Andrea Avigal*, 58, of New York has been sick her entire life.
She has had cardiac problems, gastrointestinal surgeries, broken bones and dozens of visits to the emergency room. She once nearly had to have her foot amputated when it became infected, and another time almost died after becoming septic.
But it wasn’t any medical mystery that led to the near-fatal symptoms, as doctors and nurses originally thought. Avigal had been doing it to herself.
“I’m a recovering Munchausen syndrome patient,” Avigal, who asked to remain anonymous to protect her family, told InsideEdition.com. “It’s been 14 years now that I’ve been in recovery and I no longer live a life of chaos and illness and destruction.”
Munchausen syndrome is a mental illness in which the patient acts as if he or she is sick and causes symptoms in order to receive treatment.
“A person either feigns, exaggerates or actually induces illness in themselves, and then lies about it because they are looking for attention, sympathy, care, concern,” psychiatrist Dr. Marc Feldman told InsideEdition.com. “Manipulating high-status professionals like doctors and nurses allows them to feel kind of good about themselves.”
While the American Psychiatric Association reports that approximately one in 100 people admitted to the hospital are cases related to Munchausen, Feldman says he believes the number is actually much higher than reported.
“The majority of the cases go unrecognized,” explained Feldman, who penned several books on the mysterious illness, including his most recent, "Dying to Be Ill." “It’s hard to know for sure how common Munchausen syndrome is because it’s bathed in deceit and we don’t count the cases in which someone has been successful in deceiving us. “
Most recently, the mysterious illness has been in the spotlight in various television shows, like HBO’s "Sharp Objects," and real-life events like the murder of Dee Dee Blanchard by her daughter Gypsy Rose, both of which showcase a related condition called Munchausen by proxy, or the disorder imposed on another.
But the reality of the condition is scarier than on television. Aside from the painful symptoms of making themselves ill and potential long-term effects, many Munchausen syndrome patients do not overcome the diagnosis. In fact, many die as a result of things they have done to themselves.
“There’s actually a mortality rate related with Munchausen syndrome,” Feldman explained. “Some people inject themselves with bacteria. Some people have taken chemotherapy drugs and suppressed their bone marrow, and for that and other reasons, they may actually die as a result of what they’ve done.”
Avigal, who hurt herself through her teens and part of her adulthood, said she believes her need to fake symptoms stem from a turbulent home life in her early childhood.
“My parents were hostile toward each other. A lot of arguing and fighting,” she recalled. “My father was extremely abusive. He abused all his children and he abused my mother terribly. And, he was abusing me in every way possible. It was a survival situation for everyone in the family.”
When she was 8 or 9 years old, Avigal said she was on bed rest after having a tonsillectomy. That’s when everything changed.
“During that time, I was treated very very well,” she said. “My parents were very nurturing and the fighting stopped. It taught me a valuable lesson – if you’re sick, you’re treated well.”
After she became ill and tended to several other times in her childhood, she said she thought why wait for illness when she could just make herself sick?
Through her adolescence, she faked asthma attacks and attempted to break her own bones using a hammer.
“I cut my finger and it was actually during an argument,” Avigal recalled. “They stopped arguing immediately to tend to me.”
When she got married and had kids in her 20s, Avigal stopped hurting herself.
“Being married and the responsibility of motherhood, everything stopped for many years,” she said. “I no longer needed that coping mechanism because I felt that I had a purpose in life. I felt protected and cared for by my husband, which is what I was searching for in my childhood. I started going to therapy and things started to improve in my life.”
Her good health was short-lived. Her son was just 2 years old when he developed a brain tumor and 13 when he died.
“That was it. That really pushed me over the edge,” Avigal said. “I fell back into what was familiar and the only way I knew how to cope with severe pain was the Munchausen. It reemerged with a vengeance.”
By then, and thanks to now working as a nurse, Avigal’s techniques to hurt herself changed.
She began injecting bacteria into her blood stream to induce sepsis. Once, her foot became so infected doctors had talked about amputation.
“I felt very guilt-ridden when my son passed away. I felt I was somehow responsible,” Avigal said. “I felt like I needed to go through what he went through, and he was septic many times, so I was recreating that made myself experience what happened to him.”
Avigal said she always knew what she was doing to herself was incredibly dangerous. Yet she couldn’t stop.
“I felt constant shame,” she said. “It was never that I was pulling this off and fooling the doctors. I was terribly ashamed of myself and knew that I was hurting everyone around me. I was hurting myself in a terrible way, and I could die. It was an awful time in my life.”
With the help of her therapist and some internet research, she realized there was a known diagnosis to her behavior.
Still, she continued to hurt herself.
Some days, she would take massive amounts of laxatives to cause gastrointestinal issues. Or, she would go days without drinking any water to force cardiac issues. Sometimes her attempts led to major surgeries. Other times, Munchausen syndrome landed her in the intensive care unit.
“I was already so sick. My body was so worn down already from being sick for such a long time, and I was close to death. They weren’t sure if I was going to be able to pull through,” Avigal recalled. “I was petrified. I was absolutely petrified. It got too far at that point, and I was going to kill myself.”
Even though doctors and nurses continued to scratch their heads trying to help her reach a diagnosis, her therapist had a good idea what was happening and encouraged her to come clean.
“The biggest part about this illness is the secrecy,” she said. “When you let the cat out of the bag, it’s over, and that’s exactly what happened.”
After telling doctors and hospital staff she had been doing this to herself, Avigal said she was met with a lot of anger.
“I live in a rural area, so many people know me for being a repeat offender,” she said. “Some people just showed me terrible disdain and it was difficult because part of me felt that I deserved it.”
The hardest part was telling her husband.
“He was very, very angry for a very, very long time,” she said. “I hurt a lot of people very badly. A lot of that hardship damaged our marriage and it’s a constant balance to try and figure it out. I don’t know if we have figured it out yet.”
Feldman said it isn’t rare for a shocking or extreme event to inspire patients to change.
“Almost dying can sometimes lead to a revolutionary change in behavior,” he said. “It makes me hopeful that even in the severe cases, people can recover.”
Avigal agreed: “Becoming so close to death scared me so much that I had to stop. I didn’t want to die.”
The last time Avigal had made herself ill was in 2005. She said she hasn’t hurt herself since.
“The biggest part about this illness is the secrecy. I felt so much shame, but the more I engaged in the behavior, the worse the incidents became and the closer to death I became,” Avigal said. “In my opinion, anyone who has Munchausen syndrome needs to come clean, and they need to let the secret out.”
Feldman, who didn’t meet Avigal until after her recovery from Munchausen syndrome, said her story makes him hopeful that others struggling with the same disorder can seek help and get better.
“There are relatively few cases documented in the professional world in which people have fully recovered,” Feldman said.
For those who suspect a loved one may be struggling with Munchausen syndrome, Feldman says the tell-tale signs include an inconsistent description of symptoms, treatments that are hard or impossible to verify and appointments with several different doctors.
“Unlike a lot of mental disorders, they know exactly what they’re doing,” he said. “They may not know why, but if you look at the extent of planning, sometimes for years and decades, these Munchausen patients know what they’re doing and do seek medical care.”
Feldman urges anyone struggling with Munchausen syndrome to seek help and to reach out to him directly through his website if they need help finding an expert in their area.
With the support of her therapist, Avigal has since written a book, "Secrets Unraveled: Overcoming Munchausen Syndrome," about her journey to recovery. She says she hopes speaking out will encourage others struggling with the illness to reveal themselves and seek out help.
“The lesson is that I made some really bad choices that really hurt my family and I have to live with that,” she said. “And I also need to learn to forgive myself, which I work on every day.”
Today, Avigal says she is trying to live her life with as much normalcy as possible. Her two daughters are in their 20s and she is still happily married to her husband.
She now says she only seeks out medical attention when she is sure that it’s really an emergency.
*: Name has been changed to protect the patient's identity.