What’s Your Mental Illness Decision-Making Style?

What's your mental illness decision-making style? Confused person standing by signpost

Most of us are naturally inclined towards being more rational or intuitive in our decision-making. Personally, I tend to be much more on the rational side of the spectrum. But then you layer mental illness on top of that, and it can start to get more complicated.

The basic scenario we’ll use for the post is being at the grocery store, standing in the cheese section, and needing to make a difference about what kind of cheese to get. It’s a scenario I was in not too long ago was my brain was really mashed potato-y, so that’s the story behind that.


Perhaps contamination obsessions are telling you that if you don’t pick the right cheese and take it home in exactly the right way, funky bacteria in the cheese will wipe out your family.

Needing to make the “right” choice

Perhaps your inner critic tells you that if you make the wrong cheese choice, your family, or whoever you might be serving the cheese to, will decide that your bad cheese choices make you a useless human being, and you’ll be stuck with that shame until the end of time.

Not trusting your judgment

The self-doubt monster might be sitting on your shoulder all the way to the checkout, and perhaps all the way home, hissing at you that you know sweet bugger all about cheese and you’re not even close to being qualified to make any cheese-related decisions.

Overwhelmed by pros & cons

More options is not necessarily a good thing. With 3 options, you’ve got 3 sets of pros and cons to weigh. With 10 options, you’ve got a headache. If you’ve got 20 options, your brain might explode.


By indifference

You couldn’t care less what kind of cheese you get, because you really don’t care about much of anything lately. You think you might possibly care when it’s time to eat the cheese, but it’s hard to make a decision based on a future possible interest.

By overthinking

Similar to getting overwhelmed, this paralysis gets stuck in overanalyzing. Going so far in the analytical direction leaves you with nothing in the right here, right now.

Wikipedia offers this quote from Alfred Henry Lewis: “The best thing is to do the right thing; the next best is to do the wrong thing; the worst thing of all things is to stand perfectly still.”

By underthinking

There’s a different kind of decision paralysis resulting from underthinking. The part if the brain that makes decisions is away on vacation. The relative merits of the different cheeses don’t even enter the equation.

This is what was happening to me on a recent trip to the store. There was no thinking about pros and cons; that part of my brain was MIA. So I stared blankly at the cheese for several minutes. Normally, I would give up and walk away without any cheese, but I had already made the decision to buy the ingredients for a dish that required cheese of some sort, so I stood and stared until I finally grabbed one.

Some more from the comments…


What? There’s cheese? I didn’t even realize I was in the grocery store…

Same same… and same

Decision-making can be avoided entirely if you get the same cheese every single time.

All you can eat buffet

Then there’s the manic need to have as much cheese as possible, as quickly as possible, and throw in the most expensive cheeses from the deli for good measure. Credit card limit? What’s that?

Must get it now!

The person coming down the aisle behind me might grab the only good cheese that’s left, so I have no more than 2.6 seconds to act or I’ll miss out on the good cheese!!

To summarize, the possible decision-making approaches we identified were:

  • catastrophizing
  • needing to make the “right” choice
  • not trusting your judgment
  • overwhelmed by pros & cons
  • paralyzed by indifference
  • paralyzed by overthinking
  • paralyzed by underthinking
  • dissociated
  • no decision needed when it’s always the same
  • get it all
  • get it now

There’s nothing simple about living with mental illness! Are there any other cheese decision-making processes you can think of? Do any of these resonate with you?

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61 thoughts on “What’s Your Mental Illness Decision-Making Style?”

  1. I think I experience most of these from time to time. Underthinking is the least likely I think. And indifference only happens if I am severely depressed or it is honestly something I just don’t care about at all.

  2. Yes, I am familiar with some of those you mention. Not all at the same time though. It can vary.
    I can have dissociation as well, which is a factor of a different scenario, that affects me and my mental health. Or just zone out.

    Like how I am currently now, at my peak of anxiety and stress, I can’t cope making some decisions and I have had days I can’t be arsed.
    But surprisingly, I do give a crap about some other situations and I am on a mission with that.

  3. I’d have to say that not trusting my judgement is my primary issue *because of* my need to make the right choice, which leads to indifference paralysis. This trio of terror often manifests itself into psycho-somatic physical illness, too. Like a jackpot! 🤦🏻

  4. I never overthink anything. Nor do I get paralyzed with fear resulting in activity…said me NEVER. 🙄

    Great analysis with the cheese selection. I copied the quote and will compose something on that…

  5. I think I do the autistic thing of buying the same thing every time to avoid having to make a decision or try anything new… Sometimes with a decision with lots of multiples, I have to eliminate options for quasi-arbitrary reasons to get a more manageable amount of options.

  6. I over analyze a lot of things. Before going out to the store, I’ll look online what kind of cheese they have in what store. Off course the world isn’t perfect and let’s say they don’t have it in the store when I arrive, I’ll pick one to the best of my abilities and be plagued all the way home with a little voice that says that I don’t know anything about cheeses. And that my decision will proven to be right or wrong as the recipe turns out good or bad. It can be such a difficult process for something really easy.

  7. These decision-making styles seem to map quite nicely to certain CBT thinking errors.

    Which reminds of my a particularly deadly one for me: emotional reasoning… I feel terrible, and that colours all of my thoughts and decisions… whether I want cheese, whether I even like cheese any more, maybe cheese is even the reason why my life sucks so much.

  8. I get pretty overwhelmed regarding choices and decisions. Whatever i do could have terrible consequences and that makes me stop and worry over each detail. It’s been a problem for a long time…

  9. I love this cheese example – such a simple yet very relatable instance. I’m feeling indecisive about which example rings most true for me 🙃 – a telling reminder that they all fit, individually and often simultaneously.

  10. I have had all those states of mind in varying degrees and about everything including cheese choices. Sometimes one or another is a ‘louder voice’ than the rest, but the whole social phobia around cheese bacteria has never gotten too out of hand. Well unless it’s 3 a.m. At 3 a.m. all the voices sometimes come out and shout. I try to practice mindfulness, but sometimes I lose the battle. One I didn’t see in your own list was the “I have to buy it NOW , because someone else will get it first if I don’t, and there won’t be any ‘good’ cheese left!” school of impulse buying train of thought. That one is a nasty bugger to best..

  11. Great post Ashley. I probably do all of these at anyone time. The over thinking, wanting it to be perfect and catastrophising happen when I move into am anxious state, over functioning and becoming the super planner and organiser extraordinaire. I’d know all there was to know about each and every cheese until my brain couldn’t take any more and then boom! I would stop, disengage and pick up the nearest cheese or just leave the shop, cheesless. Head home And get into bed.

  12. I am not sure what you would call my style. I always make a list of what I need. I usually buy the same brand of soap, cereal, coffee, etc.,
    I never go shopping when I am hungry, I heard or read somewhere if you are hungry when shopping you will spend more.
    Yet, if I see a good deal on something that might be an extra I will stop and consider if I really should buy it.
    Before meds I couldn’t go shopping if I thought there was going to be a crowd of shoppers. It would trigger a panic attack.

  13. All of the above, at different times, and in different situations. Lately “overthinking” seems to prevail. In fact, I’m so conscious of the tendency to overthink that I sometimes combat it by making a quick intuitive decision (and later feel guilty about it, because I might not have “gotten it right.”

  14. I am happy for someone else to make most of my choices. But I become impassioned about making my own choices with regards to my conscience. If I have to make a practical choice, I will usually go for the simplest option – avoiding expense and debt whenever possible. Sometimes it has been good for me that someone else makes the choice regarding budget, because I would be such a penny pincher, whereas others usually allow a more generous budget,

  15. Lol! I think “overwhelmed by pros and cons” resonates the most with me. I haven’t been to a store in many months, but when I did go, I definitely sometimes spent half an hour readings labels and googling things before choosing… lol. If I know I like something, I’ll definitely get that same thing over and over. I only have to make choices if they don’t have it anymore or I need something new.

  16. Grr, l wish you hadn’t set this for cheese ha ha. My Asperger’s gets what you are saying but l am literally stuck on bloody cheeses. Personally, if l am to buy cheese – l know what it is l want and get to the counter and say the cheese l want, get the cheese l want, and go.

    Too many indecisions and choices is just too much!! It’s for goodness sakes. My main concern is if in the process of viewing, some twit behind me mutters something l tend to turn around and smile at them a huge cheesey grin and shrug, whilst deep down l want to grab a hug wedge of some rock hard cheese and batter them to death with it 🙂

    So what’s my profile then doc??

  17. Great post! In my case it is usually catastrophizing followed by a state of being totally paralyzed by overthinking. But it is getting better – I used to be afraid of everything but over the years I have seen that most of my worst-case nightmare scenarios did not come true so I have kind of learnt to be a little bit more rational! Still a lot to be learnt though

  18. I felt this post too heavily related to me 😅 It’s such a constant battle with too many enemies yet in the end we command both teams. Realizing, accepting and strategizing against ourselves is the hard part.

  19. Haha I find myself doing everything above sometimes! I’m a chronic overthiker and I tend to overanalyze things as well. Being aware of myself doing these helps me put myself back on the ground and just go with a decision.

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