Anosognosia Accompanies Psychosis for Me

In my experience, the worst part of schizophrenia is having episodes of psychosis. Losing touch with reality can be terrifying. For me, psychosis always involves hearing voices, delusions, and paranoia. I usually stop eating, which most likely makes the symptoms more severe. Complicating my experience with psychosis is a symptom called anosognosia.

Anosognosia is a clinical lack of insight. Every time I have been psychotic, I have been unaware that I have schizophrenia and that I need treatment, and that is due to anosognosia. That means I think the voices I hear are real (not part of an illness). I also believe my delusions, for example, that the songs I hear are a part of someone trying to send messages to me through the lyrics. Lastly, I think I am the target of people following me, recording me, etc. (all part of my paranoia).

When Psychotic, I Always Experience Anosognosia 

I'm thankful that I only experience anosognosia when I am psychotic because most days, even with symptoms of schizophrenia, like paranoia and olfactory hallucinations, I know that I have a mental illness and need treatment, support, and a routine to try and manage it. Because I am usually aware of my mental illness, I can follow a treatment plan and self-care routine that helps reduce the likelihood of psychosis.

Why Psychosis with Anosognosia Is So Hard

Without the presence of psychosis and the symptom of anosognosia, I can experience symptoms daily but recognize that they are symptoms and they will pass, or I can discuss them with my doctor for a possible change to my treatment. The difference between daily symptoms and an episode of psychosis is the severity and the lack of insight into my illness.

The part that is so troubling about lacking insight is that I lose the ability to ask for help or receive help when I need it the most. For me, psychosis is a mental health crisis where I most need intervention. I cannot recognize my need to see a doctor, adjust my medications, and be in a safe place. For me, that means I am in danger of possibly hurting myself or putting myself in a situation where I am vulnerable. I am likely to be a victim because I often leave my home and walk the streets at night or do other unsafe things in unfamiliar settings.

Psychosis and anosognosia can be frustrating to caregivers and family members because the person experiencing it doesn't realize they need treatment, which can confuse those witnessing the symptom. It can also put the person experiencing the lack of insight at high risk for adverse outcomes. It's a terrible part of mental illness but something we must be aware of to assist those with this symptom.