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Do people with schizophrenia know they are sick?

Douglas E. Severance, MD
Family Medicine
Some people with schizophrenia may understand that they are sick, especially when they become stable after treatment with medications and therapy. Many people with schizophrenia are even able to maintain jobs and relationships with others. Others, left untreated, or during an active psychotic episode, may not understand that they are sick, and will have trouble identifying and understanding what is real. When patients have active schizophrenia symptoms, they truly believe in their delusions and hallucinations, and will deny that they are sick. Untreated patients often lack insight into their illness. One way for people with schizophrenia to understand more about their illness is to participate in a peer support group. The National Alliance on Mental Illness reports that these peer groups are very helpful for individuals living with schizophrenia.
Mark Moronell, MD
Cardiology (Cardiovascular Disease)
When a person with schizophrenia has active psychotic symptoms, she usually lacks the insight to know that she is sick. For instance, a person with schizophrenia may be convinced that the voices she is hearing, commanding her to do things, are real. Or, a person with schizophrenia is convinced that the neighbors are spying on her and planning to rob her house. Without treatment, these symptoms can cause a great deal of distress for a person with schizophrenia. However, if the person receives antipsychotic medication treatment, her hallucinations and delusions can decrease. An effective therapist can then help the person understand that the symptoms of schizophrenia are not real. Once she has this insight, she can learn how to recognize signs of the illness and also learn how to avoid a relapse.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.