Anosognosia

When we talk about anosognosia in mental illness, we mean that someone is unaware of their mental health condition or that they can’t perceive their condition accurately. The most notable symptom of anosognosia is a lack of understanding, awareness, or acceptance that you have a medical condition. Anosognosia is common in people with: 

• Schizophrenia 
• Bipolar Disorder 
• People with brain diseases such as Alzheimer’s disease or dementia 
• People who have had a stroke or a brain injury 

Anosognosia can increase a person’s unwillingness to take needed medications or get other treatments needed. Unfortunately, by declining to take medications or treatments, this condition can get worst. Carrying for a loved one with this condition can be difficult. It is not that your loved one is denying their problems. They resist recommendations because he or she does not believe they need help. They cannot understand their problems. Damage to the brain is common in people with this disorder, but the exact cause of the condition is unknown.

Youtube Video link: https://youtu.be/uj6ozlzA45o. Video provided by Treatment advocacy center, you can find more information at https://www.treatmentadvocacycenter.org/key-issues/anosognosia. NEHH is not associated with Treatment Advocacy Center. This video has been reviewed by NEHH and provided as educational content only.

How to help someone with anosognosia

• Be aware that people with anosognosia are at risk for injury because of behaviors that could be reckless and dangerous. Help your loved ones avoid injury by talking to them about their risky behaviors instead of trying to discuss the disease.
• Consult with your primary care provider and mental health provider about giving medicines at home. Remember that a person with anosognosia may not believe medicine is necessary for a brain injury, brain disease, or mental illness.
• Offer treatment, and encourage your loved one to accept treatment. Do not force treatment, this power struggle may make him or her feel isolated.
• Work with your loved one to achieve a treatment plan he or she will agree on. A therapist who specializes in this type of therapy called motivational enhancement therapy (MET) can be helpful in facilitating your loved one accepting treatment.
• Listen to his or her perception of his or her life. You do not have to agree with them, but help them to feel understood.
• Avoid arguing about his or her condition or treatment. Do not get emotional, be aware of your own reaction.
• If he or she becomes angry or defiant with you, consult with their health care provider about how to deal with the situation.

Get help right away!

• If your loved one with anosognosia becomes aggressive with you or other.
• If your loved one destroys property or he or she acts in an unsafe or reckless manner.
• If your loved one talks about self-harm or harming others.
• If your loved one hurts themselves.

If you ever feel like your loved one may hurt themselves or others, or may have thoughts about taking their lives, get help right away. You can you to your nearest emergency department or call your local emergency service (911 in the U.S) or a national suicide prevention lifeline at 1-800-273-8255 which is open 24 hours.

You can find additional resources at http://www.publichealth.lacounty.gov/ivpp/injury_topics/Suicide/suicide_hotlines.htm

Summary

• Because a person with anosognosia lacks awareness that he or she has a problem or disease, it can be hard to care for them.
• Seek help for your loved one as early as possible.
• A therapist who specializes in a type of therapy called motivational enhancement therapy can be helpful in getting your loved one to follow a treatment plan.
• Your loved one with anosognosia is at risk for injury because he or she may behave in a reckless or dangerous way.
• Call 911 if you feel your loved one may hurt themselves or others.

As always! We are here to help. At NEHH we strive to provide education and make information readily available. This information is not intended to replace advice given to you by your primary care provider.
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