When Sickness Isn't Understood
Sometimes, when a person's medical condition affects their brain, it can directly impact their ability to recognize they're unwell.
When someone rejects a diagnosis of mental illness, it may be tempting to say that they’re “in denial.” But someone with acute mental illness may not be thinking clearly enough to consciously choose denial. They may instead be experiencing “lack of insight”, “lack of awareness”, or anosognosia.
Pronounced “A No Sog No Zi Ah.”
Anosognosia is when a person with a mental illness doesn't realize they're sick. Their lack of awareness feels just as real and true to them as anyone else's self-perception. While anosognosia itself isn't dangerous, it can lead to complications because people with this condition are more likely to refuse or avoid treatment for a problem they don't believe they have.
Updating our self image
Our brains are always updating how we see ourselves. For example, if you get a sunburn, you expect to look different in the mirror. If you learn a new skill, you feel more capable. This process of updating our self-image is complicated and happens in the front part of our brain.
Conditions like schizophrenia, bipolar disorder, or dementia, can damage this part of the brain. When that happens, people may lose the ability to update how they see themselves.
This means they're stuck with an old self-image from before they got sick. Because their perceptions feel real, they might think their loved ones are lying or mistaken when they talk about their illness. If you push them too hard, they might get frustrated, angry, or start avoiding you.
How to help
The key is to support them on their journey without being pushy.
Prioritize professional help. Consult with healthcare professionals to get the best advice and resources for your loved one's specific situation.
Listen and empathize. Validate your loved one's feelings and perspective, even if you see things differently. Avoid trying to convince them they're sick; instead, express that it's okay to have different viewpoints as long as everyone is safe.
Create a stable environment. Help establish a structured daily routine that includes physical activity, proper hygiene, and good nutrition. Consistency can be comforting and grounding.
Focus on their goals. Ask your loved one about what they want to achieve and use their goals as a way to gently introduce treatment as a potential next step.
Take care of yourself. Supporting someone with a mental illness can be exhausting. Remember to practice self-care and seek your own support, whether through therapy or a support group, to maintain your well-being.
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