Is it possible for someone with schizophrenia to be self-aware?

Question

A lot of times people with this disorder might think that someone is watching them. Some even have delusions that a high-profile celebrity is somehow monitoring their every move. Is there any part of their mind that would kick in and tell them that this is illogical and must be a delusion? For example when taking some illicit drugs a person might feel paranoid but is able to reason with themselves that it is just the drugs kicking in, is this not possible with a schizophrenic? I'd especially appreciate any answers from those suffering from this...but all answerers welcome...thanks!

Answer 1

I have been diagnosed Schizoaffective. Part of my condition is paranoia. I am aware that my paranoia is illogical and that helps me to keep it in check.

However, my symptoms are not severe. I can not say for certain that all Schizophrenics have this awareness. I have known some that have some level of awareness but were not able to control their symptoms without strong medication. I have not personally met any that had no level of awareness at all.

Answer 2

From my experience no, Im not an expert, but I have worked in homes with about 3-4 different schizophrenia cases. None of them were able to distinguish reality when they were delusional. The might later come out of it and apologize for their behavior, but not during "the full swing", and they would never admit that the delusion was not real. I had one guy who would even get violent when you would insist that you were not santa claus. We were just supposed to change the subject. Another ademently beleived I was his wife and I had to get transferred out to another home. These are the most extreme kind of cases though, and it is a disorder that gets progressivly worse as time goes on. Onset is usually in the persons early 20's, and it could take years for it to affect them to the point where they have no rationale, but if it is caught and treated early enough the person can live a normal, independent lifesytyle, meds have come along way in the past 5-10 years.

Answer 3

I'm not suffering from the disorder, but I study psychology in college as a minor and just finished an abnormal psychology class. There was a case study in our text book that may be able to answer your question.

A young mother, Ann, developed schizophrenia in the normal course. She first went from being energetic and outgoing to listless and apathetic. Shortly after giving birth, she noticed some family pictures to be missing. She believed that they had been stolen so that a voodoo curse could be placed on her and her family and someone was trying to kill them. She realized the inanity of her beliefs and understood that many people were not as concerned as she was, but she still could not shake the delusions that something terrible was being planned against her family.

It's not to say all people have at least some insight into their problem, in fact, many suffering do not, but, at times, they do realize how illogical some of theit beliefs are.

Answer 4

I've been in mental health practice for a couple of decades, and one of the things I've discovered about the schizophrenic clients I have worked with is that they are more like the rest of us than you would normally assume, given the craziness of some of their beliefs.

The internal resources available to persons vary widely across the population. Some are able to deal with trauma quite effectively, while others lose the capacity to function for long periods of time. The difference appears to be the internal resources, which include intelligence, a sense of being cared for by others, a stable existence, a sense of humor, training in critical thinking skills, etc.

When it comes to the schizophrenic, it appears that some of them are quite able to logically criticize the voices they hear and their paranoid delusions. They may need to attend to their health (i.e., eat & sleep well, get moderate exercise, maintain a positive social life) even more so than the rest of us. However, I have seen a few schizophrenics who were able to eschew medications simply because they had the discipline to follow these simple rules. I have learned a lot from these inspiring clients.

Sadly, most of us, and most schizophrenics, are lacking in some of the internal resources that would allow us such displays of strength and character. Who among us has in some interaction remained unaware until later told that we were acting like overbearing fools or shy willows in the face of conflicts? Our own observing egos are lacking in the same way as a schizophrenic's who has started to believe the voices that tell him he is undeserving and that other people are only patronizing him.

So the answer to your question is, yes it is possible. With medication to reduce the intensity of the symptoms, it becomes even likely for schizophrenics to become aware that their paranoid delusions & hallucinations are artifacts of a biological illness. But as a culture, we are devoted to the idea that our thoughts are our true essence, and that if we modify them via medicine, we are committing a disservice to ourselves. Such blanket prejudice against medication is harmful to individual patients and to society at large.

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Answer 5

I know someone with schizophrenia and she got worse as she got older. She kept telling everyone she wasn't crazy and it was God talking to her and telling her what to do, etc. - Until she got medication and treatment, she never thought for one minute she was sick. She still thinks she can stop taking her medication sometimes and when she does this, she goes back to the behavior and doesn't think she is ill. She usually ends up homeless and lands back in the hospital. Because this is a chemical issue in the brain, these people can't just decide it's not okay and not normal. It takes medication. They get really paranoid when off medication and think everyone is "out to get them" by telling them they need help. Psychosis isn't something people can rationalize themselves out of.

Answer 6

i am schizophrenic and I am well aware the shadows i see are not real, the commands that i hear are internal, and that i am not healthy. it can become difficult to determine what is reality and what isnt when im under great amounts of stress, but even in a panic situation where i cannot speak and i see and hear things. i am aware of what is happening to me but i am unable to control my breatheing, speech, or thought process. its a very very very frustrating feeling to not be able to slow yourself down.

think of it like this. my brain has 2 sides, a logical side, and a schizophrenic side, neither ever fully shut down, so when i am fine, im aware that i am still schizophrenic but i am not experiencing any symptoms, but when i am having an episode, i am aware that it is just that; an episode and that it will pass. i am just unable to function on the outside to correct the speech, emotional, or physical errors.

i hope this helps.

Answer 7

It is possible to make a schizophrenic realize that he is having delusions, but this realization will be short termed and he will again fall into delusions. Delusions are nothing but a person's regular thoughts amplified multifold, the incoming thought has so much intensity that person is forced to believe it as reality

Answer 8

I really want to answer this question, but I can't right now. Bill Cosby has been monitoring my computer and I fear what he might do if he finds out that I know... he is nothing more than a delusion.