Anosognosia – “lack of insight” or “lack of awareness” – is believed to be the single largest reason why individuals with schizophrenia and bipolar disorder do not take their medications. A result of anatomical damage to the brain, it affects approximately 50% of individuals with schizophrenia and 40% of individuals with bipolar disorder. When taking medications, awareness of illness improves in some patients.” ~from The Treatment Advocacy Center’s website

Treatment Advocacy Center – Anosognosia

I didn’t have anosognosia, so I don’t have the experience or ability to offer you a personal account of it. I knew I had a problem. Even before getting help in January 1997, I researched schizophrenia. In fact, while I was homeless in Seattle, I carried around a piece of yellow legal pad paper that had the following words written on it:

“I think I’m schizophrenic.”

Still, the delusions were so convincing. Convincing isn’t the right word for it, in fact. They were as much a part of me as cocoa is to hot chocolate. Without them, I — as I knew myself — would have been nonexistent.

Anosognosia must be a very difficult affliction. Bewildering, I would imagine, for onlookers. Even more bewildering for those with it.

If you have experience with anosognosia or if you know of someone who has experience with this, perhaps you would not mind leaving a comment here explaining what that was like for you. Those comments could be very helpful for those families who are going through it now. They may even be read by someone whose life you can affect in a very positive way.

Take care…



8 thoughts on “Anosognosia

  1. mhowe91 August 17, 2013 at 5:19 pm Reply

    Edwin, found your blog today and have really enjoyed reading your posts. As for anosognosia, it is very real and very debilitating. When I was first diagnosed I refused to admit that I had a brain disorder and I refused to take medication. The side effects of zyprexa were too severe at the time and I honestly didn’t believe I had a psych problem. Fast forward 13 years – I currently consider my insight to be strong, having been stable for nearly 2 years. I know that if I miss an injection, or start tweaking my dosages I’m in for a whole new world of pain. Some of us are able to nail this thing down early. For others, it takes a lot of trial and error. I think it’s taken me this long to get stable because I never knew how bad it could get. My last episode led me to jail where I spent two months for breaking a pay phone. I understand now that if I make one mistake the consequences are severe – for myself and my family. Hope this helps someone.

    • Edwin August 17, 2013 at 5:29 pm Reply

      Hello, mhowe:

      First, thank you for your very kind words. I didn’t have a whole of time (supper in 5 minutes), but I did skim over your blog. Looks nice and I will make it a point to return to it later.

      Yeah, I wasn’t questioning whether or not anosognosia was real or not, and I am certain that it is debilitating. I was just after opening the topic up for discussion.

      Do you think there are degrees of insight? What I mean is this: Do you think insight is an either/or phenomenon? I think I had pretty good insight, yet I dealt with the disorder unmedicated for such a long time that I had some difficulty discerning certain things.

      I knew I had a problem. At times, I thought it was sz, but the certainty level wasn’t there — until I started meds.

      Anyway, thank you for your insights and sharing your experience with anosognosia.

      And, welcome to my blog! Hope to see you around.

      Take care…


      • mhowe91 August 17, 2013 at 5:56 pm

        Hi Edwin, my apologies on the tone of my comment. I just wanted to reiterate what you had already stated.

        You bring up an interesting question. I would say, in my experience, that there are degrees of insight.

        Throughout my years of living with this illness, I only recently discovered the idea of acceptance. Like, if I accept that what I have is real, and I do something to effectively treat it, then I may be able to accomplish some goals. This didn’t happen all at once for me. It’s a progression of sorts. But, just realizing that I needed medicine to keep me stable was great insight given my history of non-compliance and psychotic behavior. And, then when I was stable I started to see my life improving in other areas. Without sounding grandiose, now I’m able to see that I can make a difference and help some people.

        For me, I think that my insight compounds. Like, the longer I’m stable, and the more I contribute, the more insight I gain. And, I don’t mean “contribute” in a paying work sense. More like, sharing my story, listening to a friend, or just smiling at a stranger. These are all simple acts that have a great impact.

        Thanks for checking out my blog! Hopefully it will evolve into a decent resource with time. Just started it up a few days ago.

        Take care,


  2. Edwin August 17, 2013 at 6:41 pm Reply

    Awesome. You are very articulate. I look forward to reading your work! 🙂

    And, I can relate to the “contributing” with simple acts.

    Have a good one!


    • mhowe91 August 17, 2013 at 6:45 pm Reply

      Thank you, Edwin! I’ll stay tuned to your blog as well.

      All the best to you,


  3. lisri August 24, 2013 at 9:08 am Reply

    Hi, Edwin, Thank you for the links on the asognosia. It was very enlightening and informative. Scott is only 23 and only “officially” diagnosed with schizophrenia for 1 year. I have utilized all of the resources and alot of your personal sharing and insight to become more able to understand and advocate for Scott. I attended the NAMI family to family sessions and gained alot of great resources and understanding there, also. I’ve read most of the books you recommended.
    The recent insight to asognosia that you’ve led me to is interesting. I am not sure if Scott’s lack of insight into his illness is the normal “denial”/coping process of accepting that you have an illness, or if it is true asognosia.
    I am leaning more towards the asognosia, but hoping it is more the “denial.”
    He is refusing to take the prescribed Abilify. He had a 10 day hospitalization in June due to being psychotic, and was prescribed injectable haldoldex monthly. The first shot was given in the hospital. And he was taking daily Abilify with that discharge. He’s had 2 subsequent psych MD appts and refused the injections. He’s outright refusing the Abilify for 2 weeks now, and I’m not sure that he was swallowing it prior to that.
    His main reason for not taking the Abilify is that he doesn’t believe he has schizophrenia.
    I’m charting his sleeping, behavior, activity and pain levels and staying partnered with him for support and trust.
    I was able to proceed with becoming his guardian for finance and medical after his hospitalization in June, and he was in agreement with it. I am now maneuvering and hoping to be a good “guardian” for him to figure out how to get the medication into him to prevent the psychotic episodes and possible progressive damage to his brain. (aside from the risks of jail, etc.with irrational behavior).
    One day at a time is a great way to live.
    I love him dearly and only want the best for him!

  4. Edwin August 24, 2013 at 6:58 pm Reply

    Regarding your comment:

    I’m not sure what to say. It choked me up. That doesn’t happen all that often.

    I want you to know that you are doing everything you can for your son — all of the right things. Your son is very lucky.

    I know you’ve read the “Getting Help For a Loved One” series. Thanks. All I can say is that it is more difficult than simply following a book or a lecture or advice on a blog, isn’t it? I know it is also.

    Please keep up the outstanding work. I know you know that your son is fighting the battle of his life. And knowing that — having that education — will help you…and your son.

    Finally, are you taking time for yourself? I can’t overstate how even a few hours a week to do something for you will help not only you but your son also.

    Take care and you and your son will be in my thoughts…


    • Lisa August 25, 2013 at 9:13 am Reply

      Hey, Edwin,
      Thanks for the reminder to take care of myself! Yes, that is a key to my own balance. I like to try to read a little each day. We live close to the beach , so that’s good for both Scott and me. When I went to the family to family meetings thru NAMI I felt that I was a step ahead because of my connection with you. I was able to share some of what you taught me to the group, especially the relational/partnership/trust aspect of living with sz. You are helping many others!!! Thank you!

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