Impaired or lack awareness of illness - a neurological syndrome called anosognosia - is believed to be the single largest reason why individuals with schizophrenia and bipolar disorder do not take their medications. It is caused by damage to specific parts of the brain, especially the right hemisphere, and affects approximately 50 percent of individuals with schizophrenia and 40 percent of individuals with bipolar disorder. When taking medications, awareness of illness improves in some patients.
Impaired awareness of illness is a strange thing. To others, psychiatric symptoms seem so obvious that it’s hard to believe the person experiencing them is not aware that he/she is ill. Oliver Sacks, in his book The Man Who Mistook His Wife for a Hat, noted this problem: "It is not only difficult, it is impossible for patients with certain right-hemisphere syndromes to know their own problems.... And it is singularly difficult, for even the most sensitive observer, to picture the inner state, the 'situation' of such patients, for this is almost unimaginably remote from anything he himself has ever known."
Click here to for answers to these frequently asked questions about anosognosia:
What is impaired or lack of awareness of illness?
How big a problem is it?
Is this a new problem? I've never heard of it before.
Is impaired awareness of illness the same thing as denial of illness?
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Why is impaired awareness of illness important in schizophrenia and bipolar disorder?
Additional information about anosognosia is available through the following links:
- "Confronting anosognosia: How to get help to those who don't know they're sick" - a Treatment Advocacy Center video featuring Xavier Amador Ph.D., Jonathan Stanley, JD, and Delaney Ruston, M.D.
Why individuals with severe psychiatric disorders often do not take their medications - backgrounder from the Treatment Advocacy Center (updated April 2011)
Anosognosia: A cause of violent behavior in individuals with severe psychiatric disorders - Backgrounder (updated March 2011)
The difficulty in seeing your own illness – NAMI Advocate (2011)
Anosognosia fact sheet - NAMI
More links are available by clicking on the keywords that appear at the bottom of this page.
