Treatment Advocacy Center


Battling Obstacles: Anosognosia

Families of people with severe mental illness are all too familiar with the struggle involved in caring for a person who very well may not even realize they are sick.  It is a medical condition known as anosognosia.

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News this week brought this little known medical term home.  Blogs and news stories covered the struggle that Theresa Rockwood faced.  Her 54-year-old brother, Joseph F. Rockwood, suffers from schizophrenia.  He is now charged with her murder.

Theresa's fight to help her brother is not unlike the plight of others who care for someone with a severe mental illness, only to find that the state's laws act as a barrier to treatment.

Anosognosia is a major problem because it is the single largest reason why individuals with schizophrenia and bipolar disorder do not take their medications.  It is caused by damage to specific parts of the brain, especially the right hemisphere.  It affects approximately 50 percent of individuals with schizophrenia and 40 percent of individuals with bipolar disorder.  When taking medications, awareness of illness improves in some patients.

Impaired awareness of illness is a strange thing.  It is difficult to understand how a person who is sick would not know it.  Impaired awareness of illness is very difficult for other people to comprehend.  To other people, a person's psychiatric symptoms seem so obvious that it's hard to believe the person 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.  

"It's not uncommon for family members to struggle with trying to get care for their loved ones," says Chris Bouneff, director of marketing and development for DePaul Treatment Centers and president of the National Alliance on Mental Illness of Oregon.

"It doesn't work to say to them, 'Why don't you just get help?' Their frame of reference will never be that they need help," Bouneff told the Oregonian newspaper.

What happened to Joseph and Theresa is a reminder that states must create and use treatment laws designed to prevent situations like this.

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Treatment Advocacy Center

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