Two terms defined:
Anosognosia: I don't have a problem. Lack of awareness, lack of insight of disorder or symptoms.
Anosognosia: A lack of awareness that one has a problem, including depression, PTSD, bipolar mood swings, or narcissistic behavior. This lack of awareness is caused by the brain not fully functioning. This is not "denial" of a problem, where a person has "some" awareness of the problem.
With anosognosia, sufferers may stop medication, act out on others, withdraw, or do other things in response to not knowing they have a BRAIN DISORDER problem. For instance, a PTSD sufferer may rage at store clerks often, thinking this is justified. A PTSD sufferer could also withdraw and become agoraphobic (fear of going out or being around others). And, a bipolar person could have mood cycles and not realize that: not helping themselves during typical and repeating depression, or doing things without thought during hypomania or mania (such as "again Sue went to the mall in a great mood, chatted with strangers all day, bought a lost person lunch, and bought 10 more pair of shoes).
Anosognosia also is a part of ADD, ADHD, and Dyslexia: a person does not know that they are in their symptoms, and often must stop and self monitor or get feedback from another. For instance, a ADHD boy needs to be reminded to have his quiet time, or an ADD or Dyslexia person needs to implement and use their organization or task finishing skills if their medications are not working, or as with Adderall, has not kicked in yet.
Clearly, there are disorders which are defined by lack of awareness. The person has no insight into the problem and gaining insight is most impossible: schizophrenia, schizoaffective disorder, Alzheimer's, autism, psychosis, sociopathy and psychopathy, etc.
Anosognosia is a problem for people, and causes a forgetting. It could also be related to memory and organization parts of the brain not working. Patients taking medications often forget to take medications (though some medications can cause this "fog" also). They may forget the importance of their medication and even forget they have a Brain Disorder! They may forget more things, such as causing problems or getting into trouble, such as repeated trouble with the police. If anosognosia is functioning while this bipolar person is in a court before a judge, and they are manic, they may believe fully they do not have a disorder because of anosognosia.
Anosognosia is a problem often not discussed, not presented to patients, and not researched! But, it is anosognosia that is often why treatment fails and people's live's crumble: it is the "I don't have a problem" brain issue. And, in treatment and with families, if this is present, this is not a "bad attitude" but a real impairment of the brain. Again, this is not a denial. See the note on denial.
Denial: a person can deny they have a problem, and have varying degrees of belief in that. For instance, an alcoholic can believe, let's say, about 90% that they don't have a problem and others are the ones with problems. Narcissists, people who feel superior and bothered by others, believe about 70% that they are correct in this. If you can sit and talk to them, they can become a bit more, but not much, more aware they have a problem. Cleptomanics and eating disoder persons often have a high degree of awareness they have a problem. There are liars who believe their lie "mostly" or little, and there are cons that believe their lie to great degrees. I like to look at this as a spectrum from 1 to 10 of belief in something.
But, denial allows for "some" awareness a problem exists. Anosognosia, as a brain dysfunction, has no awareness when it's functioning, and is not related to denial of a problem where some awareness is present.
Here are 3 links on anosognosia, but I think a clear picture of "lack of insight" for PTSD, ADHD, Depression, and Bipolar has not been written yet. If you have a link you can share, do so in the comments section please. Thanks, Dr. Bunch
Anosognosia - Wikipedia, the free encyclopedia - http://goo.gl/7xLBa5
Insight in psychology and psychiatry. Although largely used to describe unawareness of impairment after brain injury or stroke, the term 'anosognosia' is occasionally used to describe the lack of insight shown by some people who suffer from a mental illness such as bipolar disorder or psychosis.
Anosognosia Keeps Patients From Realizing They're Ill - Article - Treatment Advocacy Center - http://goo.gl/EkbXVl
Impaired awareness and anosognosia in mentally ill - http://goo.gl/gzeUtg
There are several states where a person has lost touch with their story in life. One can feel empty, not have direction, and have difficulty accessing normal emotions of anger, frustration, desire, mischief, sexuality, and drive.
Of course, many bipolar medications inhibit the ability to have a life story going on. Those with years of experience on antipsychotics are happy just sitting around. They don't know the life they've lost nor do they know what exists out in the greater world for them.
Psychiatrists have been greatly to blame for this problem in bipolar patients. It seems to have a patient come in zonked on meds, and empty life, and a empty smile seems to be the best patient. They are just less trouble, "messy". Wake up psychiatrists: to have emptiness is as much a loss of life as is mania and mood swings.
Do you have these in your life:
driven for the future
knowing your purpose
knowing your story in life
wanting to learn and explore
The loss of story and resultant emptiness can be caused by meds, ongoing depression, a unipolar depressive pattern, ptsd and more. But, a person can also just give up on life and resign. Guilt, fear, and shame often are underneath this choice.
Alexithymia is defined by:
- difficulty identifying feelings and distinguishing between feelings and the bodily sensations of emotional arousal
- difficulty describing feelings to other people
- constricted imaginal processes, as evidenced by a scarcity of fantasies
- a stimulus-bound, externally oriented cognitive style.
We refer to alexithymia in our books on Soft Bipolar Disorder. Would you like more information on Alexithymia, comment below.
Soft Bipolar Books and Resources