When Lying is a Sign of a Health Problem

Memory is a funny thing. We all get details wrong from time to time, misremember or simply have gaps in recall. You may remember eating in a nice Italian restaurant before seeing My Fair Lady but really you ate at that restaurant before seeing Chicago. This kind of memory confusion is normal. But less commonly, because of underlying neurological issues, people will generate false memories with no intent to deceive.

The medical term for this is confabulation. Because the person believes what they’re saying, the term “honest lying” is also used to describe this phenomenon.

Two types of confabulation

Confabulation can be provoked, in response to being asked questions or for details a person can’t quite recall correctly, or spontaneous, when the misremembering is just that — unprompted. This phenomenon is different from delusions, or false beliefs.

The latter, spontaneous confabulation, is rarer, and may point to an underlying medical condition such as Wernicke-Korsakoff syndrome — a neurological disorder that’s caused by a lack of vitamin B1 (thiamine), most frequently from chronic and severe alcohol use. It also can be caused by a range of other conditions, from Alzheimer’s dementia and traumatic brain injury to bipolar disorder and schizophrenia.

Even in cases where the underlying condition is already known, it can be concerning when a loved one suddenly seems be making up stories about the past.

It’s very distressing when you see someone that you love isn’t remembering things or seeing things the way that you do,” says Susan Maixner, M.D., codirector of the geriatric psychiatry program and geriatric psychiatry fellowship director at the University of Michigan. This isn’t just about missing a few details here or there when recalling a shared experience. With confabulation, a person fabricates memories — for example, to fill in holes in what they recall — and believes their version of events completely, Maixner explains.

“They have no awareness that these things didn’t happen, and they’re not trying to lie or deceive anyone,” she emphasizes. Still, the resulting confusion can leave caregivers at a loss.

To learn more about confabulation, and how to respond to ‘honest lying’ from a friend or loved one, from AARP, CLICK HERE.