ANOSOGNOSIA: WHY DENYING YOUR MENTAL ILLNESS IS SO DANGEROUS

On numerous occasions over a couple of years, friends of mine have suggested I should see a therapist. I’ve never been interested in the idea or took it seriously despite a large percentage of my closest peers going to therapy sessions frequently. The idea of having any sort of mental illness has always gone against my genetic stubbornness and my faulty perfectionism. I can’t stand the idea that there is some invisible force embedded deep in my psyche dictating my actions. I don’t want there to be any excuse to stop progressing and creating. My opposition to self-diagnosing is another factor to my lack of acceptance towards having a form of mental illness. I believe that the ability to self-diagnose oneself with a condition allows for exaggeration and hyperbole. There are many people, teenagers especially, who are under stress constantly. The struggle is separating the ordinary stress of adolescence that every teenager experiences, from a genuinely harmful and serious mental disease. Due to the various goals of teenage life such as originality, popularity, and a sense of identity, many kids will blow their emotions out of proportions and claim they have unique mental conditions. The number of kids who claim to be depressed, suicidal, bipolar or mentally diseased otherwise is shocking, and is a phenomenon you’ve probably seen in your own schools. However, the number of people who are actually medically diagnosed as being depressed or mentally ill otherwise, are even more shocking, and quite frankly, frightening. According to the National Institute of Health Publication in 2013, 19 million Americans were depressed. Every day 117 people commit suicide, and 12 of those who kill themselves will be kids below the age of 18. Obviously, the problem of mental illness is very real. Another reason why I tread carefully when considering if I could possibly have a mental disease, I don’t want to disavow the suffering and the deaths of the people are are really in pain.

Unfortunately, my tendency to downplay my own chances of being mentally ill could possibly be a symptom of the disease itself. It may sound confusing, but one of the depression’s greatest weapons is it’s invisibility. In a recent report, the National Alliance on Mental Illness (NAIM) estimated that a little over 20% of children between 13 and 18 have a serious mental illness, and that nearly 50% have milder conditions. However, the number of kids estimated to have these problems, and the number who actually are diagnosed and receive treatment remains drastically different. The statistics show that millions of people, kids or adults are refusing to accept their own mental illnesses. In some worse cases of depression or brain damage, these people could suffer from what is called “anosognosia”, which is a lack of self-awareness preventing acknowledgment of one’s disease. Now, not everyone who refuses to accept their problems has anosognosia, only those who are so far gone they can’t even fathom the idea of having an illness suffer from this condition. As cited by Kevin Thompson Ph.D in his writings on psychiatric medicine, anosognosia is often paired with denial of unhappiness, constant and reoccurring pessimism and a lack of fulfilling enjoyment no matter what the person does.

But is this really a problem? Is it really that terrible that some people take longer to realize their conditions? After all, the NAIM found the average delay between a mental illness’s onset symptoms and diagnosed intervention is 8 to 10 years. Shouldn’t that mean it’s ordinary to wait awhile before meeting a doctor or therapist about your problems? Well, unfortunately that long of a delay is the norm, but it’s not a good one. Especially for teenagers who’s 8 to 10 years span their entire middle school and high school careers along with some of college. Those long years allow for mental illnesses to fester and grow, becoming more slowly embedded in a victim’s mind. Sometimes, the illnesses grow outward allowing more symptoms to be displayed and usually a quicker response from friends, families and eventually doctors. For example, someone with an anxiety disorder may begin screaming and yelling much more often then usual, their parents may see them awake much earlier or sense a constant state of aggression around them, all these symptoms grow outwardly. Those types of actions allow for a condition to be displayed, they might not create very enjoyable situations, but these outer expressions allow for easier and quicker intervention. However, many illnesses also grow inward. The victim will usually experience the same symptoms, but in secrecy and privacy. Someone who is chronically depressed with insomnia may create the appearance they keep to an ordinary sleep schedule. They might only leave their rooms at times others would expect them to according to an average sleeping pattern. And eventually, the hiding of the symptoms becomes routine. According to Treatment Advocacy Center, the worst part of depression is it’s ability to become hidden. Sometimes, a depressed person’s symptoms will reveal themselves easily to family and peers, and the person will speak about their fears and worries to others. But, the very opposite can happen as well. All the inner toil about identity, happiness, and fate that can come with a mental disease will be shoved beneath the surface. The internal struggles are hidden from public view, and then hidden from the mind of the disease’s victim as well. Guilt, embarrassment, and many other self-damaging thoughts will become burrowed in the person’s mind. That leads to a rejection of self-awareness because looking inward rings up images of a destroyed self. This type of descending mindset is what creates a lack of inward thinking about our own mental diseases, and therefore anosognosia arises.

However it should be noted that anosognosia is different from simply lying about your condition, just like depression is substantially different from just feeling the blues one day. Anosognosia is a serious mental condition that develops in the presence of some other mental issue such as depression or anxiety disorder. It isn’t a person knowing they have a certain disease or clearly showing symptoms of an illness, and then lying about the truth or their own thoughts. But, a lack of self-awareness is sometimes just as much of a problem. Refusing to accept your mental diseases can still create hugely detrimental impacts and dig a deeper grave for that victim. But anosognosia affects 50% of people with schizophrenia, and 40% of people with bipolar disorder and depression, so it clearly isn’t a small issue. This mental condition effects a huge number of people and transform previously terrible illnesses into monsters even more grim. But, the broader issue is our society’s shaming of the mentally ill. Parents hate to accept that their child is depressed, addicted to drugs or have some other kind of serious condition. They, along with teachers, friends and other family members often fear they have some hand in creating the illness their loved one may have. Along with the stereotypical and mocking manner that the mentally ill are painted in media, there is a huge amount of resistance to accept your own problems. Asserting and accepting you are depressed, bipolar or have some other mental health issues opens doors to discrimination, shame, guilt and people refusing to believe you. But, as I said before, understanding the difference between normal teen angst and much more serious illnesses is important. If you think you have a more serious condition you should check with a professional, not a close one, because even though they may be able to comfort you they don’t know how to find the real issue. Despite the negative reputation therapy and psychiatry often receive in the media, they really do work a large majority of the time, and at the very least can help provide a diagnosis. All in all, our society and we should learn how to look beyond the system’s stigma. Mental illnesses such as depression, schizophrenia, bipolar disorder or others all are very serious issues that can be diminished when they’re prevented earlier. If we continue allowing ourselves to be shut away and refuse acceptance these problems will only worsen. It’s time we accept the truth about mental disease and stop shoving away our internal struggles. Without self-awareness there can never be a solution.