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. HOW TO RESPOND TO ‘HONEST LYING’ Confabulation tends to involve autobiographical memories, or

what a person misremembers about their own past experiences, and can be as simple as getting small details wrong or as elaborate as fantastical odysseys unto themselves. The fabricated

memories may be tied to real events but plugged into a different story — or have fictitious origins. “Sometimes you’ll see plotlines of television shows that have been playing in the

background kind of woven into some of these stories that are told,” Maixner says. But, in truth, the person isn’t lying — since they’re not trying to deceive anyone. However, loved ones may

perceive the person is lying and become annoyed or offended — something experts say you’ll want to avoid.