“It’s Ok, You Can’t Help It”

The Madhouse (Photo credit: Wikipedia)

Remembering a comment my mother made some time ago when I was depressed has made me think a little. She said, “We didn’t know whether you were ill, or just being unpleasant.” It led me to question how much responsibility I really bear for my behaviour when I am ill. It is true that my depressions lead me to irritability, a conviction that everyone hates me and a determination to prove them right. My (hypo)manias lead me to think that I am the most wonderful person around and that no one else is really important. Both sides of my illness make me selfish, uncaring of the thoughts and feelings of others, and decidedly unreasonable. My parents, and to a lesser extent my other loved ones, my friends, bear the brunt of what is admittedly bad behaviour when I am ill. If I were to sum up what is wrong with the way I relate to others when unwell it is that I fail to love, respect and treat others as though they were myself. (Small caveat: in depression I am self-loathing, so it is really to treat others as they deserve, from the love that I have for them rather than being all about me, me, me.)

How far can I blame what I do in periods of illness on that illness? How much responsibility do I bear for what I do? How much is sinful behaviour, and how much something I cannot help due to my mind being unbalanced at the time? These are really difficult questions, and I would not extrapolate from my thoughts and feelings on the issue onto another person who has a mental illness – I can only speak for myself here.

It is tempting to go with those who say “you couldn’t help it” and to lay the blame for my actions squarely on the illness. But I don’t think that that is strictly true. To use Christian terms, I have a sin-nature, a propensity for evil that, if I did not have it, would not lead me to sin when ill. If there were no nastiness, no selfishness in my soul then my illness would never lead me to being that way. For instance, I am absolutely not a violent person – so when I am ill, I have never been violent, no matter how ill I may have become. I do have a tendency for self-violence, in the form of self injury which when well expresses itself as a perfectionist streak, with accompanying critical bent toward myself. When I am ill, that criticism of myself becomes a roaring fire which propels me into hurting myself partly as a punishment for being so unworthy of good treatment. I believe that my illness takes things that are already there in my nature and magnifies them. I frequently dislike myself, so when ill, I hurt myself and eventually feel suicidal. I am quite selfish, and self-absorbed, and when I am ill I become negligent of other people’s feelings and welfare, actively so, rather than in the confines of my own head.

I do feel that when I am unwell I struggle to understand the impact of my words and actions. I fail to understand that other people are hurt by what I do when I am struggling under a depression or a hypomania. I lose the control, the veneer of civility that stops me from doing bad things when well; it comes tumbling down when I am ill and my own sinful tendencies are both magnified and set free.

Mental illness is hard. It is hard for me to think beyond myself, to acknowledge other people. I am incapable of keeping up appearances. My mentally-ill-self is all my bad points writ large. To me, I cannot be forced by illness into doing something totally outside my own nature. I don’t know how other people feel about this – I am perhaps speaking for only myself.

I can sometimes barely remember, if at all, what I have done in periods of distress. My memory glosses over those parts – perhaps, as one psychiatrist said, to protect me from the emotional fall-out of what I have done, especially because I am acutely self-conscious and easily embarrassed by myself. That makes it hard to make amends, and it is then that I am grateful that those who know me, know that I have a mental illness which does affect my behaviour. I don’t think that I am fully responsible for everything I do when ill, because the illness affects my thought processes, and it does change me very visibly from the person I am when well. That said it is not a simple process – when I am unwell I am not completely well one minute, and completely unwell the next – there are stages in the journey. At what point in that journey do I become less responsible for my actions? When do I decide that the illness has played a part in something I have done?

These are questions I find very difficult to answer. I believe, in essence, that the illness takes away my agency, that it influences my choices to do good or to sin, but that it cannot create what is not already there, albeit in a differing degree. When it comes to explaining my behaviour it is a useful tool – as an explanation, but not an excuse. If I were to commit a crime I would not be judged not guilty by reason of insanity, because I know right from wrong, and I know that I should not, for instance, be unpleasant to other people when they have done only good for me. It is not an excuse, but it can explain why I do things I would not normally do, when ill.

Could I stop myself from acting wrongly when ill? That, for me, is a major question. Is it possible to be suffering mentally and yet not behave badly? Not be neglectful of others? I suppose what I am asking is whether it is possible to be mentally disordered, and yet have my behaviour not change. While I am not the most flagrantly “mad” person around, it does affect me in more than just internal moods and thoughts. I act differently when I am ill, and generally less well. Yet the Bible says that:

No temptation has overtaken you except what is common to mankind. And God is faithful; he will not let you be tempted beyond what you can bear. But when you are tempted, he will also provide a way out so that you can endure it. (1 Corinthians 10:13)

How do I deal with this verse? Can we be described as being tempted to do wrong when ill, when it does not feel like a choice we make at the time? Or can it be that we can resist wrong-doing even when we are unwell? On this one, I don’t have an answer. Just a lot of questions.

To excuse my actions by saying “it’s ok, you’re ill” is kind, but I am not sure it is right. I did the wrong thing, whether I was ill or not, that wrong deed should be amended for. I believe that we should confess to God the things we have done when ill, even when it was inadvertent. There is still hurt left in my wake, and still work to do to undo the hurt I have caused when I am ill. If I were to slap someone while ill, their face would still remain slapped, even if I was not aware of what I was doing. I believe I still need to make reparations in my life to those I have wounded – even when I was ill, and even if I had no intent to hurt anyone at the time. I also believe I owe repentance to God, again even when I had no intention to hurt him, or any other, even when I did not realise I had a choice of actions to make. I believe that, were I to have my sin-nature removed, I would not sin when ill. My bad actions grow out of bad aspects of my character. That said, I wouldn’t do the things I do when ill when I am well, whether that be because of socialisation or keeping up appearances. If I wrong you when ill then my illness may help you understand why I acted the way I did – but it does not take away the fact that I acted that way. I am still at least partially responsible for the things I do, for it is still I who does them. My illness does not make me a completely different person – we are not talking about possession here – it makes me a worse version of me, with a higher propensity to do wrong, but I am still me, even if diluted. Perhaps one day I will understand the verse in Corinthians, and find a way to guard myself from sin when ill. I don’t know whether that is possible, but I certainly pray that it is.

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• The Anti-headline (kevinroy.org)
• Mental Illness: An Excuse for Bad Behaviour? (summersolsticemusings.wordpress.com)
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• Mental Tip – MENTAL ILLNESS, MENTAL HEALTH & WORLD MENTAL HEALTH DAY (mpsehealth.wordpress.com)