What is Anosognosia Why Some People Stop Taking Their Meds?
It’s well known that many people with serious mental illnesses, like bipolar disorder or schizophrenia, don’t take their prescribed medication. One major reason for this behavior is anosognosia, a word of Greek origin that roughly translates to “without knowledge of the disease.” You may also hear it called “lack of insight.” What it boils down to is that the person is unaware of their condition and unable to accept it. Someone with anosognosia isn’t simply in denial or being stubborn. Their brain can’t process the fact that their thoughts and moods don’t reflect reality.
What Is Anosognosia?
To be clear, denial is not a mental disorder; however, people often mistakenly believe that anosognosia is denial. Also referred to as anosognosia psychosis, anosognosia is a Greek word that roughly translates to “without knowledge of disease” or “lack of insight.” This word is often used to describe people who are not denying mental health problems but are rather unaware of their condition. Many people with severe mental conditions like bipolar disorder and schizophrenia struggle with anosognosia, which is often why they don’t take their medications.
One study on anosognosia in people with schizophrenia and bipolar disorder sampled 412 people and found that approximately 30% of the ones with schizophrenia and 20% of the ones with bipolar disorder experienced a “severe” lack of self-awareness of their diagnosis. Mental illness denial is very different from a lack of understanding or insight into your condition.
As a mental therapy center in Florida, we understand how difficult it is to treat and care for patients with anosognosia. While a misdiagnosis of a mental illness can complicate matters, the situation becomes equally as difficult if the individual is simply unaware of their condition. Learning to understand this condition is crucial for ensuring affected individuals get the help they need.
What Causes Anosognosia?
Some experts believe that anosognosia is caused by brain damage in certain regions of the brain involved with self-reflection. The frontal lobe of the brain is responsible for functions like memory, emotions, impulse control, problem-solving, socializing, motor function, and of course, self-reflection and image. Regardless of your age or status, your self-image is constantly being updated. Whenever you gain new information – whether it’s a new haircut or weight changes – it affects how you think about yourself. As you can imagine, this is a never-ending, complex process. For this process to go smoothly, the frontal lobe of your brain has to absorb the new information, process it, and use it to basically “edit” your self-image.
When the brain’s frontal lobe is damaged, which is a common issue in people with conditions like schizophrenia and bipolar disorder, your self-image is affected. Your brain can no longer absorb and process new information to update how you see yourself. For a person who requires schizophrenia or bipolar disorder treatment, this can be a hindrance to their recovery.
However, anosognosia isn’t an either-or condition. Some people only partially lose the ability to see themselves clearly, and in others, the condition comes and goes. This can be especially confusing to loved ones who are trying to help. It’s hard to understand how someone can completely understand their condition in one moment and then claim they’re perfectly fine in the next. That’s why people are always comparing anosognosia vs denial.
Are You Suffering From Anosognosia?
Denial is a natural human defense mechanism that kicks in when our mental or physical equilibrium is so powerfully disturbed that it makes us extremely anxious and terrified to admit something actually exists. A form of emotional repression, denial is not a healthy way for someone to cope with disruptive and disturbing situations. But the human drive to maintain psychological and physiological homeostasis is so strong that when faced with seemingly insurmountable difficulties, your subconscious steps forward and asserts denial as a coping mechanism.
Denial is a way to repress emotions so unpleasant and trenchant that possible serious psychological damage could affect those who can’t cope with unpleasant facts about themselves or others. Mentally ill individuals with anosognosia refuse to think about how their bipolar or schizoaffective disorder is impacting family, friends, and themselves. Failing to acknowledge the consequences of not getting treatment for their mental illness is one way for people with anosognosia to avoid feeling a strong sense of guilt and responsibility.
Identifying Anosognosia Symptoms
Why it Matters
Being able to recognize anosognosia in a loved one is important. When someone with a serious mental disorder insists that they’re perfectly fine or aren’t as sick as they’re believed to be, the situation can quickly spiral out of control. When a person with a mental disorder develops anosognosia, they may not take their medications or complete their treatment. In their head, they’re thinking, “Why would I take a drug if there’s nothing wrong with me?”
As a result of not taking their medication, their symptoms may come back or get worse. Depending on their condition, they may begin to suffer from episodes of psychosis, mania, depression, or even engage in risky or reckless behaviors.  Homelessness, arrest, and even suicide become more likely risks, as well.
The most notable symptom of anosognosia is a lack of understanding, awareness, or acceptance of your condition. It’s even possible for you to develop this condition even if there’s extensive evidence that you do.
Some other signs of anosognosia include:
- Bluntly acknowledging that they think they’re fine or that nothing is wrong with them
- Avoiding talking about their condition because they think no one believes them
- Becoming frustrated or confused when people contradict what they believe to be true
- Missing appointments or treatments with their physicians or therapists
- Skipping or forgetting to take their medication
- Acknowledging some symptoms of their conditions, but not others
Remember that anosognosia isn’t an all-or-nothing condition but rather a spectrum that people can move back and forth on. Therefore, it’s important to pay attention to the person’s behavior. While you may think that they’re just trying to ignore their condition to cope, they may actually believe that they’re fine when they aren’t. Be sure to communicate with them.
Finding Mental Health Treatment
It’s estimated that 50% to 90% of people with schizophrenia and 40% of people with bipolar disorder suffer from anosognosia or severe lack of insight. If your loved one falls into these categories, we can help. We Level Up FL offers both bipolar disorder and schizophrenia treatment, among a variety of other programs to assist as many patients as possible.
Who’s at Risk
Anosognosia is common in people with serious mental illnesses. Doctors think about 40% of people with bipolar disorder and 50% of those with schizophrenia have it. Some psychiatrists believe the numbers are even higher. They estimate that anywhere from 57%-98% of people with schizophrenia have it.
Many people with neurological disorders have this condition. It isn’t unusual for someone with Alzheimer’s to get it. Stroke patients often do, too.
Treatment for Anosognosia
Anosognosia isn’t easy to treat. If you can persuade someone who has it to keep taking or restart their medication, then it might get better. About one-third of people with schizophrenia who take their medication have improvements in insight into their condition.
A therapist can also try an approach called motivational enhancement therapy (MET). This type of talk therapy is designed to help someone understand the benefits of changing their behavior.
If a loved one has anosognosia, sometimes it’s best not to try to convince them that they’re ill. Instead, talk about their goals, such as keeping a job or living on their own. This might encourage them to meet with a mental health professional, even if they don’t think they need it for their health and well-being. Someone with anosognosia can be at risk of harming themselves or others. If this is the case, a family member or mental health professional may have to take legal action. Laws vary by state, but you might have to admit someone with a serious mental illness to the hospital against their will.
Reclaim your life from Anosognosia, We Level Up Center Florida
At We Level Up Florida Treatment Center, we provide world-class care with round-the-clock medical professionals available to help you cope. In addition, we work as an integrated team providing information about the anosognosia and other aspects of treatment. Make this your opportunity to reclaim your life. Call today to speak with one of our treatment specialists. Our specialists know what you are going through and will answer any of your questions.
Your call is private and confidential, and there is never any obligation.
 NIH – Bipolar Disorder