Everyday health - When Schizophrenics Don't Recognize Their Illness

It’s not uncommon for those with schizophrenia to say they aren’t sick — and for caregivers, it’s a huge problem.

Ever heard of anosognosia?

This word means that a patient does not recognize or understand the nature of his illness. People sometimes experience anosognosia after strokes or brain injuries, and with diseases of the brain like Alzheimer’s. Also called “lack of insight,” anosognosia is also a big problem for people with schizophrenia.

Ken Duckworth, MD, medical director of the National Alliance on Mental Illness and an assistant professor of medicine at Harvard Medical School in Boston, explains, “Half of all people with schizophrenia don’t recognize that they’re sick.”

I was like this for the majority of the time I was sick which was about six years. I believed for most of that time that what I was experiencing was real. The only treatment I was interested in during this time was presenting myself as someone with ADD and anxiety so I could get adderal and Xanax. I refused to see any doctor my family was trying to get me to see out of fear that they would lock me away somewhere.

I’ve always thought though that the term “lack of insight” doesn’t quite describe what I was going through. It wasn’t that I lacked insight, it was that what I was experiencing was so real, so convincing and honestly so interesting that it consumed my mind.

I did recover but only after years of believing it was real, believing I could receive and transmit thoughts, believing all sorts of things based on my false memories…delusions. But I did recover. It wasn’t a lack of insight though, it was that it was all so seemingly real and thus very convincing.

The article said it is logical for patients not to take medicine if they do not aware of they are mentally sick. It happened to me before, I am quite a bit “lack of insight” to-date. I am medication compliance because I understand I am sick, not because I realize my brain is in disordered state.
Thanks BarbieBF for sharing.

I can relate also. It’s heartbreaking because you want to help so badly…
I think all caregivers are hoping for that “eureka” moment from their loved one…

I agree that the term ‘lack of insight’ doesn’t quit cut it :smile:

What you were experiencing goes beyond a matter of insight. I prefer anosognosia as it seems to understand that what you experienced is part of a bigger picture. Sorry not sure what I’m trying to say except that I think I understand.

I think to sum it up succinctly - What separates Schizophrenics from Spiritualists and Artists is lack of rationality resulting from panic.

Personally I believe a lot of this could be avoided if compulsory Philosophy and Psuedo-Science classes were implemented in Highschools.

For some an abrupt transition takes place in their early twenties (like myself) where they go to bed stupid but wake up a genius not immediately realizing it.

People start taking more notice of their thought processes, how they relate to the environment, and all those non-nonsensical songs begin making sense. Rather spooky I should say…hence my idea for the Highschool course.

I do agree with the fact that “lack of insight” just doesn’t cut it. My brain just could NOT make the connection as to why my behavior landed me in hospital. I never understood that.

Meds alone didn’t work for me. I needed therapy too so someone could lay out… when action A happens… Action B is the result… and then your in hospital.

I have had brief periods of elation or elevated energy, but I never feel like super happy it’s more like I’m inspired or my mind races. I’ve learned to slow down my thoughts and self control that helps control my symptoms. I do recognize that on occasion I’ve misread things, but looking back I saw a reason for everything I was saying or doing even though people didn’t understand, they also didn’t listen to me. I’m pretty sure I have Bipolar, but I was originally labelled with schizophrenia and opposed it. I don’t think it helped to be given that label. If anything it just marginalized me. Also, psychiatrists and therapists seem to exaggerate things a lot. For instance, I had a therapist who pressured me to visualize things and seemed to think she could unlock some source of suffering, and wrote in my files one of our visualizations and called it a hallucination. Like she was pushing the whole diagnosis forwards. And every day it was pressure to take medication and not go crazy, all the while not being sure I really was crazy or schizophrenic. While my dad is telling me I’m sick every day, “you’re sick. you need medicine” this will fix you. And the medicine is making me dysphoric for the first three months and feelings like I’m high. Abilify made me feel melancholy and high all the time. It made me more manic then normal, and I thought next I’ll be given a mood disorder or be called borderline like mom. And eventually that’s what they do, using my mother as the basis of their diagnoses and saying that it’s genetic, then later telling me to forget about my mom because she’ll never get helped.

I was in a deep lack of insight state for years (Anosognosia) for years- I was delusional as heck but did not know- as soon as I took my first couple of doses of an antipsychotic Bam!! Complete insight!


From my perspective on what I went through I believe that it may look from the outside, especially to someone who has never experienced symptoms such as these, to be an issue of lack of insight. But having been through it myself and having been close to others actively in the grips of this illness, I must say that it is possible to believe in delusions and hallucinations while one’s ability of insight and reason remains intact. I’ve seen it first hand as well as experienced it first hand. My good friend jcal for instance, seeing him go through psychosis I have to say that despite being delusional and experiencing hallucinations he remained the insightful and rational person I knew in all but the very worst of it. I myself, when I was suffering from my delusions and hallucinations was in a similar way as him. I don’t feel I ever really lacked insight, I was just as insightful a person sick than I had been sane. I was even, while completely delusional, also at the same time rational. I was fully capable the entire time of entertaining the possibility that what I was experiencing could be false perceptions and yet what made it possible for these perceptions to consume my mind was not something I lacked but that what I was experiencing was so very convincing, so seemingly real and so complex and clever that even the rational regions of my mind had a difficult time with the possibility, the chances of a mind gone haywire developing, creating something that made so much darn sense. I feel as though if what I was experiencing was more a clear cut case of schizophrenia or any mental illness it would have been much easier to come to that conclusion, that it was just an illness. But it was anything but this. I’ve been told that the way my illness manifested it’s self sounds unlike anything ever heard by any professional with the time to listen to the intricacies and content. It was as if the subconscious reaches of my mind, having gone haywire, wrote unbeknownst to me a novel, an opus, a saga consisting of memories complete with dialogue and remembrances of even the physical pain of being raped or having an ice pick punched through my tear duct during my fictional lobotomy.

Perceiving is believing…what it takes to come to the opposite conclusion is far beyond a matter of insight.

I didn’t know I was sick for a year. Now I have written papers and given presentations on schizophrenia in honors classes and made A’s on them.

Schizophrenia is different, its not like a physical illness where you experience abnormal things and see a doctor and get immediately diagnosed with cancer, parkinsons, diabetes, ect. No, lots of schizophrenics think that their symptoms are real and dont recognize them as abnormal. I had Truman’s Syndrome, as it is informally called, the delusion where you think you are being filmed and put on TV or the web. I remember searching for myself on google trying to find the show of my life. Not sane, not fun either.

I think I have this problem. But my “caregivers” or should I say parents have the same problem too. They won’t, can’t, don’t accept I have an illness.

In the beginning, whenever I was hospitalized it seemed to me like I was the one being reasonable, and everyone else was being irrational. I think that’s true of a lot of people, which can make things exasperating for mental health professionals.

Psychiatrist will attempt to keep you at Ground Zero while finding meds to help calm you down. The meds slowed my thoughts down enough to overcome my nerves and begin thinking more constructively.

This led to me realizing that not all of the ‘crazy’ ideas which I was having were necessarily crazy however panicking and acting dangerously irrational (which I never did) is what merits the ‘delusional’ label. Otherwise, if just taking notice of lesser mentioned strange sciences and coming to understand why there is a huge hoo-ha about reailty resulting in many different organized religions…well you’ve more or less gone the way of the artists, scientists, spritualists

As with anything…see it as a challenge and learn from it. What made things difficult for me was trying to force pretend I was daft instead of just turning to face that which I was running from and learn more about it.

During the decade I was on the lamb desperately attempting to ignore the random odd occurrences I was only upset more because I would just happily settle back down into the Ground Zero perspective only to be rudely spooked out of it again.

Imagine having a key to a hidden passage but the door was invisible except to u.

The way it made sense to me finally is that heartbreak is normally the main catalyst that starts the MI cycle.
It brings us to realization that the world is broken and not operating on par to how we feel it should.

Where our notions of ‘How things should work’ come from, I am still not sure but even that which would seem common default knowledge (that does not need to be taught) is broken in most around us as well.

From this point forward some begin asking how things can be fixed and here in is the point where I went to bed one night stupid and woke up the next day smart.

The the main problems stem from lack of information being easily available yet, with some thought, we can see why it isn’t easily available.

Other issues involve society and family (whom we depend on) being too submersed in the Ground Zero perception and heavily stressed because they don’t care to dream for a more sophisticated life beyond jumping flaming hoops for scraps (ie; "I carried an M16 in the Army and you…you…you…carry that electric “twanger”! " ). This causes them to always impose “There is no time for thinking; only doing!”

Having gone on for centuries like this mankind only marginally moves forward from the Dark Ages…still leaving everyone in the dark.

And so the plight for most of those stricken with Mental Illness is similar to “The Village Idiot” who eventually saves the day because it is left to them to have to explore and investigate what most would dare not.

Here in investigating triggers and rabbit holes, while never settling for any strong conviction, becomes more of a learning experience serving as a gymnasium that strengthens the intellect.

So no matter what new delusion one wakes up to in the morning, as long as it is accepted as only “theory” (and not acted on destructively)…that which does not kill us only makes us stranger and stronger.

And there is absolutely nothing wrong with being “Strange”; there’s an interesting, charming, and rare uniquity to it.

I’m also taking the thread in this direction to point out that some don’t need to “Recognize” their “Illness” if they’ve found a constructive manner in which to use it…

i am not sz
i am not sz
i am not sz
i am not sz
i am not sz

take care

Yes. Yes. Yes.
Never seems to come though. I never manage to shake the hope that he might wake up one day and “snap out of it.”

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