Aphantasia Is Not A Disorder

When Merlin Monzel's lab inbox began filling with distressing messages from people who had just discovered they had aphantasia, the researcher knew something had to be done. "Dear Mr. Monzel, I have recently discovered that I am suffering from aphantasia — can you recommend an expert who can cure me?" read one. Another came from a worried parent: "My daughter has aphantasia and urgently needs to have this certified in order to receive compensation for disadvantages in school." A third carried a particular urgency: "I need help urgently — is that something like dyslexia? I only get B grades at school."

Monzel, who is completing his PhD at the University of Bonn with a primary focus on mental imagery and its absence, had a personal stake in understanding these questions. He has aphantasia himself — in fact, it was the reason he started researching it in the first place, beginning with a student thesis whose results were compelling enough to launch a full doctoral investigation.

Faced with a growing pile of emails from people who were suffering, he and his colleagues decided to do what scientists do: go to the data. The result was a paper — No General Pathological Significance of Aphantasia: An Evaluation Based on Criteria for Mental Disorders — that attempts to answer one of the most practically important questions in the field. Is aphantasia a mental disorder?

The Framework: What Makes Something a Mental Disorder?

Before answering the question, Monzel needed the right tools to ask it. In psychology and psychiatry, a condition only becomes a recognized mental disorder when it is included in a formal classification system — most prominently the International Classification of Diseases (ICD), published by the World Health Organization. Aphantasia is too new to appear there yet, but that raises a useful follow-up question: what criteria would it need to meet?

Most classification frameworks converge on four key criteria. Monzel walked through each using alcoholism as a concrete comparison — a condition most people understand intuitively.

The first is statistical rarity. When something affects only a small fraction of the population, it falls outside the statistical norm. Alcoholism affects approximately 5.1% of people; rarity alone doesn't make something a disorder, but it is a necessary starting condition.

The second is violation of social norms or inappropriate behavior — specifically, behaviors so disruptive that they damage a person's ability to maintain work routines or social relationships.

The third is impairment in activities of daily living: concrete functional deficits that make it impossible to work, maintain relationships, or navigate everyday life.

The fourth — and in Monzel's view the most important — is personal distress. "When someone suffers from a condition," he explains, "I cannot say as a psychologist 'it's nothing, it's not important.' Because when this person is suffering, it is important — at least for them — and I need to help them."

Criterion One: Statistical Rarity — Met

Aggregating data from five population-representative studies, Monzel's team calculated a point prevalence of approximately 3.5–4.8% for aphantasia, depending on which measurement tool was used. That translates to somewhere between 280 million and 384 million people worldwide.

This places aphantasia in rare but notable territory. It is statistically rarer than anxiety disorders (which affect about 14.7% of people) or depression (around 10.8%) — both of which are included in the ICD. On this criterion alone, aphantasia qualifies. But rarity, of course, is only the beginning.

Criterion Two: Impairment in Daily Activities — Not Met

The most replicated finding in aphantasia research is that aphantasic individuals show meaningful impairments in autobiographical memory — the ability to mentally re-experience personal past events. Monzel's own group has published on this, and the effect is well established.

But autobiographical memory is not the same as everyday memory. When Monzel's team administered a questionnaire measuring everyday memory failures — the kind everyone experiences, like putting something down and not being able to find it minutes later, or leaving the house and realizing you've forgotten something — a different picture emerged.

Aphantasic participants did report slightly more everyday memory problems than controls, and the difference was statistically significant. But the magnitude of that difference was small — well below the threshold of two standard deviations that psychologists use to define a clinically meaningful gap. "There are impairments in everyday memory," Monzel concludes, "but they are not severe enough to impair standard activities of daily living like doing your shopping, being able to work, or maintaining relationships."

Other researchers, including those in Adam Zeman's group, have found no differences in working memory between aphantasic individuals and controls — the kind of real-time memory processing that underlies nearly everything we do each day. Some evidence suggests aphantasic individuals may compensate using spatial or verbal working memory strategies rather than visual ones, though this remains an open research question.

On this criterion: not met.

Criterion Three: Violation of Social Norms — Ambiguous

This is the murkiest of the four criteria, and Monzel acknowledges the evidence is limited. Some clues come from individual accounts, including a well-known interview in which musician and aphantasia advocate Ed Catmull — actually, Monzel cited aphantasic Alex Wheeler — described processing the death of his mother differently than his siblings. "It was an incredibly difficult time for me," Wheeler said, "but I dealt with it differently than the rest of my family because I could move on quite quickly, and I felt that was questioned by my brothers."

Whether moving on quickly represents a violation of social norms or simply a different emotional processing style is a matter of interpretation. Research has found associations between aphantasia and both alexithymia (difficulty identifying and describing one's own emotions) and autism — both of which can involve behaviors that others perceive as socially unexpected. And Zeman's group found that 46.5% of aphantasic individuals reported a negative impact of aphantasia on their relationships, often related to the absence of shared memories.

There is also neurological support for emotional differences. A study by Wicken and colleagues found that while both aphantasic and non-aphantasic participants showed elevated skin conductance (a physiological marker of emotional arousal) when viewing frightening images, only non-aphantasic participants showed this response when reading frightening text — presumably because the latter group could generate vivid mental imagery to accompany the words. Aphantasic participants, without access to that visual pathway, showed a blunted physiological response.

Yet when Monzel's team administered the "Reading the Mind in the Eyes" test — a standardized measure of theory of mind developed by Simon Baron-Cohen — aphantasic and non-aphantasic participants performed identically, averaging around 15 out of 21 correct. Since this task involves looking at actual photographs of eyes and inferring emotional states, it mirrors real-world social interaction where visual information is already present. The conclusion: aphantasic individuals appear fully capable of reading social and emotional cues in live contexts, even if their internal emotional responses to imagined scenarios may differ.

On this criterion: not clearly met, though the picture is nuanced and warrants further research.

Criterion Four: Personal Distress — Present in a Significant Minority

This is where the data gets most interesting — and most actionable.

To investigate personal distress rigorously, Monzel's team developed a new tool: the Aphantasia Distress Questionnaire. Rather than adapting a generic wellbeing measure, they built it from the ground up using interviews with aphantasic individuals, asking directly what caused them distress. Three categories emerged.

The first was feelings of inferiority — perceived deficits in memory, learning, orientation, or creativity. One participant described it this way: "Both at work and in my free time, there are challenges or tasks that I can never do as well as someone without aphantasia without a lot of effort or exercise." Crucially, Monzel emphasizes these are perceived deficits, which may or may not align with actual performance differences.

The second was social obstacles — the experience of missing shared memories, feeling communication barriers, or carrying shame around not remembering important experiences. "Not remembering people," one participant said, "therefore missing people less — not reaching out to them as much as I should."

The third was personal detachment — a sense of loss around significant life memories. "I am sad that I cannot remember details of past events — kids' birthdays, trips, or my parents' voices or faces."

When the questionnaire was administered to 156 aphantasic participants, the results were striking in both directions. A clear majority — 65.3% — did not experience significant personal distress. Monzel calls this the "aphantasia resilience group." But 34.7% did report meaningful distress, and within this group, elevated rates of anxiety and depression were found. Those with worse everyday memory and poorer emotion recognition scores were more likely to fall into the distress group.

So the question of personal suffering doesn't have a single answer. For most people with aphantasia, it isn't a source of significant distress. For roughly one in three, it is — and that matters.

Why Do Some People Suffer and Others Don't?

Monzel proposed four possible explanations for why a subset of aphantasic individuals experience distress.

The simplest is that aphantasia directly causes distress in some people — that the absence of mental imagery is itself the problem for those individuals.

A more subtle possibility is that the discovery of aphantasia, not aphantasia itself, triggers distress. Many people live their whole lives without knowing they experience the world differently. When they find out — often through an online article or community forum — they suddenly have a framework for what they've been missing, and that realization can be destabilizing. "In the moment they found out that they are different from other people, that they lack something most people experience, they started to feel different — they started to feel bad," Monzel explains.

A third theory involves a common underlying cause — such as trauma — that independently produces both aphantasia and distress. This seems particularly plausible in acquired aphantasia, where a neurological event or traumatic experience may have simultaneously altered imagery ability and introduced psychological suffering that is difficult to disentangle.

Finally, there may be a personality-based explanation in some cases, where people who are prone to experiencing distress in general attribute that distress to aphantasia. Monzel's team investigated this by looking at neuroticism — a personality trait associated with negative emotionality — but found no meaningful connection to aphantasia-related distress, casting some doubt on this explanation.

The Verdict — and What to Do About It

Applying the four criteria, Monzel's conclusion is clear: "Only one out of four criteria for disorders were met — namely statistical rarity — and the other criteria were either not met, or the impairments were simply not strong enough to have an impact on daily life, work, school, or relationships."

Aphantasia, in general terms, does not meet the threshold for classification as a mental disorder.

But that doesn't mean the one-third who are suffering should be left without help. Monzel proposes a practical bridge: the ICD category of adjustment disorder, defined as a maladaptive reaction to an identifiable psychosocial stressor. The discovery of aphantasia, he argues, can legitimately qualify as such a stressor — particularly in countries like Germany where a formal diagnosis is required to access publicly funded mental health care.

Under this framework, people who are genuinely suffering can access professional support, including psychoeducation about what aphantasia actually is and isn't, training in compensatory memory strategies, and — perhaps most importantly — information about the positive dimensions of aphantasia that often go unacknowledged.

The Upsides Worth Acknowledging

Throughout his interviews with aphantasic individuals, Monzel has noticed a recurring theme: many describe a heightened ability to be present in the moment. "Many aphantasics reported not thinking about something bad in the past or some distant future, but always living in the present," he says. "We call this mindfulness — it's a really cool concept, being in the moment. And I think this might be something essential for a happy life."

He has no hard data on whether aphantasic individuals are actually happier on average, but it's a hypothesis he's actively pursuing. The absence of intrusive visual memories may confer a kind of resilience, a natural buffer against rumination and emotional re-experiencing that many non-aphantasic people work hard to cultivate through meditation and therapeutic practice.

Where the Research Goes From Here

Monzel is careful to acknowledge the study's limitations. The four-criteria analysis covered only a narrow slice of the abilities that might theoretically be impaired or spared in aphantasia. Everyday memory and theory of mind are meaningful measures, but they don't capture everything that could constitute social impairment or daily living difficulty. More comprehensive characterization of aphantasia subtypes — visual versus multimodal, congenital versus acquired — remains an important priority.

His current recommendation: treat aphantasia as a cognitive style or a form of neurodiversity rather than a disorder. Brain imaging work from his group, due to be published in the near future, documents structural and functional differences in aphantasic brains — differences that confirm this is a genuine neurological variation, not a matter of introspection or imagination.

As the paper concludes: "According to the criteria of Davidson et al. (2016), aphantasia generally does not reach pathological significance. In individual cases, symptoms of distress should be taken seriously and reduced with the help of treatment, as they are associated with lower well-being, depression, and anxiety. The advantages of aphantasia should also be considered in future."

For the two-thirds who have discovered aphantasia and feel at peace with it, the message is straightforward: you don't need to think of yourself as disordered or different in any clinically meaningful sense. For the one-third who are struggling, the message is equally clear: your distress is real, it deserves care, and help is available — even if the therapist you visit has never heard the word aphantasia before. Send them the article. They'll read in.

For those seeking mental health support, our Aphantasia Specialist Directory connects people with aphantasia to professionals who understand the unique aspects of this neurological difference.

Is Aphantasia a Mental Disorder? A Researcher with Aphantasia Investigates