How can you tell denial from anosognosia?
Denial is pushing away a truth a person can see. Anosognosia is the illness blocking that view.
- Denial often shifts. Your loved one may admit a problem on a calm day, or avoid the subject because it hurts.
- Anosognosia is steady and sincere. Your loved one may explain symptoms in unusual ways and seem honestly puzzled that you are worried. It is common in schizophrenia and bipolar disorder.*
Only a clinician can assess it. You can describe what you see to the treatment team in writing.
How common is it?
An estimated 50 to 98 percent of people with schizophrenia and 35 to 63 percent with bipolar I have some lack of awareness of their illness.*
What can you do now?
Stop debating the diagnosis.
What this step unlocks: less fighting, more trust.
Ask what your loved one wants, like sleep, a job, or less stress.
What this step unlocks: a goal you can work toward together, instead of fighting about the diagnosis.
You can always tell the doctor what you've seen and heard. The doctor may not be able to tell you anything about your loved one's care without permission.
What this step unlocks: the care team gets the full picture.
Ask the clinic about family therapy or family education.
What this step unlocks: research shows family programs reduce relapse (Cochrane, 2010).
Learn when the law can help, if your loved one is unsafe. See how a family files for court-ordered outpatient treatment.
What this step unlocks: options like assisted outpatient treatment when safety is at risk.
Don't. Don't hide medication in food or drinks.
Where can you find help in your state?
Illinois | Wisconsin | DC | Maryland | Virginia | California
This is general information, not legal or medical advice.
FAQ
Q: Why doesn't my loved one think they are sick?
Often because of anosognosia, a symptom where the illness affects self-awareness.
Q: How is denial different from anosognosia?
Denial often shifts. Your loved one may admit a problem on a calm day. Anosognosia is steady and sincere. Your loved one may truly not see the illness.
Q: Is anosognosia a diagnosis?
It is a symptom. Clinicians often record it as impaired insight.
Q: Should I argue about the diagnosis?
No. Focus on a shared goal like sleep or less stress.
Q: Can I talk to my loved one's doctor without permission?
Yes. You can always tell the doctor what you've seen and heard. The doctor may not be able to tell you anything about your loved one's care without permission.