MH@H Mental Health

Mental Illness Jekyll & Hyde– How Responsible Are We?

Mental illness Jekyll & Hyde

I got thinking about this after reading a post on SkinnyHobbit – to what extent are we responsible for bad behaviour during active episodes of mental illness?

The short answer is that we’re 100% responsible, in the sense that there’s really no other person to lay blame upon.  Perhaps a more meaningful question would be how much control we have over our behaviour in the context of illness.  To peel back another layer, we can consider looking at the degree of responsibility we have when well(ish) to try to prevent the illness from deteriorating to the point that it affects our behaviour.

Probably the worst acting out I did in the context of illness happened the day before my first psychiatric hospitalization.  I was fighting with a friend, and ended up throwing a large rock through his window.  Is that something I would ever have contemplated doing in other circumstances?  Absolutely not.  Was it his fault?  He was being an ass, but no, I can’t blame it on him.  Was my judgment impaired?  Absolutely.

Another problematic incident was at a work team-building retreat.  At the time I was holding myself together, but just barely.  Alcohol was acceptable at these team retreats, so I brought an amount of booze I knew I should have no problem handling when spaced throughout the day and mixed with food.  Unfortunately, it was enough to be the straw that broke the camel’s back, and I went into drunken meltdown mode. 

I decided I was going to drive myself home, despite being barely coherent.  Coworkers had to physically restrain me.  Someone drove me home and I sobbed the whole way.  Was this normal behaviour for me?  No.  Does this fit my moral code of never driving while impaired?  No.  I had taken what I had thought were reasonable steps to ensure moderate alcohol consumption that would leave me sober by the end of the day.  But was I responsible?  Yup.

Sometimes when I’m depressed I’ll go through phases of being highly irritable.  The last big blowup was a couple of years ago, when I started shouting and swearing at a friend of a friend in a public place.  I knew I was irritable, but my best friend at the time was playing a musical gig, so I felt obligated to be there.  In this case I do hold my friend a little responsible for not releasing me from my friendly duties when she could tell I was about to blow.  Still, it was me who did the yelling and swearing.

None of these examples are things that I would ever even contemplate doing when in a clear frame of mind.  The first example I wasn’t receiving treatment yet, but the other two examples occurred while I was on medications, and trying the best I could to manage a difficult illness.  Sure, I could have made different decisions, but hindsight is 20/20.

So, how responsible are we for our behaviour when ill?  Sure, we’re responsible, but when judgment is seriously impaired, there’s limited control over our behaviour and limited ability to exercise the higher level thinking that would normally shut that mess down.

What I hope is that the people around us are able to distinguish between that responsibility and lack of control.  After all, when the shit hits the fan they’re likely the ones with relatively clear judgment; us, maybe not so much.

book cover: Managing the Depression Puzzle, Second Edition, by Ashley L. Peterson

Managing the Depression Puzzle takes a holistic look at the different potential pieces that might fit into your unique depression puzzle.

It’s published by MH@H Books and available on Amazon and Google Play.

29 thoughts on “Mental Illness Jekyll & Hyde– How Responsible Are We?”

  1. I totally get what you’re saying. I do feel though that when we can’t get out of our minds is difficult to see you’re making bad decisions. Is that a choice i just don’t know.

  2. Bravo Ashley. Who is responsible? Helping people see their choices and making clearer ways to deal with themselves would go a long way. In the middle of feeling like trash, we act out. We are responsible but I feel we cut a bit of slack to those navigating learning self-control. For those who totally lose it a million times… 🤦🏼‍♀️ perhaps the degrees of enlightenment is what we can explore. Obviously some are not consciously aware… so we tread lightly and help them gain the needed awareness. If possible. Perhaps that is why we developed institutions to begin with… the energy needed to help people in such situations is enormous.

  3. It’s difficult when you have a disordered mind. That’s all I’m saying. Yes I think we are responsible however, we are all the product of our upbringing, experiences aswell as other traumatic events that shaped us, our thinking and personality.

    I think it’s reasonable to say that someone with BPD or any other severe mental illness is not going to be in wise mind a lot of the time and any understanding person needs to take that into consideration.

    It’s not an excuse, that is a fact.

  4. I totally agree with this post, we are responsible for our behaviour. After years of having the illness, I am slowly learning how to handle myself when I hit rock bottom.

  5. Somebody has to take responsibility, and if we are in the wrong it is important to realize that and try to make it right. My mom always used her mental illness for an excuse for her abuse and I just don’t buy that. Especially when she would never really put effort into working on herself or getting therapy.

  6. I think where I’ve gotten into trouble with this is that I’ve confused being responsible with being a horrible person and invalidating the immense pain I’ve been in when bad behavior has happened. On the receiving end of bad behavior it’s felt like trying to understand where the other person was coming from, extending compassion (where appropriate-I know every situation is different) but not taking away that what they did hurt me…and vise versa that things I’ve done have hurt others regardless of circumstance.

  7. Bravo for this wonderful post. Yes, it’s us who takes the offending actions, and us who needs to make sincere amends afterward. The next step is making sure we’re forgiven. Ideally, of course, by those who we’ve wronged, but also by ourselves.

    That’s the hardest part for me and it winds up being a horrible cycle. Get into a bad state, do bad things, come out of the state and get clarity, feel awful about the actions committed, self-judgment and guilt start a spiral into a bad state again… It’s miserable.

  8. There are so many behaviors that I had pre-diagnosis that I always thought came from being immature. Because I would never do any of those things now.

    1. We actually agree, however that a person or persons should always be held accountable for their behavior, regardless of diagnosis. It’s the only way to get healthy and remain that way.

  9. Great post. This is definitely a thought-provoking topic. I still remember my mental state and behavior from my first (and only) manic episode. I was on autopilot and my behavior and words were not premeditated or planned. They just happened and I had little control over them. I did some really weird stuff (hahaha).

    I had no idea I was bipolar, so I wasn’t medicated. Thankfully, I didn’t do anything that harmed me or anyone else, though I did lose some friends as a result of my diagnosis. I was at college when it happened, and I tried to stay in touch with some people I met there–I was there less than a week–but nobody reciprocated. That hurt, but it made my decision to go somewhere else the following spring much easier.

  10. I have anxiety. For me, I feel like I am responsible for my behavior because there are steps I can take to change. On the other hand, I feel like I can’t control how I am because I am not fully in control at times even though I know what I am doing

  11. I can relate to this so well. I have broken my mother’s phone once and threw a bottle of water when I was angry. I felt horrible and guilty

  12. I am bipolar and had one manic episode. I picked up the waitress at a diner by my apartment building, walked her to my home, and got her blouse off. I knew I could not consummate the encounter and had a neighbor drive her to her home. I don’t do this normally. I was on lithium at the time. On a routine visit to my psychiatrist, he diagnosed my symptoms. That day, I was in the psych ward at the veterans’ hospital. I was not responsible for my behavior. I did not knw what I was doing. I remember the incident but not thinking twice about it. This happened twenty years ago and I have not had a manic episode since. My bipolar disorder is now controlled with Depakote. I do not get mood swings. I continue to preach: exercise, socializing, and pursuing hobbies. Prayer helps, too. There is more to treatment than taking your pills and staring out the window. Ashely, you should know enough not to drive and drink. You should knw enough not to drink and take your pills. Do what your doctors tell you to do! Admittedly, I drank to drunkenness on Haldol for years. Voice of experience.

    1. It’s scary how illness can make us do things we would never think about doing otherwise. Being on the right combination of meds can make a big difference.

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