The whole doctrine of accountability is one of the most beautiful in Mormonism, in my opinion. It is so much more expansive than most people realize.
We understand the concept as it relates to the "extremes" (children and the mentally handicapped on one end; fully accountable adults on the other end), but we often overlook it when dealing with the "emotionally handicapped" and the "abused" and any others whose thoughts and actions are influenced by things they didn't choose - things often outside their full control. We are learning more and more about how to treat these things, but I believe there are still so many manifestations of these types of issues that we haven't even identified completely that "Judge not" becomes an even more vital command.
I am convinced to the core of my soul, that many people who struggle mightily with feelings of guilt and despair do so largely because they are wired biologically to do so - that they simply can't help it. I believe strongly that those people are not "accountable" for their actions during those times of guilt and despair in quite the same way as others are without those episodes. I'm not saying that they are completely free from the responsibility to understand their condition and try to "repent" (meaning simply "change"), but I am saying that "repentance" in these cases often is more about learning coping mechanisms or taking medication than it is about the classic "exercise of will" often associated with repentance.
If we understood more fully that "repentance" is a positive thing - a process that includes almost anything that helps us become "righteous" (in harmony with God), I believe we could begin to tackle the "natural" guilt associated with depression and other issues in a much more productive and ennobling manner than we tend to do currently.
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