Insight into bipolar disorder is critical. Insight into anyone’s life is a good idea but for those with a mental illness, it’s vital. It’s a big part of what makes managing bipolar disorder possible. But so many people don’t have insight into bipolar disorder. Why is that?
What Is Insight?
According to the Collins English Dictionary, “insight’ in psychology is defined as:
- The capacity for understanding one’s own or another’s mental processes
- The immediate understanding of the significance of an event or action
“Insight” is also defined as the following in psychiatry according to the Collins English Dictionary:
- The ability to understand one’s own problems, sometimes used to distinguish between psychotic and neurotic disorders
And one more, this time from The American Heritage Stedman’s Medical Dictionary, “insight” is defined as:
- Understanding, especially an understanding of the motives and reasons behind one’s actions
What Is Insight in Bipolar Disorder?
Of course, none of the above definitions relate insight to bipolar disorder specifically, but that’s easily enough done.
According to Natasha’s English Dictionary of Bipolar Disorder, “insight” is defined as:
- The capacity for understanding how bipolar disorder affects thinking in the brain and in the mind
- The immediate understanding of the significance of an event or action both on the individual and on one’s illness
- The ability to understand one’s own problems and the problems associated with and complicated by bipolar disorder
- Understanding, especially an understanding of one’s own motives and reasons and how bipolar disorder affects the motives and reasons behind one’s actions
Natasha’s English Dictionary of Bipolar Disorder (NEDBD) really raises the bar on what it is to have insight.
A Lack of Insight in People with Bipolar Disorder
Let me start off by saying that many people with bipolar disorder are plenty insightful, so let’s get that right, but there’s also plenty that aren’t. And there are reasons that some with bipolar disorder aren’t insightful.
- Anosognosia – Anosognosia is a fancy word, I know, and your average person hasn’t heard of it; but, anosognosia is actually the medical term for a clinical lack of insight. People with anosognosia can’t do the above because they, typically, don’t believe they have a mental illness. And this isn’t their fault. This is a neurological condition. It’s not denial, it’s actually a result of changes to the brain. Anosognosia is not just related to bipolar disorder (bipolar psychosis) but it also occurs in illnesses like Alzheimer’s.
- Substance use/abuse – Substance abuse occurs in more than half (almost 60%) of all people with bipolar disorder. This is not a coincidence. People with bipolar disorder are looking to numb the pain of the disorder and they’re doing it the best way they know how – with alcohol and other drugs. And these drugs do exactly that – they numb. They make it so you don’t know what’s going on. You can’t really be insightful when you brain is in a drug-induced fog.
- The wrong psychiatric medication – Much like you can’t be insightful when you’re drinking or drugging your brain away, you can’t be insightful when you’re swimming in the wrong kind of prescribed chemicals either. Zombies are not known for their insight.
- One’s own psychology – Some people are prone to personal insight while others aren’t. That’s just sort of the way the cookie crumbles. (Environment and upbringing obviously have something to do with this as well.)
- Never knowing anything different – And finally, it can be really hard to be insightful about your own situation if you have only ever known a mentally ill reality. For some, mental illness starts at a young age and for those people, mental illness is their only experience.
So if you don’t happen to be insightful about your bipolar disorder, don’t worry, you’re in good, and crowded, company.
And there is a way to change that.
If you’d like to increase the insight you have into bipolar disorder, check out my next article where I talk about how to develop insight into bipolar disorder.
Hi Natasha. Love your work, so does my husband. It’s helped him a lot. I’m currently in hopsital due to, originally mixed state, now mania. I guess it’s low level but not hypomania. S* loads of drugs to keep me calm. The problem I face is that I know how bad things can get and how fast, so doctors and nurses don’t see me as ‘too unwell’. My vice when manic is online shopping. I never shop online. I hate it. So I gave majority of my money and bank access to my husband as soon as I saw what was coming. Doctors and nurses-‘oh you seem so much better. No this is Just a different phase from angry mixed. My insight works against me. I’ve worked hard to learn my illness. My kids have disabilities. I need to be in control of my life as much as I can but insight often prevents me from getting adequate treatment until I’m in emergency. I’m learning and using my skills and tools. The doctors and nurses need to listen and learn.
Are panic attacks part of or in and of itself a mental disorder?
Hey, Natasha! I love seeing your name everywhere! I just hi and see how you’re doing. I’m okay. We’ve been re-building for a year because we got hit pretty bad by Harvey, but it’s all good. I volunteer at an unbelievable place, and I have an agent in NYC pitching my book (I’m a writer.) That’s really exciting for me. Well I know you’re swamped. Love this article. Great writing. See ya’!
Insight into my disease was NOT an overnight experience
For many yrs I was in denial I was as sick as I was,not taking it seriously .
Having episodes where I’d be on/ off my meds playing chemist…….
Enjoying the highs,b/c I’d drop 7-8 pounds in a week!
Getting so much accomplished” & one time recalling so delusional thought I was Janis Joplin ( in Emerg by then
Psychotic) given pills every 2- h) I couldn’t shut up I must’ve been a real pain in the ass to staff.
But as we all know,have no control in that state of mind……….it’s stuff I try to push to the back of my brain in order to forget.
But,if I forget totally I might one day get into that head space as we’re all familiar w ” screw meds” & such
I’ve been stable many months,but I must be truthful I don’t enjoy swallowing a huge pill cocktail not only for
Bipolar but epilepsy chronic back pain,bunch vitamins I’m deficient in,migraine headaches……..ulcer…..
Some are huge to swallow causing GI issues,that last 1/2 the nite,yes I want to be well.
But there’s a price to be paid for wellness.
Insight also means you know your life should be routine- oriented.
Boring,but true.
If you take your meds on time as your psych directs you’ll get better results.
If you eat more healthfully & try your best to stay away from fast food ( but have once week cheat day) you’ll less
Likely be overweight,it’s not only the pills,it’s also your eating habits ….if it was just pills I’d weight over 300 lbs.
Try & move around a bit here & there even if it’s only a 10 min stroll,better than nothing.
Insight means you understand your illness for what it is & how serious it is
This isn’t a joke
We’re talking hardcore serious mental health disease that kills,you have to learn to live & manage it.
Like an adult,not a two yr old child.
It’s got maturity to it I think that comes more so w age,as I grew older it became easier to deal.
Yes the beast still rears her ugly head ( I’m rapid cycler) difference is I’ve my sword at my side for protection!
I feel for others that are not where I am now in my life,only hope that one day soon,they too will see bipolar disorder for what it truly is.A serious mental disorder that destroys/takes lives.
Thanks.
Hi Natasha,
Relatable! My last hospitalization the nurses all told me I had very good insight into
My disorder.
I’ve always been interested in psychology,been a big reader,but I know myself very well
Thus,I get what works for ME & what DOESNT that’s the key.
There’s not always a pill for me there’s other forms of therapy a big one is any kind
Of distraction,computer work,doing a face mask while in the tub, trying on new makeup
Taking pics of the new looks & mailing them out,walks in nature,making a wish list
If I had a million dollars,poetry writing,quiet time w my cat,naps,tea / sweets!
Calling a help line if feeling overwhelmed before things reach crisis point,cooking
In the microwave!) not allowed use stove,mind is too one track,I’d set fire to something!
Making up new recipes from traditional ones,feelings when mum or dad are here
They are both deceased) but I’ve psychic abilities,I know many think it’s BS but it’s been
Proven they come usually only when I really need them.Im not religious,but I do
Practice some Buddhism & believe in their path it’s beautiful,can’t fast though!
Learning meditation finding it very very hard w bipolar brain!
I think too,to feel inner peace & calm you must just w bipolar learn to live one day at a time
I’m telling everyone,once I began to live my life this way I slept better was calmer
Without a raise in meds or anything.It truly is the way to find serenity & your life your outlook on life
Will go from negativity to much more positivity ( but no mania) these things I’ve listed work for me
Everyone can benefit living life slower one day @ a time,please trust me.
Very much looking forward to your next article. This problem has gotten me into more trouble than anything else in my life.
Very good post! It is helpful to see all of the reasons you listed. A couple I wouldn’t have come up with myself, at least not right away.
Before my diagnosis, I had almost no insight into my elevated states (hypomanias and mania), unless there was extreme anxiety and/or depression mixed in. Being fairly ignorant about mental illness at the time, even the mixed/anxious states and depressions to me were just like “brain flues” that came on like a virus and would go away, some I would clearly attribute to situational triggers. Never, until one year after my diagnosis (I didn’t accept it at first), did I think it was a chronic condition that would continue to reappear throughout my life. Like with severe flues, I would sometimes go to a doctor (mostly GP) for help, but only when I felt bad. I’d get an antidepressant, take it a few days to a couple weeks, and then feel better. The antidepressants were like antibiotics in a sense. There was never any follow up with the doctors. They only saw me in certain conditions, plus they were mostly unqualified about mental illness to ask certain questions. And even if they did, I wouldn’t see my mood elevations as illness. Anyway, I’d take an antidepressant for maybe three days to week and quit them. I only saw a GP again when I was depressed or anxious again.
Elevated moods were just “my way”. People knew me as that as sort of a baseline. Even when it was irritable, that was “me”. During irritable states, I felt justified being angry and offensive. Hypomanic/manic behavior did affect me negatively at times, but I had a tendency to brush that off or blame others.
Eventually a GP did refer me to a psychiatrist who gave group therapy. I hate group therapy, but it was what got me finally diagnosed bipolar. That psychiatrist gave me an antidepressant, but unlike GPs that never saw me for follow-ups, that psychiatrist did. He, himself, saw the transition to developing mania. When he took me aside and told me I had manic depression and should switch to a moodstabilizer, I blew him off and quit him there and then. I didn’t even know what manic depression or bipolar disorder was. I felt fine and didn’t think my behavior that day was “ill”.
Eventually my manias grew very severe and self-medicating was involved. The * hit the fan and I was hospitalized for the first time. Nine more followed. I guess I did acknowledge the diagnosis after my first hospitalization, but still lacked insight into the onset of mood elevations, until they turned mixed.
Fifteen years has passed. My insight into my manic states has improved (isn’t perfect, though), and that helps me get help sooner sometimes. My husband’s education on the matter helps, too.
I’m on a good medication mix. I’ve sort of learned what “stable” is and have started to have peace with it. I even like the stable me because some disadvantages of manic states have eased. The increase/improvement in my insight goes beyond these two things, though. Good therapy, hitting a bottom enough, maybe maturity, and other factors play a part.
Always, always dead on…you’re amazing Natasha! Fifty percent of those with bipolar disorder suffer with anosognosia. That’s an alarming number of people and families suffering…this is such a brutal illness in and of itself. But to experience it with no insight…pure torture.
Dr. Zavier Amador figured out an miraculous way to address this while helping his schizophrenic brother. I share this (termed the LEAP program) with individuals who suffer this way and it has been extremely effective and powerful….I’d be happy to share some examples with you anytime.
thank you Natasha for helping me and so many others…
…bob