Why Can’t You See It? Understanding 'Lack of Insight' in Bipolar Disorder

You can be living in a storm and swear it’s a sunny day. That’s what it’s like when insight slips away. In this episode, Dr. Nicole (board certified psychiatrist) and Kit Wallis (lives with schizoaffective disorder) explore why people with serious mental illness, like bipolar disorder, often can’t see their own symptoms — even when the evidence is undeniable. Dr. Nicole unpacks the science behind lack of insight and explains how it isn’t all-or-nothing. Insight flickers, evolves, and sometimes disappears just when you need it most. From Kit’s early experiences hearing voices (and assuming they were just a creative mind) to the manic episodes that shattered her reality, you’ll hear firsthand how denial and confusion can coexist. Discover why antipsychotic medications didn’t convince Kit the voices weren’t real, why manic highs feel too good to question, and why telling someone “you’re sick” rarely makes them believe it. If you’ve questioned why it’s so hard to see bipolar symptoms in yourself or a loved one, this conversation will open your eyes to the hidden forces behind denial — and acceptance. Cold Open Transcript: Kit Wallis: It took me years to figure out I was hallucinating. And the voices hated it whenever I did that. They were like, don’t do that, don’t research us, don’t do that. Looking back on it, it doesn’t make sense, but in the moment, it made perfect sense to me. It’s kind of wild to me that I can go through all this effort to really figure out what is going on and I still have moments where it just completely slips my mind. It still slips my mind when it is happening most of the time. We have a guest host for this episode (Don’t worry, Gabe Howard will be back!): Our guest host, Kit Wallis, who goes by SchizoKitzo, is a content creator who advocates for schizoaffective and bipolar disorders. She uses long-form videos on her YouTube channel and short-form content on platforms like TikTok and Instagram. Her content centers around her personal experience with schizoaffective disorder and often includes deep dives into research topics regarding mental health. Kit was diagnosed with the bipolar type of schizoaffective disorder in late 2020 and has struggled with symptoms since she was in middle school. Schizoaffective disorder is a mental health condition where someone experiences symptoms of schizophrenia--such as delusions and hallucinations--but also symptoms of a mood disorder--either major depression or, in Kit's case, bipolar. Realizing there was a lack of schizoaffective advocates, she decided to start her SchizoKitzo project to raise awareness for this complex condition. The mission of SchizoKitzo is to raise awareness of schizoaffective disorder and all of its aspects, from the mood side to the psychotic side. Kit works to bridge the gap between life and science so she can help break the stigma around mental health. Our host, Dr. Nicole Washington, is a native of Baton Rouge, Louisiana, where she attended Southern University and A&M College. After receiving her BS degree, she moved to Tulsa, Oklahoma to enroll in the Oklahoma State University College of Osteopathic Medicine. She completed a residency in psychiatry at the University of Oklahoma in Tulsa. Since completing her residency training, Dr. Nicole has spent most of her career caring for and being an advocate for those who are not typically consumers of mental health services, namely underserved communities, those with severe mental health conditions, and high performing professionals. Through her private practice, podcast, speaking, and writing, she seeks to provide education to decrease the stigma associated with psychiatric conditions. Find out more at DrNicolePsych.com.