Personal Responsibility

[WinterSky]

I'd like to know how you feel about this. Mental illnesses are illnesses of the brain. How we behave is a result of what is happening in the brain, correct? When is mental illness a reason for our behavior and when do we take responsibility?

When I was working I had huge problems with insomnia. I was depressed and weepy, wasn't able to interact, concentrate, etc. I had treatment resistant depression. It affected my perceptions tremendously. I'd run into conflict after conflict with other people and thought the whole world was against me. How much of my behavior would you say I actually had control over? And at what point should accountability begin?

[Proverbs31:28]

Personally, I think so long as we are cognizant of the choices before us we are responsible. I also think far too many people use mental illness as an excuse for their behavior. I am NOT saying this is true in your case or any particular case but I do see it a lot in the media. I was in a situation similar to yours. I had a difficult time concentrating at work, would burst into tears in the middle of meetings with clients, would hide under my desk when the phone rang, could not sleep, could not interact on a regular basis with co-employees, superiors or clients but, believing I could not possibly have a mental illness, I got up everyday and went to work where very little got accomplished each day. I let deadlines pass, didn't follow up on things I should have, etc. Was I responsible for those behaviors if my depression and anxiety is what made it so difficult for me to accomplish what I needed to? I think I was responsible because I could have made a choice to take a leave of absence rather than continue performing at that abysmal level. Instead, I let it get to the point that I had no choices left- I was forced to take a short term leave of absence and, eventually, disability was the best choice for me. I do not think that excuses me from my poor performance, however.

[WinterSky]

Personally, I think so long as we are cognizant of the choices before us we are responsible. I also think far too many people use mental illness as an excuse for their behavior. I am NOT saying this is true in your case or any particular case but I do see it a lot in the media. I was in a situation similar to yours. I had a difficult time concentrating at work, would burst into tears in the middle of meetings with clients, would hide under my desk when the phone rang, could not sleep, could not interact on a regular basis with co-employees, superiors or clients but, believing I could not possibly have a mental illness, I got up everyday and went to work where very little got accomplished each day. I let deadlines pass, didn't follow up on things I should have, etc. Was I responsible for those behaviors if my depression and anxiety is what made it so difficult for me to accomplish what I needed to? I think I was responsible because I could have made a choice to take a leave of absence rather than continue performing at that abysmal level. Instead, I let it get to the point that I had no choices left- I was forced to take a short term leave of absence and, eventually, disability was the best choice for me. I do not think that excuses me from my poor performance, however.

That's exactly it, having to miss work in order to be responsible. I couldn't miss work so I couldn't do that. And I agree that there is no excuse. I guess what came to mind when I wrote this post was I had serious bouts with depression, insomnia, paranoia, suicidal ideation, panic attacks, struggled to concentrate, and was a total space cadet. Expressionless stonefaced individual was what I was. I couldn't interact and was way beyond depression. It's not like the everyday stuff we go through and have a reasonable sense of reality. Back then I wasn't medicated. This was a huge problem while in the workplace. Ideally I should have been hospitalized but I didn't know that I needed to do this.

Edited December 21, 2008 by WinterSky
clarification

[Mark]

Winter,

This is actually a complicated philosophical question you ask. IMHO, it is not the case that any particular mental disorder can be reduced simply to brain or personality (or more properly, that which we can influence and that which we have no influence over). Most all of them, and many non-mental illnesses too, are a product of both factors - nature and nurture. Some disorders lean more in to one camp than another. Bipolar is more a "brain" disorder than borderline personality, for instance. But all disorders have an element of what is out of control and what can be reigned in with proper motivation and education. People are often motivated to reduce the inputs to these problems and oversimplify them for political reasons. For instance, NAMI in america has promoted the idea of mental illness as a purely biological event, which I think is an over-simplification, but they have done this because in America, non-mental illnesses get lots of sympathy and money, but mental illnesses are crapped upon. So they have been trying to get resources allocated for mental illnesses. Not sure how intententional their campaign has been, but I do believe it has been an oversimplification. Reality/complexity and politics don't often seem to get along.

Mark

[WinterSky]

Winter,

This is actually a complicated philosophical question you ask. IMHO, it is not the case that any particular mental disorder can be reduced simply to brain or personality (or more properly, that which we can influence and that which we have no influence over). Most all of them, and many non-mental illnesses too, are a product of both factors - nature and nurture. Some disorders lean more in to one camp than another. Bipolar is more a "brain" disorder than borderline personality, for instance. But all disorders have an element of what is out of control and what can be reigned in with proper motivation and education. People are often motivated to reduce the inputs to these problems and oversimplify them for political reasons. For instance, NAMI in america has promoted the idea of mental illness as a purely biological event, which I think is an over-simplification, but they have done this because in America, non-mental illnesses get lots of sympathy and money, but mental illnesses are crapped upon. So they have been trying to get resources allocated for mental illnesses. Not sure how intententional their campaign has been, but I do believe it has been an oversimplification. Reality/complexity and politics don't often seem to get along.

Mark

Yes I understand that borderline personality disorder can be worked out and overcome. I don't know if PTSD can be totally worked out. But I would think that you could add major depression to your list of brain disorders. I was referring to "mental illness" as illnesses of the brain. Now I know that there are other diagnoses that are psychiatric but I would not think they would be considered brain diseases per se, yet what is going on is in the brain. That's my understanding anyways. I'm thinking more along the line of mood disorders, schizophrenia, and psychosis.

[Gene S.]

mood disorders, schizophrenia, and psychosis

Your grouping is strange: Mental Condition, Chronic Disease, Accute Condition.

[Guest ASchwartz]

Hi Everyone,

I believe this is an important psychological and ethical issue. Therefore, it is very complicated:

1. First, as Mark has stated, I do not believe that any of these disfunctions: Bipolar disorder, Borderline PD, Major depression, etc, are strictly "brain diseases." I would go so far as to say that there are no "brain diseases." Again, there is always a combination of social, environmental, physiological and genetic factors that are at the root of these disorders. In fact, that is why we call them "disorders" and not diseases. They have to do with behavior and moods and patterns of behavior.

Yes, Bipolar disorder stems from a chemical imbalance in the brain. However, here, too, all of the other influences play an important role. How come Winston Churchill was able to be fully functional his enitire life even though he had bipolar disorder and there was no medication. Well, there were a lot of other factors at work in his life that prevented his disorder from being as bad as other people experience. This is why we advocate psychotherapy for people even when they are on medication.

2. Here in America we have a well known tendency to minimize the impact of any illness or disorder, whether physical or mental, and to go to work regardless of how sick we may be. We call that "taking responsibility." Well, what about the idea that is sometimes "irresponsible" to go to work when ill. First, when we do that, we spread our viruses and bacteria to other people and that causes epidemics to spread through the office, school or institution. It seems to me that if someone is in a state of depression and is not fully functioning because of it, they should be allowed to stay home until they recover. Staying home, in my mind, is the responsible thing to do when ill, mentally or physically. It is true that we have even less sympathy for depression and etc. than we do for the physical illnesses and we do not have a lot of sympathy for those. What I am saying is that depression is not a fault and that the inability to pay attention and be productive at work due to depression, is not a fault.

3. We do not "work out and overcome" PTSD, Bipolar, Borderline PD, or any of the classifications in psychiatry. We can improve in our functioning but, there is no cure for being human. We all live with our strengths, weaknesses and dysfunctions but, work to improve our dysfunctions as much as possible.

Allan

[paula]

I agree head on with you Allan! You couldn't of explained it any better, with me anyway!

If you are sick, especially if your a one parent mother or you are living on your own and finding it hard to make end's meet, That no matter what you are feeling, that you have no say in the matter? If your bill's need paying then you have to go out to work, because if you don't, then it's as simple as, your bill's don't get paid?

Thinking of it in the long run, this also contributes to you suffering from Mental Health issues! Depression-Bipolar, Anxiety, Insomnia, Paranoia, Panic attack's, I suffer from all of these!

I am back at work now but I know that I am not right, but what else can I do?

[WinterSky]

Was I responsible for those behaviors if my depression and anxiety is what made it so difficult for me to accomplish what I needed to? I think I was responsible because I could have made a choice to take a leave of absence rather than continue performing at that abysmal level. Instead, I let it get to the point that I had no choices left- I was forced to take a short term leave of absence and, eventually, disability was the best choice for me. I do not think that excuses me from my poor performance, however.

Proverbs, I've thought about your post some more. I am more mindful now of my responsibilities than before whereas I wasn't before. I didn't see options. So I was not mindful or able to be "responsible". What I do in real life with my family since they are so toxic is to limit contact with them, so that I won't be in a vulnerable position. It is difficult to do that on the job. And these days corporate America has such high expectations than ever before. They expect the impossible, and what that means to me is that I tried to meet those expectations and would get pushed past my limitations. My peers didn't take it so seriously and didn't experience the stress I did.

I also felt that if I took off work and called in sick, that I would be lying about it because in my mind I wasn't sick. Also, when I was working contract, on an hourly basis, if I didn't work I wouldn't get paid.

So the only way for me to be "responsible" is to remain on disability. But with that I have mixed feelings, and also a strong desire to be self sufficient. With today's economic climate, who is to say that I will continue to get that monthly check. I have to ask, am I being responsible now.

[WinterSky]

Winter,

This is actually a complicated philosophical question you ask. IMHO, it is not the case that any particular mental disorder can be reduced simply to brain or personality (or more properly, that which we can influence and that which we have no influence over). Most all of them, and many non-mental illnesses too, are a product of both factors - nature and nurture. Some disorders lean more in to one camp than another. Bipolar is more a "brain" disorder than borderline personality, for instance. But all disorders have an element of what is out of control and what can be reigned in with proper motivation and education. Mark

Yes nature vs nurture. There is so much need in the world. I think when our needs are not met, it affects our mental health; thus the environmental factors. I have noticed that when I eliminate the environmental factors, I still have a problem with my moods; thus the nature aspect.

I understand that there is a genetic component for schizophrenia, and that environment (stress) can effect the schizophrenic and the voices/hallucinations they experience. And I also understand that once you have two or more depressive episodes, one is likely to develop clinical depression for the duration of their lives. I am not sure if this last assumption has changed over the years or not.

Hi Everyone,

I believe this is an important psychological and ethical issue. Therefore, it is very complicated:

1. First, as Mark has stated, I do not believe that any of these disfunctions: Bipolar disorder, Borderline PD, Major depression, etc, are strictly "brain diseases." I would go so far as to say that there are no "brain diseases." Again, there is always a combination of social, environmental, physiological and genetic factors that are at the root of these disorders. In fact, that is why we call them "disorders" and not diseases. They have to do with behavior and moods and patterns of behavior.

Isn't the brain an organ? You don't think Alzheimer's is a disease? Isn't mental illness all about chemistry in the workings of the brain and how one neuron communicates with another? Isn't that a physical thing, thus something to do with the body? If we have the gene for a disease, doesn't it often take something within the environment to turn it on? Doesn't it take the brain in order to react and take action? Yes through education we can learn to control our reactions and look at things another way. But without that education, who has the tools without help? How can an individual be responsible in that situation? Ultimately my understanding is that the brain is being affected here. I understand that "disease" and "disorder" is interchanged, at least in what I have read.

2. It seems to me that if someone is in a state of depression and is not fully functioning because of it, they should be allowed to stay home until they recover. Staying home, in my mind, is the responsible thing to do when ill, mentally or physically. It is true that we have even less sympathy for depression and etc. than we do for the physical illnesses and we do not have a lot of sympathy for those. What I am saying is that depression is not a fault and that the inability to pay attention and be productive at work due to depression, is not a fault.

Well, if one is suffering with mental illness, one might not see the options that others might see for them. When I was working, mental illness was not something you talked about with the boss; and even still, when requesting accommodations it is difficult to do so without sharing at least the reason why you are making such requests. If they find out, somehow they will find a way to get rid of you. It happened to me. The best job I ever had they told me that I was one of the top three if not the best in the workgroup. Yet I was placed on probation! I showed my therapist the review that got me there and she said it wasn't a bad review. As it relates to the work there was obviously no problems whatsoever. I was good. I was quite symptomatic and the reasons for placing me on probation was due to my illness. I should be allowed to work in my profession. Weeding out the mentally ill in my opinion is the incorrect and irresponsible way of operating a corporation. But let's get real, it happens.

[mscat]

Yes nature vs nurture. There is so much need in the world. I think when our needs are not met, it affects our mental health; thus the environmental factors. I have noticed that when I eliminate the environmental factors, I still have a problem with my moods; thus the nature aspect.

I understand that there is a genetic component for schizophrenia, and that environment (stress) can effect the schizophrenic and the voices/hallucinations they experience. And I also understand that once you have two or more depressive episodes, one is likely to develop clinical depression for the duration of their lives. I am not sure if this last assumption has changed over the years or not.

Isn't the brain an organ? You don't think Alzheimer's is a disease? Isn't mental illness all about chemistry in the workings of the brain and how one neuron communicates with another? Isn't that a physical thing, thus something to do with the body? If we have the gene for a disease, doesn't it often take something within the environment to turn it on? Doesn't it take the brain in order to react and take action? Yes through education we can learn to control our reactions and look at things another way. But without that education, who has the tools without help? How can an individual be responsible in that situation? Ultimately my understanding is that the brain is being affected here. I understand that "disease" and "disorder" is interchanged, at least in what I have read.

Well, if one is suffering with mental illness, one might not see the options that others might see for them. When I was working, mental illness was not something you talked about with the boss; and even still, when requesting accommodations it is difficult to do so without sharing at least the reason why you are making such requests. If they find out, somehow they will find a way to get rid of you. It happened to me. The best job I ever had they told me that I was one of the top three if not the best in the workgroup. Yet I was placed on probation! I showed my therapist the review that got me there and she said it wasn't a bad review. As it relates to the work there was obviously no problems whatsoever. I was good. I was quite symptomatic and the reasons for placing me on probation was due to my illness. I should be allowed to work in my profession. Weeding out the mentally ill in my opinion is the incorrect and irresponsible way of operating a corporation. But let's get real, it happens.

I've been there.... One thing i hate is labels. I tuned them all out. Clinical depression, Borderline Personality Disorder, and i am already 40 . No I still have that one? Whatever, I do not pay attention to all that. Lumping people into "illnesses" .

i loved my job when working, but still got fired, I went downhill afterwards , worse then ever.

I do Self injure, I must take personal responsibilty for my behavior , however it helps to do so, and I am much better afterwards and under control again.

Hate the term Mentally Ill :eek: No matter if it is caused from the brain or not, it is still always there. To me , haveing to fight of these demons most of my life never ending, and just wanting to have everything go away.... What's the matter with that? :confused:

[WinterSky]

I've been there.... One thing i hate is labels. I tuned them all out. Clinical depression, Borderline Personality Disorder, and i am already 40 . No I still have that one? Whatever, I do not pay attention to all that. Lumping people into "illnesses" .

i loved my job when working, but still got fired, I went downhill afterwards , worse then ever.

I do Self injure, I must take personal responsibilty for my behavior , however it helps to do so, and I am much better afterwards and under control again.

Hate the term Mentally Ill :eek: No matter if it is caused from the brain or not, it is still always there.

I hate the word "mental". I do think that psychiatry has way too many diagnoses. But now after looking at the receipt/insurance form where it lists all the diagnoses available, only a few are considered serious mental illnesses. PTSD is not considered serious yet OCD is. All of the mood, schizo, delusional, and psychotic disorders are are considered serious. That all makes sense. But OCD? Borderline personality disorder isn't even on the list. None of the personality disorders are on there. Hmm..

I'm sorry you had the same thing happen to you. I know it is a horrible thing to happen.

I wish there was something I could say to help with regards to self injury. While I was reading stuff on the internet these last few days, I ran into something with regards to animals and self injuring. I shall post it here if I see it again. But if it is in the nature of animals there must be an explanation for it. We humans are also animals of course. I'm just saying that perhaps one such as yourself shouldn't be so hard on themselves. There's enough self injuring humans out there to recognize that it is a human problem. It can happen to anybody. Although it is considered a "choice" to self harm... well I don't know. I've experienced suicidal ideation, some instances so dramatic that perhaps I would have done something beyond my control. Isn't it why they call it "behavioural science"?

I think with the coping tools that we learn in therapy and on here, we can find alternative ways of behaving thus replacing the bad with the good. Until one learns these tools, I am not sure how one can be held responsible IMHO, although individuals are considered responsible in a court of law. We might know that something is wrong before we do it, but perhaps when we do it, we don't know think about right or wrong and don't know how to stop ourselves. We didn't know that we could have avoided the situations that got us there. We didn't know that we could take responsibility instead of giving it to somebody else. We as in humans I mean.

Well I guess that is beyond the scope of what I was initially talking about in the original post. I wasn't breaking the law or hurting others. But there was a time when I was living at home with the folks where my father was being, well, my father. The abuse, the psychological twisting of words, concepts, needs... everything; pressure to get an apartment when I wasn't working. I was doing all that I could to get my life together. Being treated that way and doing my head that way made me feel hate. Impulsively. for one short moment in time, I wanted to hurt my father. But before I acted on that impulse, I realized what he was doing to me and I left. Perhaps he would have deserved it, but it would have ruined my life and he just wasn't worth that. This is why I don't believe in guns. If I had a gun in my hand at that point, I don't see how I could have been held responsible had I acted on impulse. Guns are bad.

I remember when I was around seven years old, there was a story of an older boy who took drugs and his father killed him. It was a horrible story and I think it became a movie later on. Anyways, I swore to myself I'd never get involved in drugs. That was when I was seven. But in my teens, it was a natural thing to do. I had forgotten about when I was seven. Your friends say this won't hurt you, "look at me". And you trust them so you do it. I know that drug abuse is not considered a serious mental illness (but might be a sign of an underlying illness due to self medicating). But it's an example of harmful behaviors and why we do the things we do. Once I understood what I was getting into before it was too late, I got out of that behavior. I even quit smoking and drinking before age 20! Well I did drink later on but not in a compulsive way, or a way to get high.

TRIGGER: SELF INJURING

I've often thought of self injuring. I've done it before, and have the scars. But it is because of the scars that I don't do it anymore. There's something about getting to a point where I enjoy the pain in a very sad way, both physically and emotionally. I got that way on New Years Eve this last one. What a horrible few days. I guess one can only get past that point through time. But it takes more than time. I called a suicide hotline, called my therapist (didn't get a response), I went grocery shopping, I journaled, I cried and cried, I wrote hateful colorful words in my journals... it helped through time. And through time, even still, I am recovering. My therapist did call me back on New Years day. We talked and I told her what was going on. She saw me the next day even though she was not working. She deserves a Nobel peace prize . Seriously.