Dishonesty and Psychiatric Misdiagnosis

By Krista Kimbrell

Trust is a two-way street, littered with deceit.


What are the reasons for deceit between psychiatrist and sufferer? The root causes for patient dishonesty to a psychologist/mental illness Doctor vary widely. Shame and guilt over sounding crazy and illogical to the Doctor can be a real concern. No one wants to look insane to their provider, even when they know they are.


CPS (child protective services), divorce proceedings,  parental alienation and other family court issues cause debilitating worry in the client. Fear of authorities abusing their right to certain privileged information is worrisome. Panic attacks and encompassing anxiety can make dishonesty necessary to avoid the possibility of losing one’s children because of divulging information.


Anxiety and confusion sprout from the internal debate of revealing addiction issues. This group, in particular, feel they must be careful not to incriminate themselves with the truth. Some of these clients are on probation, drug screening, drug court or pre-trial diversion cases. These reasons can make it dangerous to reveal a relapse. Some may not be forthcoming with addiction because of the fear that nonaddictive medications will not be effective. The admission of being an addict, even in recovery, makes one feel criminalized and suspect.





A type of dishonesty comes when a patient showers and attends to other personal hygiene before going to the Dr. when they rarely shower or brush teeth. Some people can pull themselves up by the bootstraps long enough to shave or put on make-up. While the client appears to be doing well in this area, in fact, he showers and takes care of personal hygiene only when he feels it is not avoidable. Many patients do not intend to be dishonest but will lie feeling there is no other choice.


Taking into consideration the physical symptoms of deception in the average population, like avoiding eye contact and sweating, talking fast, or not making sense. These are often not indications of dishonesty in the mental health patient; these are symptoms of the psychological condition. How does one then differentiate reality from falsehood? The diagnosis comes from a sophisticated guess.


Involuntary commitment, losing a career, paranoia and other trust issues often stem from mental illness. What about the white lies of not taking energy drinks, supplements and other over the counter drugs?  A significant number of patients may not even know what the truth is themselves. How then can they be diagnosed? Mental health patients may seem like they are untruthful even when they are doing their best to be honest.





What can one do with patients for whom the truth changes between appointments? How can all these problems be worked through to give an accurate patient diagnosis? What can psychologists and psychiatrists do to earn the trust of their clients and make them comfortable enough to speak honestly? Patients need to believe the therapist wants them to get better and that they will not hold the truth against them. When a patient calls the psychiatrist with concern, the therapist or nurse needs to make an honest effort to contact the patient. What can be done to change the worries patients have about trusting the mental health care environment so they can receive an accurate diagnosis? What does the psychiatrist do to assure his client that he can trust him? What can be done to prove it? How can that kind of trust be built?


Can patients be accurately diagnosed when they cannot be open and honest with their psychiatrist?  How is anyone correctly diagnosed when only part of the analysis accurate? Is there even a reason to seek help when you cannot be honest enough to receive a proper diagnosis and the correct medication? Does anyone in the mental health field deserve to be trusted? Psychotropic prescriptions are not best for all patients because many of them received a misdiagnosed mental illness.


I am a writer living with bipolar type 2 and generalized anxiety disorder. Interact with me on Facebook, YouTube or my WordPress. My blog is named Climbing Mount Crazy.  (WordPress)




4 thoughts on “Dishonesty and Psychiatric Misdiagnosis

    1. It’s great that you have a good psychologist, I am going to find one soon. Psychiatrist are the professionals I have an issue with. Some people really need one for hallucinations, but other then that I have hope in other avenues. There is a fine line on a counselor or psychiatrist calling patients on their bullshit and them being jerks with an intolerable bedside manner. At times love and kindness are key. Being able to tell when a client needs each type of treatment is what makes them a good counselor/ Dr. or a disposable one.


      1. Yes, I agree with you on the bs, but she calls me in a very caring way and after a lot of trust building. I think I need to be challenged too, not just agreed with all the time. She helped me have some wonderful insights that way. I’ve had some very bad experiences with psychiatrists and had some very good ones too. I love you saying “love and kindness are key” – we’re people who are experiencing something incredibly intense and that needs a caring response. I’m enjoying your blog.

        Liked by 1 person

  1. It is great that she built trust with you before challenging you, and that shows her good intentions. Insight is so important and she had a clever yey loving way of showing you what may have been questionable. You found a good one.


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