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Once again I have been remiss in my plans to blog regularly. I am currently trying to work out the direction I am going to take and remember what I’ve already written so I’m not just repeating myself. One thing I have found interesting is that despite a lack of posts I maintain a steady stream of readers to this site every day, just a few, but still some. What is most interesting about that is that I would say at least 75% of them are viewing this post. It has been shared 81 times on facebook, when I imagine most of my other posts have not even been read once! It’s a post that, to me, asks more questions than it does provide answers, but that clearly touches a nerve with many.

As such, I wanted to try and delve deeper in the topic of mental illness and responsibility. And I do not mean this is the legal way, I do not want to debate legal responsibility–is a person with schizophrenia responsible for a murder if he didn’t realize he was committing it–I want to look at the more everyday aspects of responsibility, our general behavior.

The post I wrote over 2 years ago now talked about my pet peeve being using mental illness as an “excuse”. To say, “I’m sorry I was rude to you, but I’m feeling depressed” is something that bothers me, but I do not fully understand why. As I’ve thought further about the issue I realize in many ways the potential hypocrisy of my position. I am perfectly willing to accept a person with narcolepsy falling asleep during a conversation because that is part of the disease. I worried that my distinction was a form of prejudice: was I still viewing mental illnesses as distinct from physical illness in regards to how individuals can control their behavior and symptoms?

I don’t think that is the case. And I think that narcolepsy is a poor comparison in this situation. Falling asleep is part of what makes narcolepsy narcolepsy, it’s one of the major symptoms. Rudeness is not a specific symptom of depression. But to be fair I want to set up a real comparison, and I think the example of pain is helpful. I have known a number of individuals with chronic diseases that resulted in chronic pain, and as a person who does experience pain myself I have experienced prolonged headaches and have an idea of how debilitating pain can be.
Pain is a useful comparison because it’s abstract. A person may have pain as a result of an injury or a chronic disease, but either way there is no explicit way to quantify the pain. The same is true for symptoms of mental illnesses.

Being rude and snappy is not specifically a “symptom” of pain, but I have known others and have also found myself lashing out at a friend because I was cranky due to pain. The next step, when realizing that you have behaved unfairly, is to apologize; so what do you say? I have done it myself: “I’m sorry, that was rude. It’s just that my head is killing me”. How is that any different to saying “I’m sorry I was rude, but I’m depressed”?
At the core there is no major difference, so I had to ask myself why I think there is one.

And I think the answer is that in that type of situation I agree there is no difference. This is when I realized that what really bothers me is intentionality and repetitiveness of the “excuse” and the behaviors. I have had friends apologize for being rude and explain that it was due to being exhausted and depressed and this did not bother me. The problem arises when a person is chronically rude or behaves badly in some other way, makes no effort to change, and just says “oh, I have a mental illness” as if that explains away and excuses their behavior. However, is this any different to the way some people behavior with other illnesses? There are individuals with chronic diseases who are assholes and use their disease to explain away any negative behavior. This has not stopped us generally accepting when a person explains a negative behavior as being a side effect of some aspect of their chronic disease. Why do we single out mental illness?

I think part of it is linked to what I mentioned in the original post. Individuals who are part of groups that are discriminated against are constantly held to a higher standard and seen to represent the whole group. If I behaved badly at work my employer would think that I was a bad employee. But if I had bipolar disorder and was open about that at work and then behaved badly my employer may make the assumption that anyone who had bipolar disorder was a bad employee. While this is not fair or right, this is the way that people think, we just have to look at the general attitude towards Muslims as a result of a few very bad people who are Muslim.


While I still stand by my original statement — that mental illnesses are not excuses for bad behavior — I think that I need to be more specific in the nuances. Really, nothing is an excuse for bad behavior; we can provide explanations to those who we have hurt and hope that those explanations suffice. But it is important to remember that these are explanations, not excuses. Behaving badly towards those around you is not a “symptom” of any chronic disease or mental illness in the way that falling asleep is a symptom of narcolepsy. The behavior is a consequence of other symptoms, and quite often reasonably so: a person with insomnia and crippling depression can’t be expected to be the cheery life of the party and sometimes putting in the effort to go out and be with people can be so exhausting they snap and behave meanly to those around them. This is completely understandable. But there is a difference between an explanation and an excuse. It becomes an excuse when a person behaves badly because they think they can get away with it as a result of their condition.

Unfortunately, there are situations where people use both mental and physical illness to “get away” with bad behavior. But we have to be careful not to assume that to a greater degree with mental illness than physical illness. We have to be responsible for dealing with our own biases.
I hope that the pain analogy may be helpful to distinguish our own potential ingrown prejudices. If you are frustrated by a person’s behavior and believe they are using their mental illness as an excuse, just ask yourself if you would feel the same if they had another more physically visible disorder that caused chronic pain and they were using the pain as an excuse. Would it still bother you then?