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28th Jan 2012

In Born Mad, I wrote about denial: what it felt like, how I gradually came to see the truth, wanting to go back into denial and at the same time knowing full well going back was not a realistic possibility. I called believe denial “unawareness” instead because I truly had no idea I had a mental illness.
The other day, I found confirmation that my thinking was accurate. I ran into an article written by Dr. Xavier Amado. He wrote about something called “anosognosia.” According to Amado and Wikipedia, anosognosia is a condition in which a person who suffers from a disability seems unaware of the existence of his or her affliction. This is not denial, according to, as denial is a defense mechanism used to reject something a person wants to ignore, partially avoid or reject outright because it is too stressful or painful to deal with.
Anosognosia is a Greek word meaning “without knowledge of disease.” The “a” means without; “nosis” means disease; and “gnosis” means knowledge. In psychiatry, anosognosia is used to describe the lack of insight to recognize one suffers from a mental illness.
Anosognosia differs from person to person varying is intensity from slightly unaware to completely unaware. According to Wikipedia, 15 percent of individuals with severe mental illness who refuse to take medication voluntarily may require some form of “coercion” to remain complaint because of anosognosia.
What does this mean? If you have a loved one who needs counseling who either refuses to go to counseling or does not admit to needing help, it is not because they are lying to you, themselves and/or others. It is because they truly are unaware of any illness in the first place. They are unable to see what you see. They truly believe the problem is not them and will most likely blame others and become argumentative when confronted.
I am not a mental health professional so no advice on how to handle such a person will be given here. I am just one person who lived in the anosognosia state for over 40 years. I don’t believe there was anything my family or friends could have done or said to bring me “out of it.” Lord knows many tried to tell me. If you feel you are dealing with someone in anosognosia, seek advice from a professional mental health provider on the best ways to deal with this type of person. Blaming or accusing them won’t do any good; it will just create more strife. It did with me anyway. This person may test your patience and sympathy to a breaking point but try not to get mad at them. They can’t see it; it is built-in with the mental disorder.
(For more information on Dr. Xavier Amado go to

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