The Effects Of Guilt And Mental Health Challenges On Recovery

Guilt is a complex emotion that many people experience throughout life. It might come up when you believe you’ve done something wrong or haven't taken actions that would’ve been healthy for you. When feeling guilty, you might feel shame about how you acted and want to fix your mistake. Guilt can be uncomfortable because it often prompts you to look closely at yourself and your actions. 

While guilt may serve as a helpful reminder of your values and moral compass, it may also have a connection to various mental health challenges, especially if it persists without being addressed. For instance, excessive guilt may be a symptom of depression or obsessive-compulsive disorder (OCD), among other conditions. It can be helpful to learn more about guilt and mental health challenges to recognize and work through guilt to improve mental health.

What is guilt?

Guilt is a self-conscious emotion that can arise when someone thinks they've acted wrongly. It can be like an internal alarm that may go off when one believes they’ve acted against their moral code, whether they made a mistake or believe they did. 

When exploring the concept of guilt, several terms often come up: appropriate guilt, inappropriate guilt, and guilt-proneness. Appropriate guilt is when someone genuinely makes an error and feels poorly about it. In contrast, inappropriate or excessive guilt can be unnecessary (i.e., the person did not do anything wrong) or disproportionate to the situation. Guilt-proneness is “a predisposition to experience negative feelings about personal wrongdoing, even when the wrongdoing is kept.” Some people may have a personality trait that makes them more likely to experience guilt.

Different factors can cause guilt. In some cases, guilt can arise because your actions hurt someone else. Other times, it might occur because you believe you did not do enough to help someone. In some cases, people with a mental illness, such as obsessive-compulsive disorder (OCD) or depression, may feel guilty without an apparent reason.

The way guilt affects people can vary. Guilt may sometimes be positive because it motivates people to make amends and fix mistakes. However, feeling guilty all the time or feeling excessive guilt may be harmful. Excessive guilt can cause people to feel bad about themselves, avoid their feelings, or ignore their needs to care for others. 

What is the difference between guilt and shame?

Guilt and shame are two emotions that, while closely related, can have different effects on mental and emotional health. Guilt is the feeling a person may experience when they have acted wrongly or perceive that they have acted wrongly. It's an emotion that may push individuals to take responsibility for their actions and make amends. Guilt often relates to a specific action or behavior and can serve as a tool for personal growth.

Shame, however, goes deeper. Instead of being tied to a particular action or behavior like guilt, shame often makes people feel like their entire self is flawed or inadequate. It can lead to thoughts of worthlessness, embarrassment, or loneliness due to social withdrawal. Shame may make it difficult to understand your actions or inspire change; instead, it can attack your sense of self-worth and identity.

Research has consistently shown that there is a relationship between proneness to shame and various psychological symptoms, including anxiety, depression, and low self-esteem. 

How guilt ties into mental health

Guilt can be a normal and healthy emotion. However, when it becomes excessive, guilt may start to have adverse effects on mental health. Excessive guilt may feed into various mental health conditions, including depression and OCD. 

Depression

Depression can often involve intense guilt. A person with major depressive disorder (MDD) might frequently think about past mistakes or be unkind to themselves for perceived failures. These intense feelings of guilt may also pertain to their own mental illness (such as believing they are a “burden” to others) and make their depression symptoms worse. In addition, those living with depression may experience a range of other symptoms, such as loss of interest, agitation, difficulty concentrating, fatigue, appetite changes, and sleep disturbances, which can complicate the link between guilt and mental health.

Obsessive-compulsive disorder (OCD) 

OCD is a mental health condition with a complex relationship to guilt. People with OCD may experience intrusive thoughts they perceive as "bad" or "wrong," which can lead to feelings of guilt. They might then have compulsive behaviors to get rid of the guilt. 

Researchers have found evidence that the type of guilt present in individuals with OCD may be characterized more by the “infringement of the interiorized moral code,” meaning that the guilt is often due to feeling that they violated their moral compass. 

Other mental health challenges

Untreated guilt—particularly when related to a stressful event—can also be associated with post-traumatic stress disorder (PTSD), problematic substance use, suicidal ideation, poorer functioning, and lower quality of life. 

These are just a few potential mental health conditions and challenges that may be tied to guilt. If you’re feeling a strong sense of guilt that is negatively affecting your mental state, it may be beneficial to seek help from a mental health professional for guidance or treatment. 

If you are experiencing suicidal thoughts or urges, contact the National Suicide Prevention Lifeline at 988. Support is available 24/7.

If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources. Support is available 24/7.

Ways to manage guilt

Managing guilt effectively can be a crucial part of maintaining your mental health, and there are various strategies available that may help you do so. Below, we’ll discuss a few of the techniques and resources you can try to help you cope with guilt. 

Self-help techniques

You can try several techniques on your own that might help you manage guilt. A potential starting point is figuring out where your guilty feelings are coming from. To do so, you may find it helpful to journal to reflect on your emotions. After identifying the source, consider the situation and decide if your guilt matches up with the mistake you think you've made—or if it might be excessive. 

Focus on what matters to you

Another potentially helpful strategy involves focusing on your personal values. Try to understand what's important to you and aim to make decisions that are in line with those values. If you've done something that has caused harm to someone else, you can own up to it and try to make it right. 

Support options 

If your guilt seems too heavy to handle alone, therapy may be a helpful tool. A therapist or counselor can help you look more closely at your guilty feelings and their effects. They can help you distinguish between guilt that makes sense for the situation and guilt that may be disproportionate to your actions.

By exploring the root causes and contributors to your guilt, a therapist can guide you in creating a plan to manage your guilt. They may also help you build up a healthier view of yourself and work through any concerns of low self-esteem that might be tied to your guilt.

Some people might be too embarrassed or self-conscious to talk about their feelings of guilt in a traditional therapy setting. With online therapy through a platform like BetterHelp, you can chat with your therapist right from your own home, which can take away some of the stress or stigma of seeking mental health help or having to confront your uncomfortable feelings face-to-face with someone else. 

Studies show that online therapy can be an effective treatment option for a variety of mental health conditions, including depression, with a 2019 study finding that depression symptom severity was significantly reduced after the use of a digital therapy intervention.