You Are Not Your Own Substack

You Are Not Your Own Substack

Am I at Fault for the Harm My Mental Illness Caused?

And what can I do to repair that harm?

O. Alan Noble's avatar
O. Alan Noble
Apr 13, 2026
∙ Paid

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Photo by Fernando @cferdophotography on Unsplash

A mental health condition does not just affect the person who has a diagnosis. It affects the people around them as well, their family and friends, their support system and coworkers and loved ones. When you can’t show up to work because your depression is so heavy on you, that affects your coworkers. When you can’t take your kids to school because your anxiety is spiking, that affects your spouse. When you snap at a customer because you’ve been ruminating and your anxiety is high, that affects them and your employer. When you break promises because you feel like it’s more important to pay attention to obsessive doubts that your OCD is feeding you, that affects everyone involved. The list could go on. The question many sufferers from mental afflictions want to know is, How responsible am I for the harm I’ve caused others? If doctors and therapists agree that I have a mental health condition, does that mean it’s not my fault that I’ve acted in these ways? This question has a practical importance to it, because it affects how you seek to address the harm done. Do you apologize for the harm you did or the harm that the condition did? Or both?

As always with these pieces on mental health, I’m writing as someone with lived experience, pontificating from my position, not as an expert, but as someone who cares and has thought about these issues a great deal. So take them for what they are worth. It is my belief that in most cases, we don’t get to know where the condition starts and our agency begins. I make this argument in On Getting Out of Bed. We don’t get to know. We each must make our best effort to act with agency and take responsibility while accepting grace for our condition.

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