Pathological Lying Can Occur with These Mental Disorders

Updated 2/14/25

Everyone lies. It’s a part of life, for better or for worse. Some people find peace in white lies and don’t feel bad about occasionally avoiding the truth to spare a loved one’s feelings. Others, however, see habitual lying, even major lies, as something completely inconsequential.

Pathological lying goes far beyond the standard lies most people tell. Pathological liars lie about all kinds of things, big and small, for seemingly no reason whatsoever. Individuals with this personality trait may lie about innocuous things, like weekend plans, or larger topics, like past experiences, work, schooling or relationships. This may seem like nothing more than an obnoxious personality trait — and in some cases, it is — but lying to this level can also be a symptom of a larger problem.

When narcissistic pathological lying begins to interfere with someone’s personal life or the lives of those around them, it may be time to consider a conversation with a therapist or other trained mental health professional.

What is Pathological Lying?

Pathological lying, sometimes referred to as mythomania or pseudologia fantastica, is a behavior pattern in which individuals lie chronically or compulsively for lying’s sake. To understand the meaning of pathological lying, it’s crucial to recognize that it goes beyond occasional white lies or even habitual dishonesty. In some cases, individuals may lie to make themselves look better, but in others, they may have no good reason to lie or gain nothing from the act of lying. Being the friend or family member of a pathological liar can be very frustrating, as it’s hard to tell what’s a lie and what isn’t or when a liar can be trusted.

“Sometimes lying can be a coping response, often starting in childhood, for some psychological or personality issue that may not be at first visible, it is important to see past just dealing with the lying to uncover the cause,” shares Dr. Beau A. Nelson, DBH, LCSW, Chief Clinical Officer at FHE Health.

There may be biological drivers behind pathological lying. One study found that central nervous system behavior may influence a propensity for lying, and another found evidence of lying due to an imbalance in the hormone-cortisol ratio. However, due to the differences in the nature of lying and the purposes of lying from one individual to another, there’s not always clear logic behind when or why pathological lying occurs.

Pathological vs. Habitual Lying

It’s important to distinguish between pathological and habitual lying. While both involve frequent untruths, the underlying motivations and psychological implications can differ significantly.

• Pathological Lying: This is often considered a symptom of a deeper psychological issue, like personality disorders or neurological conditions. Pathological liars may not always be aware of their lies or the reasons behind them. Their lying can be compulsive and serve no clear purpose or benefit.
• Habitual Lying: This describes a pattern of frequent lying that has become ingrained as a habit. While habitual liars may lie frequently, their behavior is not necessarily indicative of a mental health disorder. They may lie for various reasons, such as to avoid consequences, gain attention, or manipulate others. The key difference is often the presence of a diagnosable mental health condition in pathological lying.

Pathological vs. Compulsive Lying: Understanding the Nuances

The terms “pathological liar” and “compulsive liar” are often used interchangeably, but there are subtle differences between them. Both types involve persistent and often pointless lying, yet their motivations and levels of awareness differ.

Pathological lying is frequently linked to underlying personality disorders, such as narcissistic or antisocial personality disorder. Individuals who are pathological liars may be less aware of their deceptions and sometimes believe their own fabrications. Their lies can be grandiose and fantastical.

On the other hand, compulsive lying focuses on an irresistible urge to lie. While compulsive liars are generally more aware of their dishonesty, they struggle to control the impulse, often using lying as a coping mechanism for anxiety or insecurity. Their lies tend to be more mundane and frequent compared to those of a pathological liar. The emphasis here is less on a deep-seated disorder and more on the habitual, almost addictive nature of the lying.

Although the distinction can be blurry, the key differences lie in awareness—compulsive liars are generally more aware of their actions—and the underlying causes, since pathological lying often stems from personality disorders. Regardless of the label, chronic lying can damage relationships and overall well-being, making it crucial to seek professional help to address the root causes and break the cycle of deception.

What Role Do Mental Health Disorders Play in Pathological Lying?

Mental health disorders can and do play a role in pathological lying and may be a contributing factor. In many instances, getting a diagnosis can be the first step to addressing chronic lying.

Determining the difference between lying for social or personal reasons and lying due to mental illness can be a challenge. However, there are often differences in the manifestation of lying in those with mental illnesses versus those who lie for other reasons. For example, there are links between mental illness and believing your own lies; liars with other motivations often don’t believe what they’re saying.

Mental Health Disorders That Contribute to Pathological Lying

Some of the mental health disorders that cause or contribute to pathological lying include:

• Narcissistic personality disorder. Also called NPD, narcissistic personality disorder manifests as arrogant and self-centered behavior with little regard for other people’s feelings. Narcissistic pathological liars may lie for attention, to make themselves feel better, to feel superior to others or to manipulate others for self-gain.
• Obsessive-compulsive disorder. Obsessive-compulsive disorder, or OCD, is a mental disorder that features intrusive thoughts and feelings, obsessions, and a strong urge to perform certain behaviors or compulsions. In some cases, there are ties between OCD and compulsive lying. Lying can be a true compulsion in a person with OCD experiences, or it can be a negative coping method.
• Anxiety disorders. Anxiety can manifest in numerous ways, from acute episodes to more generalized anxiety. While pathological lying isn’t a defining feature of anxiety as it is with other disorders, such as NPD, anxiety and compulsive lying can sometimes go hand in hand. People with anxiety disorders may lie to protect themselves from anxiety triggers or to handle things like a fear of rejection.
• Antisocial personality disorder. Antisocial personality disorder is a serious diagnosis that often involves manipulation and cruelty toward others for the sake of personal amusement. It’s often associated with psychopathy. Those with APD might compulsively lie to manipulate the people around them, hurt others’ feelings or otherwise cause harm.

Are There Other Reasons for Pathological Lying?

While pathological lying can be linked to mental health disorders, it isn’t always. There are numerous other reasons people may lie with abandon, including:

• Insecurity. Some people feel very insecure about who they are and might lie in an effort to make themselves feel better or inflate their own sense of self-worth. Pathological lying may also be a defense mechanism to prevent ridicule or social exclusion. Lying under these circumstances is often quite transparent.
• Social status. For those who value social status, lying may be a way to maintain a reputation. For example, communities focused on looks or financial status may look down on behaviors they perceive as lesser. Participants in these kinds of communities, like country clubs or prestigious social organizations, may lie to fit in with their desired peers.
• Humor. Though less common than other reasons, some people may lie often because they find it funny. They may not understand the frustrations that come with being lied to or may believe their lies are so egregious that no one would believe them.
• Substance abuse. Many substance abusers have issues with honesty, but this is generally inspired by a desire to hide signs of abuse rather than lying for attention or sympathy.

Pathological lying can seem harmless, albeit annoying, but it may be the sign of a bigger problem. Compulsive lying can be a symptom of a mental health disorder or even substance abuse. If pathological lying is a problem in yourself or others, therapy can be a good place to start in getting to the bottom of an issue. Confronting another person about their lying can be challenging but may be a good way to bring a problem to light. When addressing a pathological liar, be prepared with a plan, including examples of lies that have harmed relationships or other life circumstances.

How to Cope With a Pathological Liar

It can be challenging, even overwhelming, to maintain a close and trusting relationship with someone prone to pathological lying. The constant uncertainty and broken trust make it difficult to have such a person in your life. If the pathological liar is a close friend, family member, or even a spouse, learning to cope with them is crucial to your own well-being.

First, it’s important to recognize that pathological lying is often a compulsion rather than a deliberate act of deceit. Much like a compulsive overeater who might not make a conscious choice to stuff themselves to the point of getting sick or causing health problems, the pathological liar probably isn’t choosing to intentionally spew falsehoods but is instead struggling with an overwhelming urge to fabricate.

You should also understand that pathological lying is usually not the underlying issue. Rather, it’s typically a symptom or manifestation of an underlying mental health condition. If you share a close relationship with a pathological liar, consider gently encouraging them to seek professional help. If you can compel them to address the root cause of the issue, you can play an active role in their healing process.

Is There Treatment for Pathological Lying?

Because it isn’t a standalone medical condition, pathological lying doesn’t have a specific treatment. That said, it can often be treated by addressing the underlying mental health issue that causes it. For instance, if pathological lying is the result of a personality disorder, such as dissociative identity or borderline personality, treatments such as medication and cognitive behavioral therapy can make a major difference.

Getting help for mental health issues, including conditions that may lead to pathological lying, can be a critical step. Contact FHE Health today to learn more about our comprehensive treatment options.