I'm thinking hard about this one, because I realized that I have taken a lot of actions in the past during manic and depressed episodes that have hurt other people, and I haven't really apologized for them. Some of them I barely remember, even right after they happened.

I like the AA model. In AA, alcoholism is considered a disease, but once you are in recovery, you are expected as part of the 12 Steps to make amends to all those you have harmed. Amends doesn't necessary mean apologizing. It means trying to improve your behavior towards that person in the future. It's an ongoing process.

You can say, well that's different, because an alcoholic can quit drinking and that solves everything. But that's not true. The behaviors still exist. I believe the parallel to recovery with mental illness is working with the mental health community to manage your illness as best as you can.

I think I probably need to apologize for some of my actions, and add, "You know I really care for you and appreciate that you are in my life. I don't intend to hurt you, but my illness sometimes gets out of my control."

You can take the high road, blame everything on your disease, and never apologize, but I wonder how many people in your life are willing to put up with that kind of behavior. I know that I've lost a lot of friendships over the years because I was depressed and didn't respond to them, and didn't try to reconnect and apologize.