Anne is a freelancer with a passion for writing and helping others by writing about important topics and issues.
Anosognosia is a term in the mental health field derived from several Greek root words meaning “not or without”, “disease”, and “knowing”. Simply put, anosognosia is the phenomenon of not knowing that you have an ailment or disease. In the realm of mental illness, this is a common occurrence with many persons experiencing mental illness, as they can sometimes seem blissfully unaware of their symptoms. Sometimes, family members might label persons with anosognosia as being “in denial” that they have a mental illness. This refusal to accept a mental health diagnosis is often a harsh reality for many people. Families must cope with the fact that their loved ones may or may not ever get treatment or help for their symptoms, and those with mental illness feel frustrated that no one believes them or is on their side.
Facts About Anosognosia
According to the National Alliance on Mental Illness, “anosognosia affects 50% of people with schizophrenia and 40% of people with bipolar disorder”. While these are the main mental disorders that tend to have higher anosognosia trends, other mental illnesses also may include persons that are in denial that they have a disorder or mental illness. Depression, borderline personality disorder, anxiety disorders, and OCD can all be mental illnesses in which persons may be more likely to experience anosognosia at some point. The reason for this is because of the basic idea that one's reality and perspective of the world is the "right" and "correct" way. For instance, many people described persons with borderline personality disorder as seeing everything in black and white. There are no gray areas, and therefore it is difficult for them to conceptualize the gray areas of life and situations. Instead, everything is either "all good" or "all bad". This can have a detrimental impact on the person's relationships and family. As a result, persons with BPD will often only see things "their way", firmly believing that everyone else is against them. This can make it extremely difficult for someone with BPD to go in and get treatment for the disorder, as they do not believe anything is wrong. They firmly and truly believe in the possible distorted realities and delusions that they perceive in their everyday life.
How Does This Impact Treatment?
Unfortunately, anosognosia often leads to conflicts with family members and friends, as well as a refusal to seek treatment for mental illness symptoms. As such, this can be very concerning for family members, especially if the mental illness is so severe that the person is more likely to act in dangerous and impulsive ways. However, those with mental illness will not see things in quite the same way. When someone feels like they are not being heard, they are often more likely to fight back against persons that are trying to help them. The National Alliance on Mental Illness states that anosognosia is “the most common reason for people to stop taking their medications.”
It is also important to note that the idea of anosognosia can start at the time of diagnosis, or after the diagnosis of a mental illness. For instance, a person with bipolar disorder may have previously been diagnosed and accepted that diagnosis. However, after taking their antidepressant medication and mood stabilizers for several months, they decide that they are “cured” and therefore no longer have bipolar disorder. However, the fact is that mental illness is not something that can be cured. It is an illness that will stay with a person for the rest of their lives. Symptoms can improve and they can live fulfilled lives with mental illness, but the consequences of stopping the medication because one believes they aren’t experiencing symptoms anymore can be dangerous. Stopping any medication, especially a medication such as a mood stabilizer or antidepressant, is not advised by psychiatrists or doctors because it can have severe consequences not only on the mental health of a person but also on their physical health. There is the potential for brain chemical imbalances to alter physical health and cause alarming symptoms. Despite these major health consequences, there are many people every day that will quit taking their medications because they believe they are cured or that they don't actually have a mental illness.
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What Can We Do About It?
There isn’t much to say about what can be done to prevent anosognosia. The best family and friends can do for someone suffering from a mental illness that is in denial is to support them, be there for them, and listen to them. You cannot force someone to get help; they must come to that conclusion themselves. Interventions rarely work because the person feels ostracized and pressured to give in to a diagnosis. Instead, to help support persons with mental illness that are refusing treatment, we must listen and stay involved in their lives. Those with mental illness who have support systems in place and plenty of social opportunities are less likely to have severe issues with their mental illness, especially with young adults and teens. This is why socialization and education in relation to mental illness is so important.
Additionally, because of the stigma against mental illness, many people feel like they are fighting the negative stereotypes and stigmas associated with a disorder on a daily basis. They don’t want to admit they have a disorder because they don’t want to appear “weak” or “problematic” to society. Maybe they were brought up in a household that viewed mental illness as a weakness or as a fake illness. These types of environmental factors also have a significant impact on whether or not a person with mental illness may develop anosognosia.
With all that being said, the most important thing for us to do is to raise awareness about anosognosia so that we may help prevent it in the future. To conclude, anosognosia is a frustrating and often overlooked phenomenon in the mental health field. It is the reason that a lot of current mental illness statistics might not even be that accurate; there are many people that may have a mental illness but have not been diagnosed. In order to combat the concerns with lack of diagnosis and treatment, we must raise awareness about this phenomenon. If you know someone that may be in denial about their own mental health, you may have a conversation with them, but don’t be accusatory. Learn to hear what their perception and experience is and use that as a stepping stone to help them move forward. One day, we might be able to prevent anosognosia from occurring, but first, we must continue to educate everyone about this so that we can start learning about it. Helping to educate and prevent anosognosia will bring us one step further to ending the stigma of mental illness in our modern society.
“Anosognosia.” NAMI, National Alliance on Mental Illness, Mar. 2015, https://www.nami.org/About-Mental-Illness/Common-with-Mental-Illness/Anosognosia.
This content is accurate and true to the best of the author’s knowledge and is not meant to substitute for formal and individualized advice from a qualified professional.
© 2022 Anne Marie Carr