The perception of reality can be altered for individuals experiencing psychosis, including those with hallucinations and delusions. Whether or not they are aware that their hallucinations and delusions are not real can vary depending on the severity and type of psychosis, as well as the individual's insight into their condition.
Lack of Insight (Anosognosia): Some people with psychosis, particularly those with severe conditions like schizophrenia, may have a lack of insight into their illness. This means they are not aware that their hallucinations and delusions are not based in reality. From their perspective, these experiences may feel just as real as anything else in their lives. This lack of insight can make it challenging for them to recognize their need for treatment or to understand why others may be concerned about their well-being.
Partial Insight: Some individuals may have moments of clarity or partial insight. They might be aware that some of their experiences are not real, but at other times, they might get completely absorbed in their hallucinations or delusions and lose this awareness.
Full Insight: In some cases, individuals with psychosis may have a better understanding of the distinction between what is real and what is not. They might be aware that their hallucinations and delusions are products of their own mind and not external reality. This level of insight is more common in some less severe forms of psychosis or during periods of remission when symptoms are not as acute.
It's important to recognize that psychosis is a complex and diverse condition, and each person's experience can differ significantly. Additionally, the level of insight can change over time, and treatment can also play a role in improving insight for some individuals.
Family members, friends, or mental health professionals often play a crucial role in helping individuals with psychosis recognize the need for treatment and supporting them in managing their condition. Early intervention, appropriate treatment, and ongoing support can improve an individual's insight and overall prognosis.