Despite over a decade of effort to raise mental health awareness, our understanding of it can feel shallower than ever. A recent incident with Kanye West highlights this tension.
Last month, he apologized for everything. Letting the world know he wasn’t finished in a full-page advertisement in the Wall Street Journal. In a letter titled ‘To Those I’ve Hurt,’ Kanye took responsibility for a series of inflammatory actions, most notably, a string of erratic and deeply antisemitic comments. He addressed the pain he caused loved ones, and apologized for letting the ‘black community’ down, attributing his disturbed behaviour to a bipolar I disorder diagnosis.
Whether his apology is sincere or a calculated move ahead of a new album is irrelevant for this discussion. I’m not here to debate his intentions, nor determine whether he is, or isn’t, antisemitic.
Instead, what intrigues me is a common cultural reflex; the confident and often angry insistence that “mental health doesn’t make you do that.” By “that,” we tend to mean anything that would more readily get you labelled “bad” rather than “sad.”
Indeed, it’s curious. We readily accept that mental illness can convince someone that their elderly parents are food-poisoning, nefarious government agents, or that they themselves are the second coming of Christ, or that a celebrity is communicating cosmic messages through hand gestures. Yet we find it inconceivable that the same distortion could warp someone into bigotry.
A few things are happening here. One stems from the intensely sanitized way we talk about mental health. Historically, mental illness was framed as dangerous, shameful, or morally suspect. In response, modern campaigns have understandably focused on reducing stigma and fostering empathy for those who suffer. As a result, we tend to emphasize the aspects of mental illness that elicit sympathy, such as how it impairs daily functioning, diminishes quality of life, or makes people vulnerable.
But this sole focus comes with a cost. As the conversation is now more centred on eliciting compassion than on cultivating self-understanding, we are far less prepared to acknowledge, at least seriously, that mental illness can also give rise to deeply unflattering and morally repugnant behaviours.
Yet those who have not only experienced persistent mental illness but observed it closely know the picture is more complicated. In the The Depressed Person by renowned writer David Foster Wallace describes his struggle with being a narcissist, “as a part of depression.
Given that ‘narcissism’ has become the bogeyman condition of the digital age, lazily applied to almost any unpalatable behavior, that might strike some as harsh. But what Wallace identifies is less about clinical narcissism than about the gravitational pull of intense suffering; the way it can collapse a person’s world inward until everything is filtered through their own pain.
In essence, many mental illnesses involve a chronic, self-focused preoccupation. Thoughts loop incessantly, centred on oneself, one’s suffering, and one’s perceived failures. By nature, this self-obsession can make a person blind to others’ needs and to the impact they have on others.
In other words, misery and harm can, and often, coexist. Yet we often pretend this isn’t the case. To admit the externally destructive side of mental illness, not just the internal pain, is to recognise that the line separating us from those we judge as “bad” is thinner than we care to believe.
And this is precisely where the phrase “mental health doesn’t make you do that” reveals its broader function: as a form of moral signalling. It exists to affirm one’s own moral stability while creating distance from those whose behaviour is easier to condemn. It preserves a reassuring narrative: that harm is primarily the result of moral failure, not the by-product of psychological fragility. Seen this way, the phrase seeks to protect one’s own self-image rather than reveal anything useful about the realities of mental illness.
We are living in the most therapized age in history, yet for all the language of “doing the work,” we continue to describe ourselves as being in the midst of a mental health crisis. Perhaps a partial reason for this lies in our incomplete and often dishonest understanding of what mental illness actually entails. The desire to protect people from shame and reduce stigma need not require us to deny uncomfortable truths.
When we insist that mental health ‘doesn’t make you do’ anything morally corrosive, we discourage the kind of self-honest examination that meaningful change demands. If we continue to conceptualize mental illness simply as purely victimhood, we risk convincing ourselves that we are incapable of causing harm, rather than learning how to recognise when we do.
The truth is, anxiety can make people controlling; depression can cause extreme selfishness; personality disorders — far beyond narcissism — can drive destructive testing of relationships; and severe conditions such as schizophrenia and bipolar disorder can produce breaks from reality in which even morally repugnant ideas can feel like undeniable truth.
Pretending otherwise does not reduce stigma; it simply replaces understanding with comfort.
When in the grip of mental suffering, the drive toward self-improvement can feel inaccessible. But confronting the impact our maladies place on others can sometimes be the only thing that drives positive change.
A more mature conversation would encourage compassion without glossing over the unsavoury aspects. It would recognize that suffering can distort behavior, not just feelings, without erasing responsibility. It would also recognize that naming this is not about adding shame to the psychologically injured. Far from cruelty, it is clarity.
And in our darkest hour, that clarity might be the only thing strong enough to pull us back toward recovery.
