ANOSOGNOSIA: The Disorder That Fails to Know it's Disordered

This condition is becoming more widespread and I have seen it manifest even with severely depressed individuals. As depression gradually progresses over many years, there tends to be an accommodation to the mental state making it seem 'normal,' demanding the individual unconsciously seek ever greater means of compensation, often resulting in maladaptive, unhealthy behaviors and self-medicating addictions.

Only when the individual seeks treatment and experiences a positive change to their mental state do they acknowledge a brain disorder. Yet, often with Anosognosia, the brain has been so disordered that awareness and acknowledgement of the disordered state is virtually impossible and the brain continues to inform that any aberrant behaviors are a normal reaction to reality. This is not the usual "denial," but a corruption of brain circuitry making awareness of a disordered state impossible, ironically, based on the disordered state.

Make no mistake, all "mental illness" is biological in origin and not a defect of personality or a failure to make correct choices. Even so-called "personality disorders" deal with specific neural hard-wiring, often based on traumatic experiences in childhood. 

Effective treatment demands a practical, holistic, biopsychosocial approach, taking into account all aspects of an individual's existence including, most importantly, the relationships and social supports necessary to a healthy and fulfilling life.


"Impaired awareness of illness is a strange thing. To others, psychiatric symptoms seem so obvious it’s hard to believe the person experiencing them is not aware he/she is ill. Oliver Sacks, in his book The Man Who Mistook His Wife for a Hat, noted this problem: "It is not only difficult, it is impossible for patients with certain right-hemisphere syndromes to know their own problems.... And it is singularly difficult, for even the most sensitive observer, to picture the inner state, the 'situation' of such patients, for this is almost unimaginably remote from anything he himself has ever known." LINK