Do the mentally insane sometimes have moment of cognitive clarity and..?

My father was the same way. He had schizoaffective disorder with bipolar. He was very intelligent and during his better days he knew the reality of his illness.

Perhaps there are moments of self awareness, but that shouldn’t be confused with the ability to change, affect or improve one’s ability to live. One may become aware of one’s limits, but it is quite another thing to have the mental capacity and strength to help oneself overcome problems that limit one’s ability to deal with life. Keep taking medication and listening to your therapists and doctors.

I was surprised when my husband told me that most of his clients are aware of the fact that they are schizophrenic, bipolar or whatever. It seems to be a myth that if you are really crazy you won’t even consider the thought. He’s actually only had a handful of clients that had no idea they were sick. I remember he told me one woman said she wouldn’t act crazy, but she couldn’t help herself because there was a certain celebrity who was controlling her thoughts and forced her to act that way.

But as far as I can see from what little my husband tells me about his job, most people with mental illness are well aware of their condition. They may not have good judgement—like they may know intellectually they have delusions that people are spying on them, but they will not think “Maybe this time I am just imagining this specific event and it’s not really happening” They will be convinced that THIS particular moment, their delusions are real. But after the psychotic moment happens, they will freely admit—yeah—that wasn’t real.

Mother has dementia and although most of the time her delusions are real to her, sometimes she is aware that things are not what she believes. When she does become aware of the discrepancies it causes her so much mental distress that sometimes I think it would be better if she did not. But, on the other hand, it is good to have mom back even if only for a short time.
Selfish, I know.

@rojo – dementia is different from other kinds of mental illnesses—I am not sure why. I think it may be because it’s degenerative – and the way it degenerates generally can wipe out out your metacognition early on.

MANY people with dementia have NO idea that they are losing their memory and their cognitive abilities. They will think people are playing tricks on them or odd things are just randomly happening. Many people are like your mother and are at least somewhat aware something is not right.

If you want some interesting stories about people’s metacognitive abilities, try out “The Man Who Mistook His Wife for a Hat” by Oliver Sacks. There are some wild stories out there about people who have serious neurological defects and will have NO idea anything is wrong. One man went basically blind and had no idea. He just imagined things around him and was convinced he could see normally. Nobody knew he was blind until Sacks did tests and his family decided not to bother telling him because there was no way to fix his vision. He had a brain tumor that not only damaged his ability to process sight, his ability to notice this abnormality was damaged as well.