pedophile? What if my therapist is wrong? What if I’m just deceiving myself? I have to be completely sure, or else I’m a danger to children.” The mere notion of possibility that it’s not OCD causes them to continue engaging in compulsive questioning and rumination. 

Those with depression may also be especially prone to doubting their experience of mental illness. Because of internalized stigma, those with this condition may be prone to interpreting their lack of motivation and interest in activities as merely “lazy.” Moreover, those with depression commonly have low self-esteem, since they experience a diminished ability to participate in their lives. That low self-esteem can lead them to discredit their own experiences. Common symptoms of depression include:

• Ongoing feelings of sadness or “emptiness”
• Feelings of hopelessness or pessimism 
• Feelings of worthlessness, guilt, shame, or helplessness
• Loss of interest/pleasure in activities that were previously pleasurable
• Fatigue or low energy
• Physical symptoms such as headaches, gastrointestinal issues, or muscle aches

Kilduff notes that autistic people may be inclined to worry that they’re faking it, too. She notes they tend to be heavily concerned with being honest, and that many autistic people may have had prior experiences where they were accused of “faking it” or just wanting to be “special.” Autism is nuanced and has a lot of variance, but some common symptoms (in adults) include:

• Having a hard time understanding what others are thinking, feeling, or trying to communicate
• Feeling very anxious in social situations 
• Not understanding unspoken social “rules”
• Being acutely aware of small details, smells, sounds, or other stimuli that others don’t notice
• Being highly interested in niche subjects or activities 

Many autistic people may appear to others as neurotypical, whether they “mask” certain behaviors or simply happen to act in ways that others don’t associate with autism. Sadly, this can sometimes cause them to doubt themselves. While they have their own, individual experience of what it means to be autistic, others’ comments or perceptions can lead them to wonder if they’re somehow lying to themselves. 

How can I learn to trust my experience? 

If you already see a therapist for your mental illness, ask if you can talk through the perceptions you have of your condition. Saying these things out loud—“Am I faking it?”—will help your therapist understand your struggles and create a plan to help you get better. And if not, your therapist can guide you in better trusting and understanding yourself. 

If you are not seeing a therapist, this might be a good sign that it’s time to. Going to therapy can feel incredibly validating. Giving language to your experience may make it feel more real to you. Moreover, your therapist may be able to provide education on your condition, giving you even more language and proof of a legitimate, shared experience.

If you resonated with the information on OCD, the best course of treatment is exposure and response prevention (ERP) therapy. 

In ERP therapy, Kilduff says you’ll “do things that bring up the possibility that something could be true and learn to sit with the uncertainty.” You’ll learn to “differentiate between possibility and probability.” She gives this example, “If you’ve had two therapists assess you and give you an OCD diagnosis, it’s possible they both got it wrong, and that you faked it so well, but that’s really not probable. That’s the kind of uncertainty that, ultimately, you want to be able to live with.”

In any case, while your interpretation of your experience is valid, the best way to receive diagnosis and an appropriate course of treatment is by consulting a licensed mental health professional—preferably one who has specialized training and experience in the condition you’re wondering about. 

And no matter your diagnosis, you can learn to trust yourself and your experience. Indeed, doing so can be an important part of gaining overall self-confidence and a healthy, holistic relationship with your own health.