No insight also known as Anosognosia

Hello, Just a friendly question. How many of you, have your loved ones with no insight into their illness also known as Anosognosia? Are there any loved ones who became ill and then got insight? The reason I am asking this question is my son had his first psychotic episode 4 years ago and took medication for little over 2 years . It took him 2 years to start medication because he didn’t think he needed it. Then even after 2 years of taking medication he decided to quit taking it. I am just looking for some answers for myself and for my family. Thanks. Sending warm hugs and positive thoughts to everyone.

Hi Lenora,

It can be frustrating…
My partner was diagnosed with sz 8 years ago. Efforts to get him to see that he is ill are frequently fraught with frustration and met with denial and/or anger.
In my case there were situations where his lack of insight could at times, create dangerous situations due to his mis-use of alcohol (he would rather self-medicate with alcohol then take medicine)
@BarbieBF has a lot a useful links to offer help on what to do and where to go.
I hope you and your family will get through this. xx

I wish that I could give some answers. My son recently went off his Invega. To a certain degree he recognizes having schizophrenia but seems to only recognize paranoia as a bad symptom. The rest he wants to experience once he starts down that path. Insight seems to come mostly from being on medications yet going off them when things are going good is common.

Recently I started this thread that you may find interesting:

Treatment Advocacy Center - under problems you will see anosognosia
Anosognosia looks like denial but is different.

I’m sorry that your son decided to go off his medications. It is hard to watch them struggle. At one point it helped to discuss meds with my son from the viewpoint of regulating neurotransmitters like dopamine. However now that he is cycling again, he likes his own world better. I really don’t know how to fight that.

My pdoc says I have “poor insight”. I’ve had one “full” psychotic episode a year ago. Before that, I was pretty functional. I had a job, family, and I could fake what I needed to to get by.

After the break, I now deal with a lot of the “negative” symptoms. The meds do not seem to help me with those, and make it harder, for me, to fake normal in public.

I know something is wrong, but I feel like it’s ALWAYS been wrong. Not only am I used to it, it’s real.

Has he tried different AAPs?

@BarbieBF and @ Becca Thanks. I went through Barbie’s topic and read all the replies. But right now 2 months without medication my son is doing better than while he was on medication. The psychiatrist has clearly told that the symptoms will return within 6 months and even if they don’t, they can re appear at any time. He sleeps well but his voices and delusions remain the same from day 1 when he first experienced Psychosis. 2 years medication didn’t do much for him. Thanks again.

I’ve been lucky so far. Once the first psychotic episode with paranoia kicked in, my son became willing to listen, and after a night spent sleeping outside went for meds the next morning, and they worked very quickly (low dose of risperdal). He had some denial at about six months, came off them, then back on again within two weeks. Now struggling with negative symptoms, but otherwise coping. But he doesn’t live with me, which perhaps pushes him into taking care of himself. Also, when it came on I framed it as a physical (genetic) illness with behavioural/mental symptoms. I said there’s no cure, but there’s treatment and it can give you a chance at a decent life, like insulin for diabetes. You can get better. All his life he has watched me deal with diabetes (type 1) so maybe all that made it seem more manageable to him, less frightening.

I know this can change. People can lose as well as gain insight. I just pray he stays well now.

I’ve been ill since my teens. While I knew I had schizoaffective/schizophrenia, like I know Paris is the capital of France, I just didn’t feel it, I didn’t take it to heart. It was just academic knowledge. If someone would ask me, I’d tell them that, yes, I am a schizophrenic. I just didn’t feel it.

That understanding, taking it to heart and believing it, accepting it, took many more years.

I have a good friend who like myself has schizophrenia. He does take medication for it, he understands he has schizophrenia, but he believes everything going on in his mind is real. The funny thing is he’ll refer to them as delusions and yet when I’ve told him “you know Jon these things aren’t real” He’ll just give me this look as if it’s me who’s the one believing I am sponsored by a sadistic skeleton sky god.

I figure as long as he takes his medicine and at least makes an effort to abstain from the drugs then what he believes is real is his business.

This is exactly how it felt for my brother. As an outsider looking in, to me, it felt like it was all a bit academic. He was told what he had, he understood that, but he didn’t seem to feel it. He couldn’t relate to it.

He knew things were harder then they should be, he knew he was falling behind in life, but he couldn’t accept the diagnosis for a long time.

As someone on the outside looking in, I believe he did have insight, he knew he was ill. He reached for the specific drugs he reached for; due to a specific reason. The XTC was always for a very specific reason and was taken the same way, for the same thing. He didn’t just party on it because he had no will power. The XTC was for a very specific way he felt, a very specific symptom.

He would say he was schizophrenic, but I don’t think the magnitude of the diagnosis sank in until he got clean and sober.

I was told I was schizophrenic then schizoaffective but it was only years later that I probed into what that meant. It meant little more than saying I’m left handed. The last note on insight said ‘poor’ then a few years later they changed the diagnosis. It’s funny how you can have ‘poor insight’ about something they later decide you don’t have . Anosognosia should be about not realising you are ill/have problems but all too often it’s a code for ‘Didn’t see eye to eye with the pdoc’.