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.

Impaired awareness of illness is a strange thing. To others, psychiatric symptoms seem so obvious it’s hard to believe the person experiencing them is not aware 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 (also known as "lack of insight")?
• 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?
• Can a person be partially aware of his/her illness?
• Are there ways to improve a person's awareness of illness?
• Why is impaired awareness of illness important in schizophrenia and bipolar disorder?  

Additional information about anosognosia is available through the following links:

• STUDY: "The anatomical basis of anosognosia" - the first published summary of recent research investigating changes to the brain in individuals with lack of insight into mental illness (August 2012) 
• BACKGROUNDER: "Why individuals with severe psychiatric disorders often do not take their medications" - updated April 2011
• BACKGROUNDER: "How unawareness of illness (anosognosia) increases violent behavior in individuals with serious mental illnesses" - March 2011 
• ARTICLE: "Anosognosia, denial and the new antipsychiatry" - Dr. E. Fuller Torrey takes on the argument that anosognosia doesn't exist (October 2012) 
• BLOG: "Why we talk about anosognosia" - We talk about ansosgnosia because our mission is eliminating barriers to treatment, and not recognizing ones' own need for treatment is a huge one (August 2012)
• BLOG: "Anosognosia is blindness - personally speaking" - Dr. David Hager, a practicing psychiatrist, on anosognosia in the clinical setting (May 2012)
• VIDEO: "Anosognosia" - a four-minute video that includes dramatic in someone actively suffering symptoms and what people experiencing it need. 
• VIDEO: "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. (2010)

More links are available by clicking on the keywords that appear at the bottom of this page.