When I first started learning about mental health, there were some ideas it took me a very long time to comprehend. In fact, I keep a notebook of these concepts close at hand so I can refresh and reevaluate whenever I feel confused.
One of the most challenging is the idea that a negative behavior — something I might find frustrating, scary or irritating in myself or others — might actually be a mental health symptom instead.
What’s the difference?
A symptom is something caused by a particular health condition. For example, if I have allergies, I can expect to suffer from a runny nose, itchy, watery eyes and possibly a terrible sinus headache. And until I get the underlying cause under control, I won’t be able to stop sneezing or scratching.
A behavior, on the other hand, describes the way I act and relate to others. Unlike symptoms, my behaviors are something I have a degree of control over. (It may take real effort, especially if behaviors have hardened into habits, but I have at least some agency over the way I behave.)
Reframing what we observe
I began to grasp the difference between symptoms and behaviors in my weekly family-and-friends support group, when we were discussing what happens when someone falls into a deep depression.
“My husband has such dark moods that he can’t get out of bed most days,” one woman related. “I hate it, because then all of the family responsibilities fall on me.”
“I can identify with that!” said a man whose son lived in a room littered with dirty laundry and unwashed dishes. “He won’t pick up after himself, no matter what I say or do.”
Around the table, heads nodded. You could feel the resentment in the air. And then someone said:
“You know, I used to feel the way I think you’re feeling, and sometimes I still do. But I’ve come to realize that my partner’s not doing these things just to infuriate me. His struggle with getting things done is a symptom of his depression. It’s not a behavior he’s choosing.”
A realization that fights stigma, frustration and blame
A great conversation followed. What other symptoms could we point to that might be caused by depression — our own or someone else’s? Here were just a few:
Poor sleep habits
Drinking too much
Overeating or not eating at all
Skipping the most basic forms of self-care, like showering and brushing teeth
Refusing to leave the house
Outbursts of anger, sarcasm and abuse
It was transformative to think of these as symptoms caused by depression, rather than bad behaviors our loved ones could change if they tried hard enough. We could see that reframing negative actions in the context of mental health struggles might help prevent stigma, blame and needless conflict.
Where a sense of responsibility comes in
Since then, I’ve reflected on the fact that this isn’t a black-and-white question. All of us living with mental health issues have to take responsibility for how we behave. But it helps so much to realize that symptoms aren’t always under our direct control.
The way I think about it now, responsibility means creating and sticking to a mental health treatment plan. For example, when I’m experiencing depression symptoms, I might not want to exercise, take my meds or see a talk therapist. But I’m still on the hook for doing these things because they’re essential to my recovery.
Remembering that my symptoms will ease up over time can help me find the motivation I need to practice effective self-care. And realizing that I have imperfect control over the way I feel gives me the self-compassion I need to accept a slow but steady pace, realizing I’m doing my best, day by day.
A version of this post appeared in The Mighty.